scholarly journals Simulator training and residents’ first laparoscopic hysterectomy: a randomized controlled trial

2019 ◽  
Vol 34 (11) ◽  
pp. 4874-4882 ◽  
Author(s):  
Ewa Jokinen ◽  
Tomi S. Mikkola ◽  
Päivi Härkki
Keyword(s):  
Virtual Reality ◽  
Surgical Outcomes ◽  
Intervention Group ◽  
Laparoscopic Hysterectomy ◽  
Simulator Training ◽  
Global Rating Scale ◽  
Control Group ◽  
Global Rating ◽  
Virtual Reality Simulator ◽  
The Mean

Abstract Background Hysterectomy rates are decreasing in many countries, and virtual reality simulators bring new opportunities into residents’ surgical education. The objective of this study was to evaluate the effect of training in laparoscopic hysterectomy module with virtual reality simulator on surgical outcomes among residents performing their first laparoscopic hysterectomy. Methods This randomized study was carried out at the Department of Obstetrics and Gynecology in Helsinki University Hospital and Hyvinkää Hospital. We recruited twenty residents and randomly signed half of them to train ten times with the laparoscopic hysterectomy module on a virtual reality simulator, while the rest represented the control group. Their first laparoscopic hysterectomy was video recorded and assessed later by using the Objective Structured Assessment of Technical Skills (OSATS) forms and Visual Analog Scale (VAS). The scores and surgical outcomes were compared between the groups. Results The mean OSATS score for the Global Rating Scale (GRS) was 17.0 (SD 3.1) in the intervention group and 11.2 (SD 2.4) in the control group (p = 0.002). The mean procedure-specific OSATS score was 20.0 (SD 3.3) and 16.0 (SD 2.8) (p = 0.012), and the mean VAS score was 55.0 (SD 14.8) and 29.9 (SD 14.9) (p = 0.001). Operative time was 144 min in the intervention group and 165 min in the control group, but the difference did not reach statistical significance (p = 0.205). There were no differences between the groups in blood loss or direct complications. Conclusion Residents training with a virtual reality simulator prior to the first laparoscopic hysterectomy seem to perform better in the actual live operation. Thus, a virtual reality simulator hysterectomy module could be considered as a part of laparoscopic training curriculum.

scholarly journals Computer-Based Virtual Reality Colonoscopy Simulation Improves Patient-Based Colonoscopy Performance

2014 ◽  
Vol 28 (4) ◽  
pp. 203-206 ◽  
Author(s):  
Keith S McIntosh ◽  
James C Gregor ◽  
Nitin V Khanna
Keyword(s):  
Virtual Reality ◽  
Virtual Colonoscopy ◽  
Controlled Trial ◽  
Simulator Training ◽  
Control Group ◽  
Virtual Reality Simulator ◽  
Virtual Training ◽  
Computer Based ◽  
Cecal Intubation Rate ◽  
To Receive

BACKGROUND: Colonoscopy simulators that enable one to perform computer-based virtual colonoscopy now exist. However, data regarding the effectiveness of this virtual training are limited.OBJECTIVE: To determine whether virtual reality simulator training translates into improved patient-based colonoscopy performance.METHODS: The present study was a prospective controlled trial involving 18 residents between postgraduate years 2 and 4 with no previous colonoscopy experience. These residents were assigned to receive 16 h of virtual reality simulator training or no training. Both groups were evaluated on their first five patient-based colonoscopies. The primary outcome was the number of proctor ‘assists’ required per colonoscopy. Secondary outcomes included insertion time, depth of insertion, cecal intubation rate, proctor- and nurse-rated competence, and patient-rated pain.RESULTS: The simulator group required significantly fewer proctor assists than the control group (1.94 versus 3.43; P≤0.001), inserted the colonoscope further unassisted (43 cm versus 24 cm; P=0.003) and there was a trend to intubate the cecum more often (26% versus 10%; P=0.06). The simulator group received higher ratings of competence from both the proctors (2.28 versus 1.88 of 5; P=0.02) and the endoscopy nurses (2.56 versus 2.05 of 5; P=0.001). There were no significant differences in proctor-, nurse- or patient-rated pain, or attention to discomfort.CONCLUSIONS: Computer-based colonoscopy simulation in the initial stages of training improved novice trainees’ patient-based colonoscopy performance.

scholarly journals The Effects of Virtual Reality on Patients’ Anxiety Before Dental Surgery

