scholarly journals Effectiveness of cadaver-based educational seminar for trauma surgery: skills retention after half-year follow-up

2016 ◽  
Vol 4 (1) ◽  
pp. 57-67 ◽  
Author(s):  
Hiroshi Homma ◽  
Jun Oda ◽  
Tetsuo Yukioka ◽  
Shogo Hayashi ◽  
Tomoya Suzuki ◽  
...  
Keyword(s):  
Trauma Surgery ◽  
Skills Retention ◽  
Educational Seminar

scholarly journals Repeated participation in the cadaver-based educational seminar for trauma surgery (C-BEST) could maintain training effects: skill retention at a 2-year follow-up

2021 ◽  
Keyword(s):  
Trauma Surgery ◽  
Training Effects ◽  
Self Assessment ◽  
Skill Retention ◽  
Time Points ◽  
Self Evaluation ◽  
Confidence Levels ◽  
Educational Seminar ◽  
Over Time

Although the effectiveness of cadaver surgical training has been clarified, the decline in training effects over time has become a problem. This study examined whether repeated participation in cadaver-based educational seminar for trauma surgery (C-BEST) could suppress the decline in training effects. Basic and advanced C-BEST have pelvic package (PP) and fasciotomy of the lower extremity (FLE) as common training skills. For participants of these skills twice each, we examined the changes in a 10-point self-assessment of confidence levels (SACL) at six time points: (1) before the seminar of basic C-BEST, (2) immediately after basic C-BEST, (3) half a year after basic C-BEST, (4) before advanced C-BEST, (5) immediately after advanced C-BEST, and (6) half a year after advanced C-BEST. Data were collected from 28 basic C-BESTs and 5 advanced C-BESTs conducted from January 2013 to January 2020. Statistical analysis was performed by comparing SACL results from seminar evaluations at the six points, with significance at P < 0.05. A total of 60 participants were enrolled (postgraduate year, 16.5 ± 5.7). The interval between basic and advanced C-BEST was 27.1 ± 6.9 months. In PP, the SACL did not decrease at all six points. In FLE, SACL did not decrease at all six points, had a greater increase before versus immediately after advanced C-BEST, and did not decrease thereafter (P < 0.05). After participants retook the seminar, FLE-like procedures, which are unfamiliar to nonorthopedic surgeons, had increased and maintained self-evaluation values, whereas PP-like procedures, which are familiar to abdominal surgeons, had maintained high self-evaluation values. Therefore, repeated seminar participation could maintain the effects of cadaver training.

Behavior Change and Skills Retention With an Action Record After Ultrasonography Training

2021 ◽  
Author(s):  
Toru Yamada ◽  
Jun Ehara ◽  
Hiraku Funakoshi ◽  
Keita Endo ◽  
Yuka Kitano ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Behavior Change ◽  
Test Scores ◽  
Simulation Training ◽  
Image Acquisition ◽  
Image Interpretation ◽  
Median Number ◽  
Positive Behavior ◽  
Skills Retention

Abstract Background In simulation training, behavior change (Kirkpatrick’s level 3) is more important than learning improvement (Kirkpatrick’s level 2). However, few studies have evaluated behavior change because it is difficult to assess objectively. Skills retention is another challenge. We evaluated whether keeping a record of the number of ultrasound (US) examinations performed after a simulation course led to positive behavior changes and improved skills retention. Methods A 2-day point-of-care ultrasound (POCUS) course in cardiac US, lung US, lower extremity deep vein thrombosis (DVT) US, and abdominal US was held for Japanese nurse practitioners and trainees in 2018 and 2019. Participants kept a record of the number of US examinations they performed for 3 months before and 3 months after the course. The number of US exams performed was grouped into six categories. All participants underwent pre-course, immediate post-course, and 4-month post-course testing to assess image interpretation skills, image acquisition skills, and confidence. Results Thirty-three participants from 21 facilities completed the program. The median number of US exams performed during the 3-month period after the course increased significantly from before the course (P < 0.001). The median number of each US examination type (cardiac, lung, lower extremity DVT, and abdominal) after the course statistically significantly increased compared with before the course (P < 0.001). The immediate post-course and 4-month follow-up test scores for image interpretation skills, image acquisition skills, and confidence were statistically significantly higher than the pre-course test scores (P < 0.001). The results of the 4-month follow-up test showed no decline compared with immediate post-course scores. Conclusions Keeping a record after a POCUS simulation course increased the number of US examinations and improved knowledge, skills, and confidence. Keeping a record after simulation training led to positive behavior change and improved skills retention.

