scholarly journals P.102 Simulation-based training for surgical instrument recognition

2017 ◽  
Vol 44 (S2) ◽  
pp. S39-S40
Author(s):  
DB Clarke ◽  
M Hong ◽  
N Kureshi ◽  
L Fenerty ◽  
G Thibault-Halman ◽  
...  
Keyword(s):  
Simulation Training ◽  
Surgical Simulation ◽  
Surgical Instruments ◽  
Perioperative Nurses ◽  
Instrument Recognition ◽  
Simulation Based ◽  
Group A ◽  
Repeated Use ◽  
Instrument Identification ◽  
Group B

Background: Surgical simulation training offers trainees the opportunity to practice surgical skills before entering the operating room. The objectives of this study were to determine the effect of simulation for learning instruments for burr hole surgery and whether this learning is translated to real instrument recognition with retention. Methods: Randomized trials of PGY1 neurosurgery residents and perioperative nurses were conducted, using PeriopSim™ for instrument recognition, as well as real instruments. Group A performed simulation tasks using PeriopSim™ prior to identifying real instruments, whereas Group B identified real instruments prior to performing simulation tasks. Nurses’ recall was assessed at seven days. Results: Sixteen residents and 100 nurses were recruited. All participants showed significant overall improvement in their scores for simulated tasks. Group A demonstrated enhanced accuracy and speed of identifying real instruments compared with Group B (p<0.001). Furthermore, knowledge recall testing at one week demonstrated retained learning, shown by 97% accuracy in instrument identification. Conclusions: Our results demonstrate that recognition of surgical instruments improves with repeated use of the PeriopSim™ platform. Instrument knowledge acquired through simulation training results in improved identification and retained recognition of real instruments.

Knowledge transfer and retention of simulation-based learning for neurosurgical instruments: a randomised trial of perioperative nurses

2020 ◽  
pp. bmjstel-2019-000576
Author(s):  
David B Clarke ◽  
Alena I Galilee ◽  
Nelofar Kureshi ◽  
Murray Hong ◽  
Lynne Fenerty ◽  
...  
Keyword(s):  
Nursing Education ◽  
Simulation Training ◽  
Controlled Trial ◽  
Randomised Trial ◽  
Control Group ◽  
Perioperative Nurses ◽  
Instrument Recognition ◽  
Simulation Based ◽  
Group A ◽  
Group B

IntroductionPrevious studies have shown that simulation is an acceptable method of training in nursing education. The objectives of this study were to determine the effectiveness of tablet-based simulation in learning neurosurgical instruments and to assess whether skills learnt in the simulation environment are transferred to a real clinical task and retained over time.MethodsA randomised controlled trial was conducted. Perioperative nurses completed three consecutive sessions of a simulation. Group A performed simulation tasks prior to identifying real instruments, whereas Group B (control group) was asked to identify real instruments prior to the simulation tasks. Both groups were reassessed for knowledge recall after 1 week.ResultsNinety-three nurses completed the study. Participants in Group A, who had received tablet-based simulation, were 23% quicker in identifying real instruments and did so with better accuracy (93.2% vs 80.6%, p<0.0001) than Group B. Furthermore, the simulation-based learning was retained at 7 days with 97.8% correct instrument recognition in Group A and 96.2% in Group B while maintaining both speed and accuracy.ConclusionThis is the first study to assess the effectiveness of tablet-based simulation training for instrument recognition by perioperative nurses. Our results demonstrate that instrument knowledge acquired through tablet-based simulation training results in improved identification and retained recognition of real instruments.

