Operative performance outcomes of a simulator-based robotic surgical skills curriculum

Abstract Objective The objective of our paper is to review all of the relevant literature in ophthalmology microsurgical education and identify which teaching methodologies were most effective. Methods A systematic review and meta-analysis of the literature was conducted. Electronic databases, including Ovid MEDLINE, Cochrane CENTRAL, and EMBASE, were searched with preset terms. The search was through December 11, 2019. Eligibility criteria included studies with sufficient data for analyzing associations between surgical teaching techniques and success rates in surgical skills and the organization of the intervention as a microsurgical skills course, curriculum, or program. The articles were independently reviewed by two authors. Each included study was evaluated for quality using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach and risk of bias using the Cochrane Collaboration's tool for assessing bias. Data Extraction and Synthesis Data extraction was performed by two reviewers and disagreements were checked by a third reviewer. A random-effects analysis was used to pool the outcomes of studies. Main Outcomes and Measures Outcomes included time for completion of surgical task, level of preparedness, competency score, and number of surgeries with complications. Results A total of 439 studies were reviewed and 13 studies (n = 8,790 surgical cases; n = 115 trainees) were included in the meta-analysis. Excluded articles studied cataract simulation training as the primary intervention or were not related to ophthalmology. All pooled results demonstrated a positive association with surgical outcomes; however, video-based education (standardized mean difference [SMD] = 2.49 [95% confidence interval (CI): 0.36–4.63]; four effects [four studies]; n = 69; I 2 = 90%) and stepwise teaching method (odds ratio [OR = 3.84 [95% CI: 2.66–5.55]; six effects [six studies]; n = 6,968; I 2 = 39%) interventions were the most favorable. Conclusion and Relevance The following five interventions evaluated in this paper were found to be effective methods of improving performance outcomes in ophthalmic microsurgery: (1) didactic lectures, (2) video-based education, (3) surgical wet-laboratory, (4) stepwise method, and (5) direct supervision and feedback. Our meta-analysis concludes that video-based education and stepwise teaching interventions are the most effective methods for a microsurgical ophthalmology training curriculum. Combining the strengths of the interventions analyzed in this study should be considered when implementing and adjusting ophthalmic surgical skills curriculums.

Download Full-text

Quantifying Vocal Power: Correlation of Whole-Body Anaerobic Power to Vocal Function Measures

Journal of Speech Language and Hearing Research ◽

10.1044/2020_jslhr-20-00110 ◽

2020 ◽

Vol 63 (8) ◽

pp. 2597-2608

Author(s):

Emily N. Snell ◽

Laura W. Plexico ◽

Aurora J. Weaver ◽

Mary J. Sandage

Keyword(s):

Fundamental Frequency ◽

Forced Vital Capacity ◽

Vital Capacity ◽

Anaerobic Power ◽

Performance Outcomes ◽

Sound Level ◽

Whole Body ◽

Vocal Function ◽

Laryngeal Diadochokinesis ◽

High Sound

Purpose The purpose of this preliminary study was to identify a vocal task that could be used as a clinical indicator of the vocal aptitude or vocal fitness required for vocally demanding occupations in a manner similar to that of the anaerobic power tests commonly used in exercise science. Performance outcomes for vocal tasks that require rapid acceleration and high force production may be useful as an indirect indicator of muscle fiber complement and bioenergetic fitness of the larynx, an organ that is difficult to study directly. Method Sixteen women (age range: 19–24 years, M age = 22 years) were consented for participation and completed the following performance measures: forced vital capacity, three adapted vocal function tasks, and the horizontal sprint test. Results Using a within-participant correlational analyses, results indicated a positive relationship between the rate of the last second of a laryngeal diadochokinesis task that was produced at a high fundamental frequency/high sound level and anaerobic power. Forced vital capacity was not correlated with any of the vocal function tasks. Conclusions These preliminary results indicate that aspects of the laryngeal diadochokinesis task produced at a high fundamental frequency and high sound level may be useful as an ecologically valid measure of vocal power ability. Quantification of vocal power ability may be useful as a vocal fitness assessment or as an outcome measure for voice rehabilitation and habilitation for patients with vocally demanding jobs.

Download Full-text

Executive Functions and Clinical and Academic Outcomes in Speech-Language Pathology Graduate Students

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2020_persp-19-00143 ◽

2020 ◽

Vol 5 (5) ◽

pp. 1221-1230

Author(s):

Jane Roitsch ◽

Kimberly A. Murphy ◽

Anastasia M. Raymer

Keyword(s):

Executive Function ◽

Academic Outcomes ◽

Graduate Program ◽

Performance Outcomes ◽

Future Research ◽

Speech Language Pathology ◽

Grade Point ◽

Praxis Ii ◽

Language Pathology ◽

Preliminary Study

Purpose The purpose of this study was to investigate executive function measures as they relate to clinical and academic performance outcomes of graduate speech-language pathology students. Method An observational design incorporating correlations and stepwise multiple regressions was used to determine the strength of the relationships between clinical outcomes that occurred at various time points throughout the graduate program (clinical coursework grades throughout the program and case study paper scores at the end of the program), academic outcomes (graduate grade point average and Praxis II exam in speech-language pathology scores), and executive function (EF) scores (EF assessment scores, self-reported EF scores). Participants were 37 students (36 women, M age = 24.1) in a master's degree program in speech-language pathology at a southeastern U.S. university during the 2017–2018 academic year. Results Findings of this preliminary study indicated that a limited number of objective EF scores and self-reported EF scores were related to clinical and academic outcomes of graduate speech-language pathology students. Conclusion As results of this preliminary study suggest that EF tests may be related to clinical and academic outcomes, future research can move to study the potential role of EF measures in the graduate admissions process in clinical graduate programs such as speech-language pathology.

Download Full-text