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Procedural skills teaching

Ciara O'Toole, Alice S-Y Lee, Fiona E Gibbon, Anne K van Bysterveldt, Nicola J Hart
BACKGROUND: Communication and language development are areas of particular weakness for young children with Down syndrome. Caregivers' interaction with children influences language development, so many early interventions involve training parents how best to respond to their children and provide appropriate language stimulation. Thus, these interventions are mediated through parents, who in turn are trained and coached in the implementation of interventions by clinicians. As the interventions involve a considerable commitment from clinicians and families, we undertook this review to synthesise the evidence of their effectiveness...
October 15, 2018: Cochrane Database of Systematic Reviews
J Kevin Dorsey, Austin M Beason, Steven J Verhulst
PROBLEM: The traditional clerkship model of brief encounters between faculty and students results in reduced meaningful learning opportunities due to the lack of a relationship that enables repeated observation, supervisor feedback, trust formation, and growth. INTERVENTION: Clinical clerkships at our institution were restructured to decrease fragmentation of supervision and foster an educational alliance between faculty and student. A mixed-methods approach was used to study the impact of this curriculum reform on the student experience in the obstetrics and gynecology clerkship...
October 15, 2018: Teaching and Learning in Medicine
Young Park, Hitoshi Yokoyama
Dr. William Halsted started residency-based surgical training at Johns Hopkins University in 1889. On the job training(OnJT) conducted there is an in-hospital training that residents imitate what senior doctors are doing with their patients. [ See one, do one, teach one] is the word briefly expressing this traditional training. Since then all surgeons learned surgery from the mentors and senior doctors in this way. In this OnJT, surgeons spent many years and years and accumulated experience and tried to crime up step by step from beginners to experts...
September 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Michael N Young, Roshanak Markley, Troy Leo, Samuel Coffin, Mario A Davidson, Joseph Salloum, Lisa A Mendes, Julie B Damp
Background: Simulation-based training has been used in medical training environments to facilitate the learning of surgical and minimally invasive techniques. We hypothesized that integration of a procedural simulation curriculum into a cardiology fellowship program may be educationally beneficial. Methods: We conducted an 18-month prospective study of cardiology trainees at Vanderbilt University Medical Center. Two consecutive classes of first-year fellows (n = 17) underwent a teaching protocol facilitated by simulated cases and equipment...
January 2018: Journal of Medical Education and Curricular Development
Luiz Gonzaga de Moura Júnior, Paulo Roberto Leitão de Vasconcelos, Francisco Vagnaldo Fechine, Mayra Sabiá de Moura, Régis Luiz Sabiá de Moura, Hermano Alexandre Lima Rocha, Manoel Odorico de Moraes Filho
BACKGROUND: Video surgery requires acquisition of psychomotor skills that are different from those required for open surgery. The aim of this study was to assess the EndoSuture Trainer Box Simulator (ESTBS), a new bariatric laparoscopic skills simulator, as a tool for surgical education, comparing it with a standard laparoscopic trainer (SLT). METHODS: A randomized prospective crossover study was designed to compare ESTBS versus SLT as a tool for training bariatric laparoscopic skills...
October 9, 2018: BMC Surgery
Yang Kun, Jacques Hubert, Luo Bin, Wang Xing Huan
OBJECTIVE: Video-based teaching is considered highly effective in debriefing, especially in minimally invasive surgeries. In this study, the benefits of using a new integrated video recording system, were investigated and compared to those of the standard basic skills robotic training procedure. DESIGN: Fifty residents from the 2nd and 3rd year medical faculty without any experience of robot usage or laparoscopy were randomized into 2 groups: group A--a natural self-training group without a trainer, and group B--a self-training group assisted by an integrated video recording system during training...
October 3, 2018: Journal of Surgical Education
A B Walinga, S R van Mil, L U Biter, M Dunkelgrün, G H E J Vijgen
INTRODUCTION: This study describes a stepwise training program to teach a laparoscopic Roux-en-Y gastric bypass (LRYGB). Results of a resident are compared to experienced bariatric surgeons (EBS). METHODS: The resident performed a varying amount of surgical steps and the duration of every step was measured using video analysis. In order to compare the resident's results to EBS, the average time per step was calculated for 30 procedures. RESULTS: The total procedure time of LRYGB was 61...
