scholarly journals Is robotic pancreaticoduodenectomy for you? Defying the steep learning curve!

HPB ◽  
2016 ◽  
Vol 18 ◽  
pp. e101
Author(s):  
M.U. Butt ◽  
H. Osman ◽  
H. Aderianwalla ◽  
R. Hellums ◽  
S. Furlough ◽  
...  
Keyword(s):  
Learning Curve ◽  
Steep Learning Curve ◽  
Robotic Pancreaticoduodenectomy

scholarly journals Current Status of Laparoscopic and Robotic Pancreatic Surgery and Its Adoption in Singapore

2020 ◽  
Vol 49 (6) ◽  
pp. 377-383
Author(s):  
Brian KP Goh ◽  
Roxanne Y Teo
Keyword(s):  
Learning Curve ◽  
Pancreatic Surgery ◽  
Current Status ◽  
Current Evidence ◽  
Perioperative Outcomes ◽  
Open Approach ◽  
Steep Learning Curve ◽  
Laparoscopic Pancreatic Surgery ◽  
Randomised Controlled ◽  
Robotic Pancreaticoduodenectomy

Despite the potential clinical advantages offered by laparoscopic pancreatic surgery (LPS), the main obstacle to its widespread adoption is the technically demanding nature of the procedure and its steep learning curve. LPS and robotic pancreatic surgery (RPS) have been proven to result in superior short-term perioperative outcomes and equivalent long-term oncological outcomes compared to the conventional open approach, with the caveat that they are performed by expert surgeons who have been trained to perform such procedures. The primary challenge faced by most pancreatic surgeons is the steep learning curve associated with these complex procedures and the need to undergo surgical training, especially with regards to laparoscopic and robotic pancreaticoduodenectomy. Current evidence suggests that RPS may help to shorten the lengthy learning curve required for LPS. More robust evidence—in the form of large randomised controlled trials—is needed to determine whether LPS and RPS can be safely adopted universally. Ann Acad Med Singapore 2020;49:377–83 Key words: Laparoscopic pancreatectomy, Laparoscopic pancreaticoduodenectomy, Minimally invasive pancreatic surgery, Robotic pancreatectomy, Robotic pancreaticoduodenectomy

scholarly journals Laparoscopic pectopexy: the learning curve and comparison with laparoscopic sacrocolpopexy

2021 ◽  
Author(s):  
Fei Chi Chuang ◽  
Yu Min Chou ◽  
Ling Ying Wu ◽  
Tsai Hwa Yang ◽  
Wen Hsin Chen ◽  
...  
Keyword(s):  
Learning Curve ◽  
Operation Time ◽  
Synthetic Mesh ◽  
Laparoscopic Sacrocolpopexy ◽  
Apical Prolapse ◽  
Steep Learning Curve ◽  
Surgical Method ◽  
Surgical Field ◽  
Uncontrolled Bleeding

Abstract Introduction and hypothesis In addition to laparoscopic sacrocolpopexy (LS), laparoscopic pectopexy (LP) is a novel surgical method for correcting apical prolapse. The descended cervix or vaginal vault is suspended with a synthetic mesh by fixing the bilateral mesh ends to the pectineal ligaments. This study was aimed at developing a learning curve for LP and to compare it with results with LS. Methods We started laparoscopic/robotic pectopexy in our department in August 2019. This retrospective study included the initial 18 consecutive women with apical prolapse receiving LP and another group undergoing LS (21 cases) performed by the same surgeon. The medical and video records were reviewed. Results The age was older in the LP group than in the LS group (65.2 vs 53.1 years). The operation time of LP group was significantly shorter than that of the LS group (182.9 ± 27.2 vs 256.2 ± 45.5 min, p < 0.001). The turning point of the LP learning curve was observed at the 12th case. No major complications such as bladder, ureteral, bowel injury or uncontrolled bleeding occurred in either group. Postoperative low back pain and defecation symptoms occurred exclusively in the LS group. During the follow-up period (mean 7.2 months in LP, 16.2 months in LS), none of the cases had recurrent apical prolapse. Conclusions Laparoscopic pectopexy is a feasible surgical method for apical prolapse, with a shorter operation time and less postoperative discomfort than LS. LP may overcome the steep learning curve of LS because the surgical field of LP is limited to the anterior pelvis and avoids encountering the critical organs.

Learning curves for transradial access versus transfemoral access in diagnostic cerebral angiography: a case series

2021 ◽  
pp. neurintsurg-2021-017460
Author(s):  
Michael K Tso ◽  
Gary B Rajah ◽  
Rimal H Dossani ◽  
Michael J Meyer ◽  
Matthew J McPheeters ◽  
...  
Keyword(s):  
Learning Curve ◽  
Case Series ◽  
Learning Curves ◽  
Fluoroscopy Time ◽  
Access Site ◽  
Steep Learning Curve ◽  
Transradial Access ◽  
Primary Operator ◽  
Technical Proficiency ◽  
Over Time