Video Tutorials Increase Precision in Minimally Invasive Surgery Training – a Prospective Randomised Trial and Follow-up Study

2018 ◽  
Vol 144 (02) ◽  
pp. 153-162
Author(s):  
Michael Thomaschewski ◽  
Hamed Esnaashari ◽  
Anna Höfer ◽  
Lotta Renner ◽  
Claudia Benecke ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Randomised Trial ◽  
Prospective Randomised Trial ◽  
Simulation Based ◽  
Video Tutorials ◽  
Group A ◽  
Group B

Abstract Background Simulation-based practice has become increasingly important in minimally invasive surgery (MIS) training. Nevertheless, personnel resources for demonstration and mentoring simulation-based practice are limited. Video tutorials could be a useful tool to overcome this dilemma. However, the effect of video tutorials on MIS training and improvement of MIS skills is unclear. Methods A prospective randomised trial (n = 24 MIS novices) was conducted. A video-trainer with three different tasks (#1 – 3) was used for standardised goal-directed MIS training. The subjects were randomised to two groups with standard instructional videos (group A, n = 12) versus comprehensive video tutorials for each training task watched at specific times of repetition (group B, n = 12). Performance was analysed using the MISTELS score. At the beginning and following the curriculum, an MIS cholecystectomy (CHE) was performed on a porcine organ model and analysed using the GOALS score. After 18 weeks, participants performed 10 repetitions of tasks #1 – 3 for follow-up analysis. Results More participants completed tasks #1 and #2 in group B (83.3 and 75%) than in group A (66.7 and 50%, ns). For task #2, there was a significant improvement in precision in group B (p < 0.001). For the entire cohort, the GOALS-Scores were 12.9 before and 18.9 after the curriculum (p < 0.001), with no significant difference between groups. Upon follow-up, 84.2% (task#1), 26.3% (task#2) and 100% (task#3) of MIS novices were able to reach the defined goals (A vs. B ns). There was a trend for a better MISTELS score in group B upon follow-up. Conclusions Standardised comprehensive video tutorials watched frequently throughout practice can significantly improve precision in MIC training. This aspect should be incorporated in MIS training.

Study of Nimbadi Dhoopa in the management of Dushtavrana

2018 ◽  
Vol 6 (3) ◽  
Author(s):  
Jayshree K. Saraf ◽  
Naimish Saraf ◽  
Jayashree Saraf
Keyword(s):  
Control Group ◽  
Trial Group ◽  
Group A ◽  
Repeated Use ◽  
Healing Wounds ◽  
Bed Sores ◽  
Fast Healing ◽  
Group B ◽  
Micro Organisms ◽  
Diabetic Wounds

Wounds and wound infections have become a common entity which is faced by different physicians and surgeons. Chronic, non-healing wounds like Diabetic wounds, Varicose ulcers, bed sores have become a challenge to the medical fraternity. Antibiotics are efficient in killing and controlling the growth of micro-organisms by their bactericidal and bacteriostatic actions but due to the repeated use of antibiotics, organisms have become resistant to their action. Vrana Dhoopana  described in Ayurveda helps in cleaning and disinfecting the wound and also promotes fast healing of wounds1.In this study, 60 patients were randomly selected and divided in two groups. Vrana dhoopana followed by dressing with vrana shodhana taila was administered to the 30 patients in Group A(Trial group) and only dressing with vrana shodhana taila was done in the 30 patients in Group B (Control group).Significant results were obtained in Trial group where the wound was subjected to Nimbadi Dhoopa. It means we can conclude that Vrana Dhoopana  with Nimbadi Dhoopa 2has significant results on Dushta Vrana.3 It helps in minimizing the infection present in the wound thus, having Rakshoghna4 effect on it.

scholarly journals ROLE OF ARKA TAILA AND BAAKUCHIKADYAM CHURNA ON VICHARCHIKA: A RANDOMIZED CONTROL TRIAL

2021 ◽  
pp. 1-7
Author(s):  
Sheetal Yadav ◽  
Anita Sharma ◽  
Dinesh C. Chouhan
Keyword(s):  
Atopic Dermatitis ◽  
Skin Diseases ◽  
Living Condition ◽  
Chemical Additives ◽  
External Application ◽  
Number Of Patients ◽  
Group A ◽  
Repeated Use ◽  
Group B

