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Procedural skills teaching

Thomas Hildebrandt, Seher Emir, Alexander Boosz, Matthias W Beckmann, Andreas Müller
PURPOSE: Surgical training usually means inexperienced physicians initially doing operations supervised by an experienced physician, to gain the experience and skills needed to conduct surgery independently. Various issues arise here for both hospitals and patients. Are training procedures associated with higher complication rates, blood losses, and transfusion rates? What does training in the operating room ultimately cost in terms of valuable surgical time? Do longer hospitalization periods potentially mean financial losses for the hospital under the diagnosis-related groups (DRG) system? METHODS: A retrospective analysis was carried out of data for 571 patients who underwent total laparoscopic hysterectomy (TLH) in the Department of Gynecology at the University of Erlangen from 2009 to 2012, with/without adnexectomy, due to benign indication; and of data for 255 patients who underwent the same procedures in Karlsruhe Municipal Hospital in 2013-2014...
August 11, 2018: Archives of Gynecology and Obstetrics
Michael W van Emden, Jeroen J Geurts, Patrick Schober, Lothar A Schwarte
BACKGROUND: Manikins are widely used in airway management training; however, simulation of realism and interpatient variability remains a challenge. We investigated whether cadavers embalmed with the novel Fix for Life (F4L) embalmment method are a suitable and realistic model for teaching 3 basic airway skills: facemask ventilation, tracheal intubation, and laryngeal mask insertion compared to a manikin (SimMan 3G) and formalin-fixed cadavers. METHODS: Thirty anesthesiologists and experienced residents ("operators") were instructed to perform the 3 airway techniques in 10 F4L, 10 formalin-fixed cadavers, and 1 manikin...
August 9, 2018: Anesthesia and Analgesia
Philip J Kellman, Sally Krasne
RATIONALE: Recent advances in the learning sciences offer remarkable potential for improving medical learning and performance. Difficult to teach pattern recognition skills can be systematically accelerated using techniques of perceptual learning (PL). The effectiveness of PL interventions is amplified when they are combined with adaptive learning (AL) technology in perceptual-adaptive learning modules (PALMs). INNOVATION: Specifically, PALMs incorporate the Adaptive Response Time-based Sequencing (ARTS) system, which leverages learner performance (accuracy and speed) in interactive learning episodes to guide the course of factual, perceptual, or procedural learning, optimize spacing, and lead learners to comprehensive mastery...
August 9, 2018: Medical Teacher
Faiz U Shariff, Adeline M Deladisma, Josué W Menard, Patricia A Shewokis, D Scott Lind
OBJECTIVE: We incorporated a hybrid-abdominal wound simulation to teach/assess the acquisition of three essential clinical skills in the ACS/ASE Medical Student Simulation-based Surgical Skills Curriculum. METHOD: Third year students (N = 43) attended a workshop based on the ACS/ASE surgical skills curriculum for drain care/removal, staple removal and Steri-Strip application. Following a didactic session and demonstration using a simulated patient, student skill acquisition was assessed using the ACS/ASE module rating tool...
July 24, 2018: American Journal of Surgery
Deanna N Devlin, Mateus Rennó Santos, Denise C Gottfredson
Despite existing efforts to prevent bullying, research suggests that bullying remains a serious and common problem across the United States. Therefore, researchers should continuously propose and evaluate alternative policies that may mitigate bullying as a social issue. One such strategy that has been proposed is the use of police officers in schools, best known as School Resource Officers (SROs). The current study evaluated the efficacy of SROs as an intervention against bullying in schools in the United States...
July 25, 2018: Evaluation and Program Planning
George Kovacs, Richard Levitan, Rob Sandeski
"See one, do one, teach one" remains an unofficial, unsanctioned framework for procedural skill learning in medicine. Appropriately, medical educators have sought alternative simulation venues for students to safely learn their craft. With the end goal of ensuring competence, educational programming will require the use of valid simulation with appropriate fidelity. While cadavers have been used for teaching anatomy for hundreds of years, more recently they are being repurposed as a "high-fidelity" procedural skill learning simulation resource...
July 2018: AEM education and training
Adam Slomer, Jordan Chenkin
Introduction: Teaching procedural skills in medicine is time- and resource-intensive, and it is therefore important to determine which educational strategies are most effective. Test-enhanced learning (TEL) has been demonstrated to be effective in improving learner retention; however, there is little research evaluating the testing effect on the acquisition of procedural skills in medicine. The objective of this study was to examine the impact of TEL on learning ultrasound-guided intravenous (USG IV) insertion on a simulated model...
October 2017: AEM education and training
John R Potts, R James Valentine
OBJECTIVE: The objective of this study was to document trends in the performance of open arterial vascular surgery procedures (OAVP) by general surgery residents (GSR). BACKGROUND: The ACGME Review Committee for Surgery considers vascular surgery (VS) to be an "essential content area." However, the operative experience in VS for GSRs is threatened by 1) increasing numbers of GSRs, 2) increasing numbers of VS trainees, and 3) the proliferation of endovascular surgery...
July 24, 2018: Annals of Surgery
Nina Kimmich, Roland Zimmermann, Martina Kreft
AIMS OF THE STUDY: Video documentation is nowadays well established in many fields of medicine, but mostly in unreal situations such as simulation training. We here present the application of video for teaching and learning purposes during the birth process. The aim of video documentation during labour is to provide an observational tool for obstetric care by midwives and obstetricians, with the opportunity for evaluation and education afterwards, especially in absence of the woman in labour and her family...