2021 ◽  
Vol 27 (3) ◽  
pp. 384-399
Author(s):  
Mina Mohammadpour ◽  
◽  
Majid Hosseini Abrishami ◽  
Sahand Samiei Rad ◽  
Jahanshir Tavakolizadeh ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Intervention Group ◽  
Study Groups ◽  
Demographic Characteristics ◽  
T Test ◽  
Control Group ◽  
Time Interval ◽  
Dental Surgery ◽  
The Mean ◽  
Experimental Group

Aims: Anxiety due to dental interventions and its complications are common in cases, like wisdom tooth surgery. Related pharmacotherapy is also associated with adverse effects and are not accepted by some patients. Virtual Reality (VR) is one of the new and non-invasive technologies proposed in this regard. This study aimed to determine the effects of VR on patients’ anxiety before dental surgery. Methods & Materials: In this clinical trial, 60 patients who were candidates for dental surgery in Dental School in Mashhad City, Iran, were randomly assigned to two groups of control and intervention (n=30/group). Initially, in addition to demographic characteristics, patients’ anxiety levels were measured using the Spielberger State-Trait Anxiety Inventory (STAI). Then, the intervention group was placed in VR space for 12 minutes using the Remax-RT-V03 audio-visual device; however, no intervention was performed in the control group. Before surgery, anxiety was re-measured by a questionnaire in two groups with the same time interval (15 minutes after the first stage). The obtained data were analyzed in SPSS by Independent Samples t-test, Paired Samples t-test, and Chi-squared test at a significant level of P≤0.05. Findings: The Mean±SD age of the examined patients was 26.5±4.9 years. In total, 53.3% and 46.7% of the study participants were female and male, respectively. The research groups were homogeneous concerning demographic characteristics. The Mean±SD scores of anxiety in the research units before the intervention were 55.56±7.08 in the experimental group and 53.70±10.53 in the control group, i.e., not significantly different. However, after the intervention, anxiety decreased in the experimental group (45.56±10.52), compared to the control group (54.53±9.83); the difference between the study groups was significant (P<0.001). Conclusion: Applying VR was effective in reducing patients’ anxiety before dental surgery; thus, its use in dental clinics is recommended after additional studies.

scholarly journals P33 Effectiveness of OSCEs in training German pharmacy students in consultation on self-medication – a randomised controlled investigation

2019 ◽  
Vol 104 (6) ◽  
pp. e30.2-e31
Author(s):  
I Farahani ◽  
A Laven ◽  
S Farahani ◽  
MA Deters ◽  
M Feickert ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Communication Skills ◽  
Rating Scale ◽  
Intervention Group ◽  
Pharmacy Students ◽  
Global Rating Scale ◽  
Control Group ◽  
Global Rating ◽  
Self Medication ◽  
Consultation Skills

BackgroundIn Germany 37.1% of dispensed medicinal products were intended to use in self-medication in 2017.1 An investigation showed that 25.2% of children and adolescents used self-medication in Germany.2 Hence, pharmacists’ education needs to include training for competence in consultation.3A modern method to train this competence is the use of OSCEs (Objective Structured Clinical Examinations). The aim of this study was to assess whether the use of OSCEs in pharmacy students to train the consultation performance on self-medication is more effective than a conservative teaching method.MethodsThis randomised controlled investigation was conducted in a pre-post-design with pre-OSCEs before training and post-OSCEs after training in each group. Clinical skills at baseline and after the training were measured. Forty students in their last year of pharmacy studies were randomised into a control and an intervention group. The control group attended a lecture on self-medication and the intervention group had additionally to the lecture one hour of OSCEs for training purpose. An analytical checklist was used for measuring consultation skills and a global rating scale for assessing communication skills.ResultsComplete data was received from 30 students (n=16 intervention group, n=14 control group). Consultation skills improved significantly (analytical checklist: 19.88% ± 10.95% intervention group vs. 9.29% ± 10.89% control group, p< 0.05). However, the communication skills (global rating scale: 20.83% ± 24.33% in the intervention group vs. 11.90% ± 17.12% in the control group, p= 0.380) did not improve significantly during the one-hour training period.ConclusionOSCEs for training purpose are an effective method to convey pharmacy students consultation skills in self-medication. However, communication skills need more training. Based on these results OSCEs on self-medication for the paediatric population should be investigated. This is relevant due to the frequency of self-medication in the paediatric population.ReferencesAbda.de. [Internet]. Berlin: Federal union of German associations of pharmacists. Numbers, data, facts 2016. [Cited January 30, 2019]. Available from: https://www.abda.de/fileadmin/assets/ZDF/ZDF_2018/ABDA_ZDF_2018_Brosch.pdf Du Y, Knopf H. Self-medication among children and adolescents in Germany: results of the National Health Survey for children and adolescents (KiGGS). Br J Clin Pharmacol 2009;68:599–608.Joint Statement by the International Pharmaceutical Federation (FIP) and the World Self Medication Industry (WSMI). [Internet]. Responsible Self-medication. 1998. [Cited January 30, 2019]. Available from: https://www.fip.org/www/uploads/database_file.php?id=241&table_id=.Disclosure(s)Imaneh Farahani, Anna Laven, Samieh Farahani, Maira A. Deters, Martin Feickert, Fabian K. Suessenbach, Holger Schwender and Stephanie Laeer declare that they have no conflict of interest.