In the present era skin diseases like atopic dermatitis/eczema get a suitable atmosphere especially in developing countries like India, due to unhygienic living condition, Disturbed life style, Polluted environment and repeated use of chemical additives. This type of diseases make a person feels much more humiliation in society because no one wants to touch them, forbidden by everyone, in that conditions person leads to lack of confidence and feels underestimated mentally as well as physically. Due to this life disturbing condition this disease was chosen for the study. The study was conducted in 30 clinically diagnosed patients of Vicharchika (Atopic Dermatitis) and randomly divided in to two groups, namely group A and group B. Each group has 15 number of patients. Group A is treated with Arka Taila (external application) used twice in a day for 45 days along with Baakuchikadyam Churna for internal consumption (3-6 grams). Group B is treated with Cutis Capsule (2 Capsules) twice a day orally along with external application of Cutis Cream as required for 45 days.

A Comparative Assessment of Novel Mini-Laparoscopic Tools

2016 ◽  
Vol 24 (1) ◽  
pp. 35-41 ◽  
Author(s):  
Emily D. Dorian ◽  
Francis J. DeAsis ◽  
Brittany Lapin ◽  
Robert Amesbury ◽  
Ryota Tanaka ◽  
...  
Keyword(s):  
Surgical Simulation ◽  
Rubber Band ◽  
Invasive Technique ◽  
Laparoscopic Instruments ◽  
Institutional Review ◽  
Standard Laparoscopy ◽  
Group A ◽  
Group B ◽  
Laparoscopic Tools ◽  
Tissue Trauma

Background: Mini-laparoscopy, or needlescopy, is an emerging minimally invasive technique that aims to improve on standard laparoscopy in the areas of tissue trauma, pain, and cosmesis. The objective of this study was to determine if there was a difference in functionality between 2 novel mini-laparoscopic instruments when compared to standard laparoscopic tools. Differences were assessed in a simulated surgical environment. Methods: Twenty participants (5 novices, 10 intermediate, 5 expert) were recruited for this institutional review board–approved study in a surgical simulation training center. Group A tools were assembled intracorporeally, and Group B tools were assembled extracorporeally. Using standard laparoscopic graspers, mini-laparoscopic graspers, or a combination of both, each participant performed 3 basic laparoscopic training tasks: a Peg Transfer, Rubber Band Stretch, and Tootsie Roll Unwrapping. Following each round of tasks, participants completed a survey evaluating the mini-laparoscopic graspers with respect to standard laparoscopic graspers. Data were analyzed using Kruskal-Wallis test with Dunn’s test for post hoc comparisons. Results: When comparing task times, both mini tools performed at the level of standard laparoscopic graspers in all participant groups. Group A tools were quicker to assemble and disassemble versus Group B tools. According to posttask surveys, all participant groups indicated that both sets of mini-laparoscopic graspers were comparable to the standard graspers. Conclusion: In a nonclinical setting, mini-laparoscopic instruments perform at the level of standard laparoscopic tools. Based on these results, clinical trials would be a reasonable next step in assessing feasibility and safety.

scholarly journals Simulation Training in Minimally Invasive Direct Coronary Artery Bypass Grafting

2020 ◽  
Vol 23 (6) ◽  
pp. E774-E780
Author(s):  
Song Wu ◽  
Yuan-hao Fu ◽  
Hong Zhao ◽  
Yun-peng Ling
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Minimally Invasive ◽  
Coronary Artery Bypass ◽  
Simulation Training ◽  
Artery Bypass ◽  
Simulator Training ◽  
Bypass Grafting ◽  
Group A ◽  
Group B