Characterisation of Victims Of Violence in the A & E Department and Analysis of the Acceptance of a Medico-Legal Expertise Centre After its Implementation vs. Multi-Year Consolidation

2018 ◽  
Vol 157 (04) ◽  
pp. 426-433 ◽  
Author(s):  
David Latz ◽  
Anja Bergermann ◽  
Jeannie Jungnitsch ◽  
Jan Peter Grassmann ◽  
Erik Schiffner ◽  
...  
Keyword(s):  
Trauma Surgery ◽  
Social Impairment ◽  
Number Of Patients ◽  
Medical Reports ◽  
Close Cooperation ◽  
Victims Of Violence ◽  
One Year ◽  
Trauma Surgeons ◽  
Attending Physician

Abstract Background People who have become victims of domestic or public violence often suffer long-term physical, psychological and social impairment. Due to physical injury, the first contact with the health care system is frequently an A & E Department. Thus, physicians and especially surgeons play a key role in detecting victims of domestic or public violence. The specific needs of victims are adequate medical treatment of injuries, forensic documentation, as well as interdisciplinary medical support to prevent further morbidity and violence. To take this into account, so-called expertise centres for victims of violence have been established at several locations in Germany in recent years. In this study: I. We tried to define the characteristics of victims of domestic and public violence to ensure better identification by physicians/surgeons. II. We elucidate the acceptance and effectiveness of such an expertise centre one year after its implementation and for a period of three years (2007 – 2009) and for a follow-up period of three years (2014 – 2016) after establishment. Material and Methods Patients were prospectively classified as victims of violence by the attending physician at the A & E Department and further treatment was initiated by the expertise centre for victims of violence. Medical reports from the A & E Department were analysed anonymously and compared with the number of patients of the expertise centre for victims of violence who had been referred from A & E Department. Results Orthopaedic and trauma surgery is the main referring discipline for the expertise centre for victims of violence. 0.9% of patients (2007 – 2009) and in the follow-up period (2014 – 2016) even 1.6% of patients were identified as victims of violence. However, the acceptance of such a centre fell from 22.2% (2007 – 2009) to 17.2% (2014 – 2016). Conclusion Physicians and especially trauma surgeons are responsible for identifying victims of domestic or public violence and ensuring further treatment. Accordingly, it is crucial that the expertise centre should characterise the victims of violence and be aware of their different needs, if the expertise centre is to be accepted. The results of this study indicate that interdisciplinary training and close cooperation between traumatology and legal medicine are the main prerequisites for continuous improvement in the treatment of victims of violence.

scholarly journals Development, Implementation and Evaluation of A Pain Management and Palliative Care Educational Seminar for Medical Students

2014 ◽  
Vol 19 (5) ◽  
pp. 230-234 ◽  
Author(s):  
Denise Paneduro ◽  
Leah R Pink ◽  
Andrew J Smith ◽  
Anita Chakraborty ◽  
Albert J Kirshen ◽  
...  
Keyword(s):  
Palliative Care ◽  
Pain Management ◽  
Medical Students ◽  
Test Scores ◽  
Pain Education ◽  
Post Test ◽  
Based Instruction ◽  
One Year ◽  
Educational Seminar