scholarly journals The effect of microsurgical training on novice medical students’ basic surgical skills—a randomized controlled trial

2019 ◽  
Vol 43 (4) ◽  
pp. 459-466
Author(s):  
Stian Kreken Almeland ◽  
Andrew Lindford ◽  
Henriette Pisani Sundhagen ◽  
Karl Ove Hufthammer ◽  
Eivind Strandenes ◽  
...  
Keyword(s):  
Medical Students ◽  
Plastic Surgery ◽  
Rating Scale ◽  
Assessment Tool ◽  
Intervention Group ◽  
Global Rating Scale ◽  
Control Group ◽  
Diagnostic Study ◽  
Global Rating ◽  
Suturing Skills

Abstract Background It has been demonstrated that medical students are capable of learning microsurgical techniques. We hypothesize that microsurgical training might give insight into the importance of delicate tissue handling and correct knot tying that could have a positive influence on macrosurgical skills. The primary aim of this study was to evaluate the effect of microsurgical training on macrosurgical suturing skills in novice medical students. Subjects and methods In 2018, 46 novice medical students were enrolled and randomized into two groups. The intervention group received both macro- and microsurgical training and the control group received only microsurgical training. Both groups underwent an assessment test that consisted of macrosurgical tasks of three simple interrupted sutures with a square knot and continuous three-stitch long over-and-over sutures. These tests were individually filmed and assessed using the University of Bergen suturing skills assessment tool (UBAT) and the Objective Structured Assessment of Technical Skill global rating scale (OSATS). Questionnaires regarding future career ambitions and attitudes towards plastic surgery were also completed both prior to and following the tests. Results The intervention group needed a longer time to complete the tasks than the control group (12.2 min vs. 9.6 min, p > 0.001), and scored lower on both the UBAT (5.6 vs. 9.0, p > 0.001) and the OSATS (11.1 vs. 13.1, p > 0.001) assessments. The microsurgery course tended to positively influence the students’ attitudes towards a career in plastic surgery (p = 0.002). This study demonstrates poorer macrosurgical skills in the medical students group exposed to microsurgical training. The true effect of microsurgical training warrants further investigation. Level of evidence: Level I, diagnostic study.

scholarly journals OP0159 EFFICACY OF COMPREHENSIVE TECHNOLOGY-ASSISTED HOME-BASED EXERCISE IN ANKYLOSING SPONDYLITIS: A RANDOMIZED, CONTROLLED TRIAL

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 100.3-100
Author(s):  
Y. Wang ◽  
X. Liu ◽  
Y. Shi ◽  
X. Ji ◽  
W. Wang ◽  
...  
Keyword(s):  
Exercise Intervention ◽  
Medical Center ◽  
Controlled Trial ◽  
Intervention Group ◽  
Exercise Program ◽  
Group Differences ◽  
Control Group ◽  
Home Based ◽  
The Mean