Background: To evaluate the effect of minimally invasive direct coronary artery bypass (MIDCAB) simulator for cardiac residency training. Methods: A total of 26 resident surgeons who had never trained for coronary artery anastomosis participated in this training program. They received coronary artery anastomosis training on off-pump coronary artery bypass grafting (OPCAB) simulator for 15 h. After training, their performance of anastomosis was evaluated on the OPCAB simulator according to 12 items and a 5-point global rating scale. Based on the total score of assessment, those with an individual score of 12-36 formed group A, while group B was composed of the remaining trainees. The two groups then received another 15 h coronary artery anastomosis training on the MIDCAB simulator, and the performance was assessed. Results: Trainees improved their performance of coronary artery anastomosis after training on the OPCAB simulator. Group A was composed of 7 trainees with an individual with a total score of 12–36 points and group B was composed of the remaining 19 trainees. After MIDCAB simulator training, significant differences were noted in the pre- and post-training values in the A group (P < .001), and the assessment value of group A was significantly better than those of group B (P < .05). No significant difference was detected between pre- and post-training values in group B after MIDCAB simulator training (P > .05). Conclusion: We concluded that trainees who performed well in OPCAB simulation training can also perform better in MIDCAB, and our designed MIDCAB simulator was useful for residency training.

Bent Subcutaneous Peritoneal Catheter Shape for Regular Dialysis Treatment in Children

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 263-267 ◽  
Author(s):  
Klaus-Eugen Bonzel ◽  
Bernhard Lettgen ◽  
Martin Bald ◽  
Ludwig Kleine ◽  
Jochen Erhard
Keyword(s):  
The Body ◽  
Surgical Instruments ◽  
Dialysis Treatment ◽  
Tunnel Infection ◽  
Upward Direction ◽  
Severe Peritonitis ◽  
Group A ◽  
Regular Dialysis Treatment ◽  
Subcutaneous Tunnel ◽  
Group B

A permanent bowing of the subcutaneous part of the Tenckhoff-type catheter (bent neck -Qulnton, and swan neck -Accurate Surgical Instruments) enables the catheter to turn from an upward direction of the subcutaneous tunnel to a downward direction by a smooth 160°-180° bend creating a downward skin exit° We have used this catheter shape In combination whh a colled Intra-abdominal edge. Two sizes are available for children° We use 2 cuffs and glue them ourselves according to the body size. In this study we compare the durability of the traditional subcutaneously straight catheter In 8 children aged 0.1-12.6 years (Group A) whh the bent shaped catheter In 8 children aged 3°7–15°8 years (Group B)° Median duration of function was 10°5 (2–34) and 8 (3–36) months, respectively; Frequency of complications was equal In both groups: peritonitis episodes 0°69/year in Group A and 0°53/year in Group B; tunnel Infection 0.16 vs 0°11/year; skin exit infection 0°54 vs 0.53/year; noninfectious complications 0°16 vs 0°32/year; mean number of catheters used was 1°0 vs 1°1/treatment years treatment had to be terminated in some patients: kidney transplantation 5, kidney recovery 1, severe peritonitis 1. The bent subcutaneous catheter shape did not show any medical or technical disadvantage compared with the straight type, but the downward directed catheter skin exit can be covered Invisibly under bikini or bermuda shorts which means aesthetic and social advantage. Whether the downward drainage of secretes and cell detritus Influences the rate of tunnel Infection positively cannot be answered to date.

Additional simulation training: does it affect students’ knowledge acquisition and retention?

2018 ◽  
Vol 5 (3) ◽  
pp. 140-143 ◽  
Author(s):  
Dario Cecilio-Fernandes ◽  
Carolina Felipe Soares Brandão ◽  
Davi Lopes Catanio de Oliveira ◽  
Glória Celeste V Rosário Fernandes ◽  
René A Tio
Keyword(s):  
Knowledge Acquisition ◽  
Simulation Training ◽  
Training Group ◽  
Repeated Measure ◽  
Clinical Rotation ◽  
Traditional Curriculum ◽  
Emergency Situations ◽  
Group A ◽  
The Difference ◽  
Group B