October 5, 2018: Obesity Surgery
Benjamin R Veenstra, Aleksandra Wojtowicz, Nathan Walsh, Jose M Velasco
BACKGROUND: Emergency surgical airway is a low frequency, high risk clinical scenario. Implementing a simulation-based curriculum may bridge the gap in surgical training and address quality assurance/performance improvement (QAPI) needs. METHODS: We designed and implemented an Advanced Surgical Airway Curriculum (ASAC) modeled after proficiency-based training. General Surgery residents and student nurse anesthetists were enrolled. Evaluation consisted of cognitive tests, procedure checklists and questionnaire...
September 22, 2018: American Journal of Surgery
Stephen Gauthier, Lindsay Melvin, Maria Mylopoulos, Nadine Abdullah
OBJECTIVES: Direct observation is the foundation of assessment and learning in competency-based medical education (CBME). Despite its importance, there is significant uncertainty about how to effectively implement frequent and high-quality direct observation. This is particularly true in specialties where observation of non-procedural skills is highly valued and presents unique challenges. It is therefore important to understand perceptions of direct observation to ensure successful acceptance and implementation...
October 1, 2018: Medical Education
Qiao-Hui Huang, Yi-Chen Lin, Wei-Siang Huang
BACKGROUND: Rate of contamination is a well-known indicator of quality of care in the emergency department. Blood-culture results may affect clinical decision making. From January 1, 2015 to December 31, 2015, the contamination rate of blood culture in our emergency department was 5.63%, which exceeded the maximum of 3% suggested by the American Society for Microbiology and the clinical laboratory at our hospital. PURPOSE: Using a quality improvement strategy, this project aimed to (1) identify potential factors contributing to the high blood culture contamination rate and (2) achieve a blood culture contamination rate below 3%...
October 2018: Hu Li za Zhi the Journal of Nursing
Michael C Trawicki, Karin L Zuegge, Lana M Volz, Alaa A Abd-Elsayed
Background: Between 2011 and 2013, medical students at a large, tertiary academic hospital reported a lower-than-expected perception of direct observation and feedback during their third- and fourth-year clinical clerkships. The anesthesiology clerkship is a team-based care model that involves an anesthesiologist, resident or anesthetist, and student. This model allows for direct supervision of all patient interactions and procedures. Despite this structure, medical students reported an acceptable but lower-than-anticipated perception of direct observation and feedback taking place during a 2-week anesthesiology clerkship...
2018: Ochsner Journal
Sang-Min Park, Feng Shen, Ho-Joong Kim, Hyoungmin Kim, Bong-Soon Chang, Choon-Ki Lee, Jin S Yeom
OBJECTIVE: To determine the amount of screws needed to achieve an adequate skill level for pedicle screw placement (PSP) via the freehand technique in the nondeformed thoracolumbar spine using the cumulative summation test for learning curve (LC-CUSUM) analysis. METHODS: This study includes the first 85 patients who underwent pedicle screw installation in the thoracic and lumbar spine by a single orthopedic surgeon. The surgeon had 1 years' experience of fellowship training in a tertiary teaching hospital...
October 2018: World Neurosurgery
Anna B Newcomb, Chang Liu, Amber W Trickey, Jonathan Dort
OBJECTIVE: The purpose of this effort was to create an educational experience that provided learners a realistic disclosure experience and improved resident confidence discussing an adverse outcome with a patient and family. DESIGN: Residents practiced disclosing a surgical complication to a patient/family with simulated patients (SPs). We paired professional SPs with former patient SPs to present a realistic case. Junior residents were given extra training time before their disclosure of a laparoscopic cholecystectomy conversion to an open procedure; senior residents disclosed a bile duct injury...
September 21, 2018: Journal of Surgical Education
Jeffrey Huang, Jinlei Li, Hong Wang
For inexperienced users, training with phantoms is an important part of training. Inexperienced users can teach themselves to gain significant procedural skills. Participating in training courses or practising with experts can enhance the outcomes. Inexperienced users need to understand the indications, clinical pearls, and pitfalls of each procedure to avoid potential complications. Inexperienced users can also train and teach themselves to become proficient in ultrasound techniques.