BackgroundThe perception of a steep learning curve associated with transradial access has resulted in its limited adoption in neurointervention despite the demonstrated benefits, including decreased access-site complications.ObjectiveTo compare learning curves of transradial versus transfemoral diagnostic cerebral angiograms obtained by five neurovascular fellows as primary operator.MethodsThe first 100–150 consecutive transradial and transfemoral angiographic scans performed by each fellow between July 2017 and March 2020 were identified. Mean fluoroscopy time per artery injected (angiographic efficiency) was calculated as a marker of technical proficiency and compared for every 25 consecutive procedures performed (eg, 1–25, 26–50, 51–75).ResultsWe identified 1242 diagnostic angiograms, 607 transradial and 635 transfemoral. The radial cohort was older (64.3 years vs 62.3 years, p=0.01) and demonstrated better angiographic efficiency (3.4 min/vessel vs 3.7 min/vessel, p=0.03). For three fellows without previous endovascular experience, proficiency was obtained between 25 and 50 transfemoral angiograms. One fellow achieved proficiency after performing 25–50 transradial angiograms; and the two other fellows, in <25 transradial angiograms. The two fellows with previous experience had flattened learning curves for both access types. Two patients experienced transient neurologic symptoms postprocedure. Transradial angiograms were associated with significantly fewer access-site complications (3/607, 0.5% vs 22/635, 3.5%, p<0.01). Radial-to-femoral conversion occurred in 1.2% (7/607); femoral-to-radial conversion occurred in 0.3% (2/635). Over time, the proportion of transradial angiographic procedures increased.ConclusionTechnical proficiency improved significantly over time for both access types, typically requiring between 25 and 50 diagnostic angiograms to achieve asymptomatic improvement in efficiency. Reduced access-site complications and decreased fluoroscopy time were benefits associated with transradial angiography.

Sustainability, Ethics and Education

2014 ◽  
pp. 424-440
Author(s):  
Tehmina Khan
Keyword(s):  
Learning Curve ◽  
Sustainability Education ◽  
Accounting Education ◽  
Steep Learning Curve ◽  
Body Of Knowledge ◽  
Sustainability Ethics ◽  
Ethics Course ◽  
Royal Melbourne Institute ◽  
Institute Of Technology ◽  
Development Of Students

Accounting education has faced limitations as a highly technical and discipline-specific body of knowledge. The case presented in this chapter demonstrates and reflects on an attempt at incorporating the study of sustainability-related accounting knowledge through multiple forms of delivery and assessment. Sustainability-related material that draws from business, accounting and ethics' perspectives was included in an accounting ethics course for accounting majors at Royal Melbourne Institute of Technology (RMIT) University in Melbourne, Australia. This pedagogy has encouraged the development of students' soft skills including their emotional intelligence. Sustainability education has been found as engaging and thought provoking, albeit involving a steep learning curve for students as far as knowledge and awareness are concerned. It has allowed for the promotion of multiple and broader perspectives and education on key sustainability-related concerns, from a range of angles including ethics and accounting frameworks for sustainability as well as multidisciplinary approaches to sustainability and business.

Virtual Learning Environments

2011 ◽  
pp. 62-74 ◽  
Author(s):  
Mitzi P. Trahan ◽  
Nan B. Adams ◽  
Susan Dupre
Keyword(s):  
Distance Learning ◽  
Learning Curve ◽  
Learning Environments ◽  
Real Life ◽  
Virtual Learning ◽  
Learning Opportunities ◽  
Virtual Learning Environments ◽  
Development Model ◽  
Steep Learning Curve ◽  
Barriers To Access

The growing experimentation with multi-user virtual environments for educational purposes demands rigorous examination of all aspects of these digital worlds. While their use appears to enhance and expand traditional distance learning, educators acknowledge that barriers to access remain, including a steep learning curve for orienting users to MUVE navigation and functionality. The application of Adams’s Knowledge Development Model for Virtual Learning Environments provides a framework for the design of in-world learning opportunities and activities, many of which tend to mirror pedagogical best-practices in Real Life (RL).

Mixed Realities

2012 ◽  
pp. 209-216 ◽  
Author(s):  
Daniel Rolf
Keyword(s):  
Learning Curve ◽  
Mobile Phone ◽  
Mixed Reality ◽  
Training And Education ◽  
Steep Learning Curve ◽  
Technological Support ◽  
Specific Technology ◽  
Innovative Approaches

Teaching with technological support brings its own set of problems, some of them technical and others social in nature. Familiarity with specific technology can enhance the teacher’s, the practicing professional’s and the student’s experience, otherwise each will face a potentially steep learning curve before being able to achieve the best outcomes. We live in a time of rapid technical advancement bringing us new and ever more exciting opportunities at ever decreasing cost. In this chapter the authors will look at technologies which present opportunities in the virtuality continuum, from the ubiquitous mobile phone to more specialized augmented and mixed reality systems. They show examples from various fields of endeavor in an attempt to whet the appetite of those interested in new and innovative approaches to training and education.

Collaborative Work and Learning with Large Amount of Graphical Content in a 3D Virtual World Using Texture Generation Model Built on Stream Processors

2014 ◽  
Vol 5 (2) ◽  
pp. 18-40 ◽  
Author(s):  
Andrey Smorkalov ◽  
Mikhail Fominykh ◽  
Mikhail Morozov
Keyword(s):  
Learning Curve ◽  
Virtual Worlds ◽  
Virtual World ◽  
Collaborative Work ◽  
Three Dimensional ◽  
Generation Model ◽  
Network Resources ◽  
Steep Learning Curve ◽  
Technical Requirements ◽  
Texture Generation

In this paper, the authors address the challenges of applying three-dimensional virtual worlds for collaborative work and learning, such as steep learning curve and the demands for computational and network resources. We developed a texture generation model utilizing stream processors that allows displaying large amount of meaningful content in virtual worlds, reducing the technical requirements and allowing convenient tools that simplify the use of the technology, and therefore, improve the negative learning curve effect. The authors present original methods of generating images and several tools implemented in vAcademia virtual world. A tool called Sticky Notes is presented in detail as an example. In addition, the authors provide the evaluation of the suggested model and the first result of the user evaluation.

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