BACKGROUND: Despite calls for the development and evaluation of pain education programs during early medical student training, little research has been dedicated to this initiative.OBJECTIVES: To develop a pain management and palliative care seminar for medical students during their surgical clerkship and evaluate its impact on knowledge over time.METHODS: A multidisciplinary team of palliative care and pain experts worked collaboratively and developed the seminar over one year. Teaching methods included didactic and case-based instruction, as well as small and large group discussions. A total of 292 medical students attended a seminar during their third- or fourth-year surgical rotation. A 10-item test on knowledge regarding pain and palliative care topics was administered before the seminar, immediately following the seminar and up to one year following the seminar. Ninety-five percent (n=277) of students completed the post-test and 31% (n=90) completed the follow-up test.RESULTS: The mean pretest, post-test and one-year follow-up test scores were 51%, 75% and 73%, respectively. Mean test scores at post-test and follow-up were significantly higher than pretest scores (all P<0.001). No significant difference was observed in mean test scores between follow-up and post-test (P=0.559), indicating that students retained knowledge gained from the seminar.CONCLUSIONS: A high-quality educational seminar using interactive and case-based instruction can enhance students’ knowledge of pain management and palliative care. These findings highlight the feasibility of developing and implementing pain education material for medical students during their training.

scholarly journals 192 Interleukin-6 and C-Reactive Protein Predict all Cause Death and Poor Functional Outcome after Non-Severe Stroke and Transient Ischaemic Attack

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Sarah Coveney ◽  
John J McCabe ◽  
Murphy Sean ◽  
Orina Belton ◽  
M Crowe ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Trauma Surgery ◽  
C Reactive Protein ◽  
Poor Functional Outcome ◽  
Severe Stroke ◽  
Cox Regression Analysis ◽  
Reactive Protein ◽  
Markers Of Inflammation ◽  
Unit Increase

Abstract Background Inflammation plays a role in the development of ischaemic cerebrovascular events. High sensitivity C-reactive protein (CRP) is known to predict recurrent events. Little data exists for more upstream serum markers of inflammation. Methods BIO-STROKE and BIO-TIA were multicentre prospective biomarker and imaging studies of patients with non-severe stroke, TIA and controls. Exclusion criteria were malignancy, infection, recent trauma / surgery, recurrent stroke before phlebotomy/MRI. Serum biomarkers analysed included Interleukin (IL) – 6, CRP, IL-1, IL-8, IL10, IL12p70, IFN and TNF.Plasma CRP and IL-6 were measured by mass spectrometry. Additional biomarkers were measured using ELISA. Follow up was performed at 7, 28, 90 days and 1 year. Results 680 patients (439 strokes, 241 TIAs) and 68 controls were included in the analysis. The median age was 70 for cases. Carotid stenosis was present in 23.6% of cases. Median CRP was 3.75mg/L, 2.36mg/l and 1.87mg/L in the stroke, TIA and control groups (p=<0.001). Median IL-6 was 5.86pg/ml (stroke), 4.25pg/ml (TIA), 3.06pg/ml (control) (p=<0.001). On multivariate cox regression analysis baseline IL6 and CRP were independent predictors of all cause death at 1 year with a HR of 1.005 (95% CI 1.002-1.007, p<0.001).and 1.005(95% CI 1.002-1.007, p<0.001) per unit increase. Both IL6 and CRP were associated with vascular death at 1 year. In adjusted analyses, IL6 and CRP were associated with poor functional outcome at 1 year (OR of 1.02(CI 1.01 -1.03) and 1.02(CI 1.01-1.03) per unit increase, for IL6 and CRP respectively). On adjusted analysis, when IL6 was analysed as quartiles, there was a strong association with death at 1 year with an OR 1.87 (95% CI 1.19-2.93).CRP, analysed as quartiles, demonstrated an OR for death at 1 year of 1.64 (1.10-2.46). Conclusion IL-6 and CRP may be a useful prognostic factor for the prediction of outcome and death after stroke at 1 year follow up.

