Can everyone achieve proficiency with the laparoscopic technique? Learning curve patterns in technical skills acquisition

Abstract Background: Abdominal paracentesis is an essential competence for physicians. Simulation-based mastery learning (SBML) programs lead to developing these skills for medical students. Most programs are structured as short boot-camps, without assessing skills' retention mid and long-term or learning curves.Aim: To assess the learning curve of paracentesis through an SBML program for medical students and compare this learning curve-based program with the boot-camp method.Methods: A prospective quasi-experimental study was conducted. A cohort of medical students participated in an SBML program with successive sessions until proficiency criteria were met while their learning curve was assessed (LC group). A control group received an SBML boot-camp intervention (BC group). As a proficient group, gastroenterology fellows (GF group) performed a paracentesis on the simulated model. The skills of the three groups were compared using technical/proficiency scores. Learning curves and cost analysis were performed.Results: 100% of the LC group achieved proficiency in the fourth session, with a flattening learning curve between third-fourth sessions. Comparing the initial and final sessions of LC group showed a significant improvement in their scores. When comparing the three groups, statistical differences were found in the skill scores, with the BC group having the lowest. The overall cost per participant was highest for the LC group.Conclusion: This study identifies a learning curve for paracentesis with an SBML program. The LC group significantly improved their skills, comparable with the GF group’s performance. SBML focused on a learning curve ensured better skills acquisition than the “boot-camp method.”

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Simulation training in pancreatico-jejunostomy using an inanimate biotissue model improves the technical skills of hepatobiliary-pancreatic surgical fellows

PLoS ONE ◽

10.1371/journal.pone.0244915 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0244915

Author(s):

Ryuji Yoshioka ◽

Hiroshi Imamura ◽

Hirofumi Ichida ◽

Yu Gyoda ◽

Tomoya Mizuno ◽

...

Keyword(s):

Learning Curve ◽

Simulation Training ◽

Surgical Simulation ◽

Technical Skills ◽

Summary Score ◽

The Other ◽

Actual Operating ◽

Technical Proficiency ◽

Time Required ◽

Safe Performance

Background Technical proficiency of the operating surgeons is one of the most important factors in the safe performance of pancreaticoduodenectomy. The objective of the present study was to investigate whether surgical simulation of pancreatico-jejunostomy (PJ) using an inanimate biotissue model could improve the technical proficiency of hepato-biliary pancreatic (HBP) surgical fellows. Methods The biotissue drill consisted of sewing biotissues to simulate PJ. The drill was repeated a total of five times by each of the participant surgical fellows. The improvement of the surgical fellows’ technical proficiency was evaluated by the supervisor surgeons using the Objective Structured Assessment of Technical Skills (OSATS) scale. Results Eight HBP surgical fellows completed all the 5 drills. Both the OSATS 25 score and OSATS summary score, assessed by the two supervisor surgeons, improved steadily with repeated execution of the PJ drill. The average OSATS score, as assessed by both the supervisor surgeons, improved significantly from the first to the final drill, with a P value of 0.003 and 0.014 for the assessment by the two surgeons, respectively. On the other hand, no chronological alteration was observed in time of procedure (P = 0.788). Conclusion Repeated execution of a biotissue PJ drill improved the HBP surgical fellows’ technical proficiency, as evaluated by OSATS. The present study lends support to the evidence that simulation training can contribute to shortening of the time required to negotiate the learning curve for the technique of PJ in the actual operating room.

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Skills Acquisition and Labour Market Opportunities for Graduates of Higher Education in Cameroon

African Journal of Development Studies (formerly AFFRIKA Journal of Politics, Economics and Society) ◽

10.31920/2634-3649/2021/v11n1a12 ◽

2021 ◽

Vol 11 (1) ◽

pp. 249-272

Author(s):

Sophie Ekume Etomes

Keyword(s):

Social Skills ◽

Labour Market ◽

Quantitative Data ◽

Technical Skills ◽

Positive Sign ◽

Skills Acquisition ◽

Entrepreneurial Skills ◽

Market Opportunities ◽

Competency Based ◽

Conceptual Skills

This study examines skills acquisition and labour market opportunities for graduates of public universities in Cameroon. Four research objectives and one hypothesis guided the study which examined the extent to which social, technical, conceptual and entrepreneurial skills acquired by graduates enhance their employability. The population of the study consisted of 79 graduates with bachelor’s degree, including 29 employers. Statistical Package for the Social Sciences (SPSS 2.3) was used to analyse the quantitative data. The quantitative data were analysed using frequency count and percentages while the qualitative data were analysed using a thematic approach with the aid of key concepts/themes, groundings and sampled quotation. The Spearman’s rho test was adopted for the study in testing the hypothesis. Results reveal a significant relationship between skills acquisition and labour market opportunities for graduates (P<0.05). The positive sign of the coefficient value for each of the skills to labour market opportunities (social skills .132*, technical skills .241*, conceptual skills .241*, entrepreneurial skills .393**) shows a positive correlation with labour market opportunities; that is, graduates stand a better chance to be employed when they possess the above-mentioned skills with entrepreneurial skills contributing more, followed by conceptual and technical skills with higher correlation values and lastly social skills. It was recommended that HE institutions should design competency-based curriculum for all programmes to enable graduates acquire the relevant skills. A closer engagement of universities and employers is recommended for better skills productivity.

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