Background:Clinical practice guidelines recommend that exercise is an essential component in the self-management of Ankylosing Spondylitis (AS). Attending supervised interventions requiring periodic medical center visits can be burdensome and patients may decline participation, whereas, effective home-based exercise interventions that do not need regular medical center visits are likely to be more accessible and acceptable for patients with AS. Recently, increasing evidences have been accumulated that the wearable devices could facilitate patients with inflammatory arthritis by giving exercise instructions and improving self-efficacy. Therefore, patients with AS may benefit from an effective technology-assisted home-based exercise intervention.Objectives:To investigate the efficacy of a comprehensive technology-assisted home-based exercise intervention on disease activity in patients with AS.Methods:This study was a 16-week assessor-blinded, randomized, waiting-list controlled trial (ChiCTR1900024244). Patients with AS were randomly allocated to the home-based exercise intervention group and the waiting-list control group. A 16-week comprehensive exercise program consisting of a moderate intensity (64%-76% HRmax) aerobic training for 30min on 5 days/week and a functional training for 60min on 3 days/week was given to patients in the intervention group immediately after randomization, with 1.5h training sessions for two consecutive days by a study physical therapist at baseline and Week 8. The aerobic exercise intensity was controlled by a Mio FUSE Wristband with a smartphone application. The functional training consisted of the posture training, range of motion exercises, strength training, stability training and stretching exercises. Patients in control group received standard care during the 16-week follow-up and started to receive the exercise program at Week 16. The primary outcome was ASDAS at Week 16. The secondary outcomes were BASDAI, BASFI, BASMI, ASAS HI, peak oxygen uptake, body composition and muscle endurance tests. The mean difference between groups in change from baseline was analyzed with the analysis of covariance.Results:A total of 54 patients with AS were enrolled (26 in intervention group and 28 in control group) and 46 (85.2%) patients completed the 16-week follow-up. The mean difference of ASDAS between groups in change from baseline to 16-week follow-up was −0.2 (95% CI, −0.4 to 0.003, P = 0.032), and the mean change from baseline was -0.4 (95% CI, -0.5 to -0.2) in the intervention group vs -0.1 (95% CI, -0.3 to 0.01) in the control group, respectively. Significant between-group differences were found between groups for BASDAI (−0.5 [95% CI, −0.9 to −0.2], P = 0.004), BASMI (−0.7 [95% CI, −1.1 to −0.4], P <0.001), BASFI (−0.3 [95% CI, −0.6 to 0.01], P=0.035), peak oxygen uptake (2.7 [95% CI, 0.02 to 5.3] ml/kg/min, P=0.048) and extensor endurance test (17.8 [95% CI, 0.5 to 35.2]s, P=0.044) at Week 16. Between-group differences were detected in ASAS HI (−0.9 [95% CI, −1.7 to −0.1], P=0.030), body fat percentage (−1.0 [95% CI, −2.0 to −0.01] %, P=0.048) and visceral adipose tissue (−4.9 [95% CI, −8.5 to −1.4] cm2, P=0.008) at Week 8, but not at Week 16. No significant between-group differences were detected in the total lean mass, time up and go test and the flexor endurance test during the follow-up.Conclusion:Comprehensive technology-assisted home-based exercise has been shown to have beneficial effects on disease activity, physical function, spinal mobility, aerobic capacity, and body composition as well as in improving fatigue and morning stiffness of patients with AS.References:[1]van der Heijde D, Ramiro S, Landewé R, et al. Ann Rheum Dis 2017;76:978–991.Disclosure of Interests:None declared

scholarly journals Comparison of the effectiveness of lecture instruction and virtual reality-based serious gaming instruction on the medical students’ learning outcome about approach to coma

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Meysam Siyah Mansoory ◽  
Mohammad Rasool Khazaei ◽  
Seyyed Mohsen Azizi ◽  
Elham Niromand
Keyword(s):  
Virtual Reality ◽  
Medical Students ◽  
Learning Outcomes ◽  
Learning Outcome ◽  
Serious Game ◽  
Control Group ◽  
Serious Gaming ◽  
E Learning ◽  
The Mean ◽  
Lecture Instruction

Abstract Background New approaches to e-learning and the use of virtual reality technology and serious game in medical education are on the rise. Therefore, the purpose of this study was to compare the effectiveness of lecture method and virtual reality-based serious gaming (VRBSG) method on students learning outcomes about the approach to coma. Methods We adopted a randomized trial method for this study and selected 50 medical students dividing them into experimental and control groups. Students’ learning outcome was measured with a 10-item test. Serious game usability scale was used to evaluate the usability of the serious game. Descriptive and inferential statistics were used for data analysis by SPSS-22 software. Results Students’ familiarity with e-learning and VRBSG was low. The mean usability of a VRBSG was 126.78 ± 10.34 out of 150. The majority of students were eager to be instructed through VRBSG. The mean score of learning outcomes in the experimental group was significantly higher than the control group (t = − 2.457, P = 0.019). Conclusion Students’ learning outcomes in the VRBSG group in the test approach to coma were significantly better than the lecture group. The usability of the serious game instruction method was high. Taken together, instruction through VRBSG had an effective role in medical students’ learning.

The effectiveness of emotional freedom techniques (EFT) on depression of postmenopausal women: a randomized controlled trial

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Asieh Mehdipour ◽  
Parvin Abedi ◽  
Somayeh Ansari ◽  
Maryam Dastoorpoor
Keyword(s):  
Randomized Controlled Trial ◽  
Postmenopausal Women ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Randomized Controlled ◽  
Moderate Depression ◽  
Before And After ◽  
The Mean ◽  
And Control