Retained Foreign Bodies after Emergent Trauma Surgery: Incidence after 2526 Cavitary Explorations

2007 ◽  
Vol 73 (10) ◽  
pp. 1031-1034 ◽  
Author(s):  
Pedro G.R. Teixeira ◽  
Kenji Inaba ◽  
Ali Salim ◽  
Carlos Brown ◽  
Peter Rhee ◽  
...  
Keyword(s):  
Foreign Bodies ◽  
Damage Control ◽  
Trauma Surgery ◽  
Radiographic Evaluation ◽  
Trauma Patients ◽  
X Rays ◽  
Chest X Ray ◽  
Cavity Closure ◽  
Level 1 Trauma Center

Trauma patients are thought to be at high risk for iatrogenic retained foreign bodies (RFBs). The objective of this study was to evaluate this incidence. All cases of RFB after cavitary trauma surgery were identified by review of Morbidity and Mortality reports at a Level 1 trauma center from January 1998 to December 2005 and confirmed by the Octagon Risk Management System. Over 8 years, 10,053 trauma operations were performed (2075 laparotomies, 377 thoracotomies, and 74 sternotomies). Three cases (0.1%) of RFB (all sponges) occurred during one single-stage and two damage control laparotomies. The counts were correct before definitive closure in two of three cases. No postoperative x-rays were obtained in any of the cases. RFB diagnosis occurred between days 3 and 9, one on a routine chest x-ray and the other two on abdominal computed tomography scans during a septic workup. Four-month to 8-year follow up documented one pleural effusion and one abscess resulting from the RFB. Iatrogenic RFBs after emergent cavitary trauma surgery occur at a rate of 0.12 per cent and are associated with significant morbidity. In addition to standard preventive strategies, in emergent cases with risk factors such as requiring damage control, before final cavity closure, even with a correct sponge count, radiographic evaluation is warranted.

What factors influence follow-up in orthopedic trauma surgery?

2015 ◽  
Vol 135 (3) ◽  
pp. 321-327 ◽  
Author(s):  
Paul S. Whiting ◽  
Sarah E. Greenberg ◽  
Rachel V. Thakore ◽  
Vignesh K. Alamanda ◽  
Jesse M. Ehrenfeld ◽  
...  
Keyword(s):  
Trauma Surgery ◽  
Orthopedic Trauma ◽  
Orthopedic Trauma Surgery

scholarly journals Trauma surgery at a designated COVID-19-free site during the pandemic

2020 ◽  
Vol 1 (6) ◽  
pp. 302-308
Author(s):  
Gianluca Gonzi ◽  
Kathryn Rooney ◽  
Rhodri Gwyn ◽  
Kunal Roy ◽  
Matthew Horner ◽  
...  
Keyword(s):  
Trauma Surgery ◽  
Electronic Record ◽  
Health Board ◽  
Trauma Patients ◽  
Staff Members ◽  
Patient Demographics ◽  
Orthopaedic Patients ◽  
Trauma Service ◽  
Surgical Unit

Aims Elective operating was halted during the COVID-19 pandemic to increase the capacity to provide care to an unprecedented volume of critically unwell patients. During the pandemic, the orthopaedic department at the Aneurin Bevan University Health Board restructured the trauma service, relocating semi-urgent ambulatory trauma operating to the isolated clean elective centre (St. Woolos’ Hospital) from the main hospital receiving COVID-19 patients (Royal Gwent Hospital). This study presents our experience of providing semi-urgent trauma care in a COVID-19-free surgical unit as a safe way to treat trauma patients during the pandemic and a potential model for restarting an elective orthopaedic service. Methods All patients undergoing surgery during the COVID-19 pandemic at the orthopaedic surgical unit (OSU) in St. Woolos’ Hospital from 23 March 2020 to 24 April 2020 were included. All patients that were operated on had a telephone follow-up two weeks after surgery to assess if they had experienced COVID-19 symptoms or had been tested for COVID-19. The nature of admission, operative details, and patient demographics were obtained from the health board’s electronic record. Staff were assessed for sickness, self-isolation, and COVID-19 status. Results A total of 58 surgical procedures were undertaken at the OSU during the study period; 93% (n = 54) of patients completed the telephone follow-up. Open reduction and internal fixation of ankle and wrist fractures were the most common procedures. None of the patients nor members of their households had developed symptoms suggestive of COVID-19 or required testing. No staff members reported sick days or were advised by occupational health to undergo viral testing. Conclusion This study provides optimism that orthopaedic patients planned for surgery can be protected from COVID-19 nosocomial transmission at separate COVID-19-free sites. Cite this article: Bone Joint Open 2020;1-6:302–308.