2018: Swiss Medical Weekly
Hasan Naveed, Richard Hudson, Manaf Khatib, Fernando Bello
Background: Learning the skills required for open surgery is essential for trainee progression towards more advanced technical procedures. Simulation supports skill enhancement at a time when exposure to actual surgical procedures and traditional apprentice-based teaching has declined. The proliferation of smartphone and tablet devices with rich, touch sensitive displays and increasing processing power makes a compelling argument for expanding accessibility further by development of mobile virtual simulations for training on demand in any setting, at any time...
2018: Advances in Simulation
Maury Pinsk, Jolanta Karpinski, Euan Carlisle
Purpose of the review: The Royal College of Physicians and Surgeons of Canada, with its Competence by Design initiative, is adopting the principles of competency-based medical education for residency training and continuing professional development. This initiative is being undertaken to meet the new standards of medical education in Canada, which include social accountability to meet performance-based outcomes of training. Nephrology is poised to implement Competence by Design into residency training in July 2018 and initiate a continuous quality improvement cycle to periodically renew and update the training requirements to be socially accountable and relevant in the modern age of medicine...
2018: Canadian Journal of Kidney Health and Disease
Abhishek G Singh, Shrikant J Jai, Arvind P Ganpule, Mohankumar Vijayakumar, Ravindra B Sabnis, Mahesh R Desai
Introduction: Simulation-based training in laparoscopic urology is essential, as these surgeries require a different skill set. We validated a chicken model for laparoscopic left modified Lich Gregoir type of ureteric reimplantation. Materials and Methods: Prospective observational study was conducted from August 2016 till February 2017. Thirty novice surgeons and 20 trained laparoscopic surgeons were included in the study. The relevant chicken anatomy and surgical steps were described to all the surgeons...
July 2018: Indian Journal of Urology: IJU: Journal of the Urological Society of India
Andrey Iskrenov Kotzev, Dennis Yang, Peter V Draganov
ESD is an established technique for the endoscopic therapy of dysplastic and early cancerous lesions throughout the GI tract. The procedure requires both a sophisticated knowledge for lesion characterization and high-level endoscopic skills. As a result, the learning curve is very steep and in Japan it takes years to gain proficiency under the traditional Master-Apprentice teaching model. At present, due to multiple limitations, this training model is not applicable in the U.S. Nevertheless, a unique, multi-pronged, stepwise approach has emerged as a viable pathway to train U...
July 19, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Tayebeh Mahvar, Mansoureh Ashghali Farahani, Aidin Aryankhesal
Introduction: Classroom management is leading the class by setting the class schedule, organizing the procedures, supervising the learners' progress, and predicting and solving their problems. Students' disruptive behaviors and classroom management are the most important challenges and concerns of the teachers. The current review aimed to analyze the classroom management techniques and strategies used to cope with the students' disruptive behaviors. Methods: The present study was systematic review...
July 2018: Journal of Advances in Medical Education & Professionalism
N Patel, A Leusink Leusink, N Singh, M Z Koto, T Luvhengo
BACKGROUND: Surgical training varies significantly amongst universities within the same country. This trend is reflected in South Africa and provides an opportunity for innovation to improve the quality of general surgical training. OBJECTIVE: To assess the perceptions of South African general surgery registrars regarding surgical training. METHOD: A prospective descriptive study was performed by means of a confidential questionnaire distributed to general surgical registrars at all eight training centers in South Africa...
June 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
Mario V Mitkov, Colleen S Thomas, Jordan J Cochuyt, Antonio J Forte, Galen Perdikis
Background: Learning to inject botulinum toxin for cosmetic purposes is difficult for beginners given the nature of the procedure and patient population. Simulation training is an effective modality for medical professionals to acquire skills in an environment that provides low stress and ample opportunity for questions and correction of mistakes. Objective: Compare posttraining comfort, knowledge, and practical botulinum toxin injection scores between trainees who underwent simulation versus video training only...
July 3, 2018: Aesthetic Surgery Journal
K C Prasad
Stapes surgery is a highly skilled surgery among otological procedures and needs a good dexterity. To improve the skills one may need to do procedures using temporal bone dissections. We describe a procedure that is simple, inexpensive and improves the skills and can be done using easily available materials like disposable syringe, stapler pin and a forceps.
June 2018: Indian Journal of Otolaryngology and Head and Neck Surgery
Gabriel Makuei, Mali Abdollahian, Kaye Marion
BACKGROUND: Reducing Maternal Mortality Rate (MMR) is considered by the international community as one of the eight Millennium Development Goals. Based on previous studies, Skilled Assistant at Birth (SAB), General Fertility Rate (GFR) and Gross Domestic Product (GDP) have been identified as the most significant predictors of MMR in South Sudan. This paper aims for the first time to develop profile limits for the MMR in terms of significant predictors SAB, GFR, and GDP. The paper provides the optimal values of SAB and GFR for a given MMR level...
July 3, 2018: BMC Pregnancy and Childbirth
Cheri S Blevins, Regina DeGennaro
BACKGROUND: Delirium poses increased morbidity and mortality risks for hospitalized patients. Underrecognition by health care providers contributes to poor outcomes for patients. Little has been published about methods used to teach health care providers how to screen for delirium using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). OBJECTIVE: To evaluate the effectiveness of a multimodal educational intervention for nurses in the medical intensive care unit to improve their knowledge and skills regarding delirium and delirium recognition...
July 2018: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Ari Gilad Mandler
This manuscript reviews Touch Surgery, a novel online platform geared towards innovating professional training for surgical procedures. In other industries, such as aviation, simulation has already been shown to reduce costs and improve outcomes in crisis (JETS 3(4):348-352, 2010). Studies involving simulation-based learning in healthcare similarly indicate the potential for reducing errors through skill acquisition and cognitive retention (Int J Oral Maxillofac Surg 46:211, 2017). Cohort studies have shown improved performance among simulator-trained medical students in comparison to those with traditional ward training (Med Teach 9:53-57, 1987)...
June 28, 2018: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
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