IntroductionTeaching medical skills during clinical rotation is a complex challenge, which often does not allow students to practise their skills. Nowadays, the use of simulation training has increased to teach skills to medical students. However, transferring the learnt skills from one setting to the other is challenging. In this study, we investigated whether adding a simulation training before the clinical rotation would improve students’ acquisition and retention of knowledge.MethodsTwo subsequent cohorts were compared. Group A followed the traditional curriculum without additional simulation training. Group B attended an additional simulation training, in which history taking, physical examination and procedures for the primary survey in emergency situations were taught. Both groups answered the same knowledge test before entering their clinical rotation and after 6 months. To analyse students’ scores over time, we conducted a repeated measure analysis of variance. To investigate the difference between knowledge, we conducted a t-test.ResultsGroup B scored significantly higher in both tests and all subscores, except in the Trauma topic in the first measurement point. Students in group A showed decay in knowledge whereas group B showed an increase in knowledge.ConclusionsAdding a simulation training, before students entered their clinical rotation, improves students’ knowledge acquisition and retention compared with those who did not receive the additional simulation training.

An ultrastructural study of sertoli cells in two geographically isolated populations of Aphanius dispar

1992 ◽  
Vol 50 (1) ◽  
pp. 548-549
Author(s):  
Taber A. Ba-Omar ◽  
Philip F. Prentis
Keyword(s):  
Ultrastructural Level ◽  
Uranyl Acetate ◽  
Freshwater Teleost ◽  
Isolated Populations ◽  
En Bloc ◽  
The North ◽  
Group A ◽  
Ultrathin Sections ◽  
Group B ◽  
Geographically Isolated

We have recently carried out a study of spermiogenic differentiation in two geographically isolated populations of Aphanius dispar (freshwater teleost), with a view to ascertaining variation at the ultrastructural level. The sampling areas were the Jebel Al Akhdar in the north (Group A) and the Dhofar region (Group B) in the south. Specimens from each group were collected, the testes removed, fixed in Karnovsky solution, post fixed in OsO, en bloc stained with uranyl acetate and then routinely processed to Agar 100 resin, semi and ultrathin sections were prepared for study.

Comparison of one-year prognosis of patients classified as chronic critical lower limb ischaemia according to TASC II or European consensus definition in the COPART cohort

VASA ◽  
2015 ◽  
Vol 44 (3) ◽  
pp. 0220-0228 ◽  
Author(s):  
Marion Vircoulon ◽  
Carine Boulon ◽  
Ileana Desormais ◽  
Philippe Lacroix ◽  
Victor Aboyans ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Critical Limb Ischaemia ◽  
Limb Ischaemia ◽  
Medical Group ◽  
Consensus Definition ◽  
Transcutaneous Oxygen ◽  
European Consensus ◽  
Group A ◽  
One Year ◽  
Group B

Background: We compared one-year amputation and survival rates in patients fulfilling 1991 European consensus critical limb ischaemia (CLI) definition to those clas, sified as CLI by TASC II but not European consensus (EC) definition. Patients and methods: Patients were selected from the COPART cohort of hospitalized patients with peripheral occlusive arterial disease suffering from lower extremity rest pain or ulcer and who completed one-year follow-up. Ankle and toe systolic pressures and transcutaneous oxygen pressure were measured. The patients were classified into two groups: those who could benefit from revascularization and those who could not (medical group). Within these groups, patients were separated into those who had CLI according to the European consensus definition (EC + TASC II: group A if revascularization, group C if medical treatment) and those who had no CLI by the European definition but who had CLI according to the TASC II definition (TASC: group B if revascularization and D if medical treatment). Results: 471 patients were included in the study (236 in the surgical group, 235 in the medical group). There was no difference according to the CLI definition for survival or cardiovascular event-free survival. However, major amputations were more frequent in group A than in group B (25 vs 12 %, p = 0.046) and in group C than in group D (38 vs 20 %, p = 0.004). Conclusions: Major amputation is twice as frequent in patients with CLI according to the historical European consensus definition than in those classified to the TASC II definition but not the EC. Caution is required when comparing results of recent series to historical controls. The TASC II definition of CLI is too wide to compare patients from clinical trials so we suggest separating these patients into two different stages: permanent (TASC II but not EC definition) and critical ischaemia (TASC II and EC definition).

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