Abstract Objectives Postmenopausal women are at greater risk of depression. Depression may negatively affect the quality of life of women. An emotional freedom technique (EFT) is an evidence-based therapy combining cognitive and exposure components with acupressure. This study aimed to evaluate the effect of EFT on depression in postmenopausal women. Methods This was a randomized controlled trial in which 88 women with mild to moderate depression recruited from a menopausal clinic in Ahvaz, Iran, and randomly assigned into two groups of EFT (n=44) and control for sham therapy (n=44). Women in the EFT group received two sessions of training and asked to continue EFT for 8 weeks, one time per day. The Beck Depression Inventory (BDI2) completed by women before and after the intervention. The control group received training on sham acupressure points similar to the intervention group. Data collected using a demographic and BDI2. Women requested to complete the BDI2 before and after the intervention. The independent t-test, chi-square, and ANCOVA were used to analyze data. Results The mean depression score in the intervention group reduced from 20.93 ± 4.6 to 10.96 ± 4.38 in comparison to the control group that reduced from 19.18 ± 2.79 to 17.01 ± 6.05 after intervention (p=0.001). After the 8 week intervention, the frequency of moderate depression decreased from 56.8 to 9.35% in the intervention and from 50 to 29.5% in the control group. In total, 63.4 and 34.15% in the intervention and control groups were free of depression respectively after the intervention (p<0.001). Conclusions The results of this study showed that using EFT for 8 weeks could significantly reduce the mean score of depression in postmenopausal women. Using this method in public health centers for postmenopausal women is recommended.

scholarly journals Effect of Engaging Trainees by Assessing Peer Performance: A Randomised Controlled Trial Using Simulated Patient Scenarios

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Charlotte Loumann Krogh ◽  
Charlotte Ringsted ◽  
Charles B. Kromann ◽  
Maria Birkvad Rasmussen ◽  
Tobias Todsen ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Global Rating ◽  
Training Performance ◽  
Significant Difference ◽  
Training Format ◽  
Peer Performance ◽  
And Performance ◽  
Randomised Controlled

Introduction. The aim of this study was to explore the learning effect of engaging trainees by assessing peer performance during simulation-based training.Methods. Eighty-four final year medical students participated in the study. The intervention involved trainees assessing peer performance during training. Outcome measures were in-training performance and performance, both of which were measured two weeks after the course. Trainees’ performances were videotaped and assessed by two expert raters using a checklist that included a global rating. Trainees’ satisfaction with the training was also evaluated.Results. The intervention group obtained a significantly higher overall in-training performance score than the control group: mean checklist score 20.87 (SD 2.51) versus 19.14 (SD 2.65)P=0.003and mean global rating 3.25 SD (0.99) versus 2.95 (SD 1.09)P=0.014. Postcourse performance did not show any significant difference between the two groups. Trainees who assessed peer performance were more satisfied with the training than those who did not: mean 6.36 (SD 1.00) versus 5.74 (SD 1.33)P=0.025.Conclusion. Engaging trainees in the assessment of peer performance had an immediate effect on in-training performance, but not on the learning outcome measured two weeks later. Trainees had a positive attitude towards the training format.

Effects of an Off-Site Walking Program on Energy Expenditure, Serum Lipids, and Glucose Metabolism in Middle-Aged Women

2003 ◽  
Vol 4 (3) ◽  
pp. 181-192 ◽  
Author(s):  
Fumiko Furukawa ◽  
Keiko Kazuma ◽  
Masako Kawa ◽  
Mitsunori Miyashita ◽  
Kyohko Niiro ◽  
...  
Keyword(s):  
Energy Expenditure ◽  
Nurse Managers ◽  
Intervention Group ◽  
Density Lipoprotein ◽  
Control Group ◽  
Middle Aged ◽  
Walking Program ◽  
Before And After ◽  
The Mean ◽  
Blood Profiles

The present study aims to identify the effects of systematic walking on exercise energy expenditure (EEE) and blood profiles in middle-aged women. Fifty-two female nurse managers, aged 32 to 57 years (42.0 ± 6.2), were randomly assigned to an intervention group (IG) and a control group (CG) for a 12-week study of the walking program. EEE was measured using a microelectronic device. Blood profiles were assessed before and after the walking program. The mean EEE (kcal/kg/d) in the IG and CG was 4.73 ± 1.02 and 3.88 ± 0.81 ( P = 0.01), indicating an increase of 1.17 ± 0.98 and 0.46 ± 0.68 from baseline ( P = 0.01), respectively. The mean change in high-density lipoprotein cholesterol in the IG and CG was 1.8 ± 8.3 mg/dL and −2.9 ± 7.0 mg/dL ( P = 0.051); that in insulin was −4.5 ± 7.5 μU/dL and −0.6 ± 4.3 μU/dL ( P = 0.046), respectively. These results show that systematic walking increases EEE and improves blood profiles.

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