July 13, 2018: Curēus
Michael Wagner, Kirstin Hauser, Francesco Cardona, Georg M Schmölzer, Angelika Berger, Monika Olischar, Tobias Werther
OBJECTIVES: Critically ill neonatal and pediatric patients often require central vascular access. Real-time ultrasound guidance for central venous catheterization is beneficial. Because the diameter of central veins is much smaller in neonates than in adults, extensive training is needed to master the visualization and catheterization of central veins in neonates. This study assessed the learning effect of a standardized simulation-based teaching program on ultrasound-guided cannulation in a low-cost cadaver tissue model...
September 18, 2018: Pediatric Critical Care Medicine
Mateusz Puslecki, Marcin Ligowski, Michal Kiel, Marek Dabrowski, Sebastian Stefaniak, Maciej Sip, Adrian Maciejewski, Agata Dabrowska, Ilona Kiel-Puslecka, Tomasz Kłosiewicz, Marcin Misterski, Piotr Buczkowski, Lukasz Szarpak, Kurt Ruetzler, Bartlomiej Perek, Michael Czekajlo, Marek Jemielity
Background: Simulation is widely accepted as an important tool in training and educating healthcare providers. The first regional polish extracorporeal membrane oxygenation (ECMO) program called "ECMO for Greater Poland" was recently started. Methods: We present a prototype for ECMO prepared for high-fidelity medical simulation in extracorporeal life support. ECMO therapy is a complex, difficult and expensive therapy in patient care. We have constructed an advanced ECMO simulation prototype, which can be used as a training tool in scenarios that prepare for real-life experiences...
August 2018: Journal of Thoracic Disease
Benjamin L Schrant, Lisa L Archer, Robert Long
The KCOM campus hosts a modern, state of the art human patient simulation (HPS) laboratory, which allows simulation of neonatal, pediatric, obstetric, and adult patients. Students are able to utilize the HPS lab to become comfortable with physical exam skills, procedural skills and communication skills before attempting them in a true clinical environment. Involvement of students from other disciplines has facilitated interprofessional education. Involvement of community health providers has expanded the richness of the student experience...
January 2018: Missouri Medicine
K C Prasad, Abhilasha Karunasagar, P K Anjali
Stapedotomy followed by placement of a piston prosthesis is the mainstay for surgical management of otosclerosis primarily undertaken to improve hearing in patients. Although a simple and elegant procedure, prosthesis placement in stapes surgery is difficult to master. Improper surgical technique or improper placement of prosthesis may result in complications which may require revision surgery. We here describe a training technique that is simple, inexpensive, improves the skills and can be done using easily available materials such as a disposable syringe, stapler pin and micro-forceps...
September 2018: Indian Journal of Otolaryngology and Head and Neck Surgery
Amy Levi, Suzan Goodman, Tracy Weitz, Roula AbiSamra, Kristin Nobel, Sheila Desai, Molly Battistelli, Diana Taylor
BACKGROUND: Studies in multiple countries have found that the provision of aspiration abortion care by trained nurses, midwives, and other front-line health care workers is safe and acceptable to women. In the United States, most state abortion laws restrict the provision of abortion to physicians; nurse practitioners, nurse-midwives, and physician assistants, can legally perform medication abortion in only twelve states and aspiration abortion in five. Expansion of abortion care by these providers, consistent with their scopes of practice, could help alleviate the increasing difficulty of accessing abortion care in many states...
August 13, 2018: International Journal of Nursing Studies
Douglas Miyazaki, Catherine A Matthews, Mujan Varasteh Kia, Amr Sherif El Haraki, Noah Miyazaki, Chi Chiung Grace Chen
INTRODUCTION AND HYPOTHESIS: The Miya Model ™ (Miyazaki Enterprises, Winston-Salem, NC, USA) was designed as a realistic vaginal surgery simulation model. Our aim was to describe this model and present pilot data on validity and reliability of the model as an assessment tool of vaginal hysterectomy skills. METHODS: We video recorded ten obstetrics and gynecology residents (novice group) and ten practicing gynecologists (expert group) performing vaginal hysterectomy using the Miya model...
September 6, 2018: International Urogynecology Journal
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