CSF rhinorrhea following alectinib treatment for anaplastic lymphoma kinase rearranged lung adenocarcinoma - e contrario

2020 ◽  
Vol 5 ◽  
pp. 127-130
Author(s):  
Deepa Shrestha ◽  
Raghava Rao Gandra ◽  
Ramandeep Singh Virk ◽  
Paramjeet Singh ◽  
Aditi Mehta ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Skull Base ◽  
Anaplastic Lymphoma Kinase ◽  
Trauma Surgery ◽  
Skull Base Tumors ◽  
Alk Rearrangement ◽  
Csf Rhinorrhea ◽  
Anaplastic Lymphoma ◽  
Metastatic Lung

Cerebrospinal fluid (CSF) rhinorrhea is a condition characterized by leakage of CSF from skull base through the nostril(s). It is commonly associated with trauma, surgery, infections of paranasal sinuses/skull base, and intracranial and skull base tumors. Among malignant causes, lung cancer is rarely associated with CSF rhinorrhea. Herein, we report the case of a 51-year-old lady who was initially diagnosed with metastatic lung adenocarcinoma (LUAC) with anaplastic lymphoma kinase (ALK) rearrangement and initiated on treatment with alectinib. She had good clinicoradiological response, but on follow-up developed CSF rhinorrhea that required surgical correction. We also discuss the proposed mechanisms associated with occurrence of CSF rhinorrhea in the setting of metastatic ALK-rearranged LUAC.

The effectiveness of the cadaver-based educational seminar for trauma surgery (C-BEST) for residents

2021 ◽  
Keyword(s):  
Statistical Analysis ◽  
Trauma Surgery ◽  
Surgical Skills ◽  
P Value ◽  
Surgical Experience ◽  
Self Assessment ◽  
Time Points ◽  
Confidence Levels ◽  
Self Confidence ◽  
Educational Seminar

To assess the effectiveness of the cadaver-based educational seminar for trauma surgery (C-BEST) for residents using a 10-point self-assessment of confidence levels (SACL) survey. We collected data, including SACL for 21 surgical skills and an evaluation of the contents before, immediately after, and half a year after the seminar, from 42 seminars conducted between January 2013 and March 2019. On comparing SACL results from evaluations at the three time points using statistical analysis, a p value of <0.05 was obtained. We enrolled 412 participants; of the 52 residents, 47 respondents were included in the study. Improvements in all skills were observed on comparing SACL before and immediately after the seminar (2.2 ± 2.6 vs. 5.3 ± 2.5; p < 0.001), but a decrease was observed between immediately after and half a year after the seminar (5.3 ± 2.5 vs. 4.9± 2.7; p < 0.01). Upon examining the results according to each skill, SACL did not decrease between immediately after and half a year after the seminar (p > 0.05). The most performed procedure was left anterior thoracotomy and aortic clamp (n = 13), and the number of residents majoring in surgery increased from 27 to 32 half a year after the seminar. C-BEST boosts more self-confidence of the participating residents immediately after the seminar. Although this effect is not maintained half a year after the seminar, many participants practiced their skills after the seminar. Therefore, C-BEST is useful for residents with little surgical experience; this may also inspire the residents to major in surgery.

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