TELEMENTORING IN TIMES OF COVID-19 FOR TRAINING IN GENERAL SURGERY

Abstract INTRODUCTION Telemedicine applied to surgery is called telementorization (TM). It allows remote assistance by expert surgeons to others with less experience in certain techniques, thus guaranteeing learning that overcomes the barriers of time and location without being associated with a higher rate of complications. The objective is to publicize the use of this type of technology in our surgical department, particularly needed with the current restrictions. MATERIAL AND METHODS In our center, the Proximie platform (www.proximie.com) is used as a tool for TM. It allows to remotely broadcast live procedures performed by expert surgeons, as well as to create a virtual library of our own procedures that can be used as study and teaching tool by residents. This platform transmits not only bidirectional image and sound, but it also allows the active participation of a remote assistant with interactive features that are projected directly on the screen of the local surgeon. RESULTS The Proximie platform is being used frequently (and more intensively during this time of greatest restrictions) in advanced colorectal surgeries, with TM by remote experts and in our department for the continuing training program for residents. It also offers the possibility of conducting multidisciplinary sessions and webinars with subsequent availability control online. CONCLUSIONS TM and digital platforms such as Proximie provide important benefits in the practical learning and training of surgeons, especially with the current restrictions, being a safe technique and a teaching tool to be exploited.

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261 Using Technology to Improve Inpatient Surgical Lists

British Journal of Surgery ◽

10.1093/bjs/znab134.393 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

A Gowda ◽

Z Chia ◽

T Fonseka ◽

K Smith ◽

S Williams

Keyword(s):

Quality Improvement ◽

Patient Care ◽

Junior Doctors ◽

Research Projects ◽

Point Scale ◽

Improvement Project ◽

Surgical Department ◽

Team Meetings ◽

And Training ◽

Multi Disciplinary Team

Abstract Introduction Every day in our surgical department; prior to our quality improvement project, Junior Doctors spent on average 3.26 clinical hours maintaining 5 surgical inpatient lists of different specialities with accessibility of lists rated as “neutral” based on a 5-point scale from difficult to easy. Our hospital previously had lists stored locally on designated computers causing recurrent difficulties in accessing and editing these lists. Method We used surveys sent to clinicians to collect data. Cycle 1: Surgical Assessment Units list on Microsoft Teams Cycle 2: Addition of surgical specialities and wards lists onto Microsoft Teams. Cycle 3 (current): expand the use of Microsoft Teams to other specialities. Results Utilising technology led to a 25% reduction in time spent on maintaining inpatient lists, to 2.46 hours a day, and an improvement in the accessibility of lists to “easy”. Across a year, this saves over 220 hours clinician hours which can be used towards patient care and training. Furthermore, use of Microsoft Teams has improved communication and patient care, in the form of virtual regional Multi-Disciplinary Team meetings and research projects. Conclusions Microsoft Teams is currently free to all NHS organisations in England so there is potential for these efficiency savings to be replicated nationwide.

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Live streaming of laparoscopic general surgery is a useful teaching tool

Bulletin of The Royal College of Surgeons of England ◽

10.1308/rcsbull.2018.144 ◽

2018 ◽

Vol 100 (3) ◽

pp. 144-148

Author(s):

JW O’Brien ◽

M Natarajan ◽

K Aryal

Keyword(s):

Medical Students ◽

General Surgery ◽

Live Streaming ◽

Teaching Tool

Results from a survey of medical students.

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Learning to Adapt in a Global Pandemic of COVID-19: Insights to Support Vocational Education and Training (VET) in Southern Africa

Southern African Journal of Environmental Education ◽

10.4314/sajee.v36i1.18 ◽

2021 ◽

Vol 36 ◽

Author(s):

Emmanuel Ojo ◽

Presha Ramsarup ◽

Nicola Jenkin

Keyword(s):

Vocational Education ◽

Adaptive Capacity ◽

Education And Training ◽

Local Communities ◽

Vocational Education And Training ◽

Small Scale ◽

Local Networks ◽

Digital Platforms ◽

Global Pandemic ◽

And Training

The COVID-19 pandemic impacted all education sectors significantly during the full global lockdown between March and June 2020, including the Vocational Education and Training (VET) sector. During this period, the authors jointly led nine researchers who were postgraduate students in six Southern African Development Community (SADC) countries (Botswana, Eswatini, Mozambique, South Africa, Zambia and Zimbabwe). Due to the restrictions during the lockdown, these nine researchers conducted a literature review and thirty interviews in local communities in these six SADC countries. This included both VET colleges as well as individuals in informal, small-scale and entrepreneurial activities. The authors refer to the qualitative data gathered by the interviews with these interviewees as ‘stories of adaptation’. In this paper we used these ‘stories of adaptation’ to explore the links between learning to adapt and expertise, and to consider how together these constructs offer insights into how VET can be strengthened to better support local communities.Two research questions were asked: (1) how do the notions of adaptive capacity and expertise as conceptual constructs help to understand vocational learning in a global pandemic? and (2) what insights can be drawn from the ‘stories of adaptation’ to strengthen the role of VET in local communities? Through a thematic analysis of the ‘stories of adaptation’, three key findings emerged: (1) capacity to adapt is a multi-level and multi-pronged construct; (2) use of digital platforms as well as local networks were key enabling mechanisms for adaptation; and, (3) learning and expertise are embedded in the capacity to adapt. Thus, we argue that building a responsive VET system for the SADC region is achievable by strengthening the nexus between learning, expertise and adaptive capacity. Keywords: adaptive capacity; expertise; global pandemic; vocational education

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Personalized Surgical Planning to Support Interventions and Training of Surgeons

Clinical Image-Based Procedures. From Planning to Intervention - Lecture Notes in Computer Science ◽

10.1007/978-3-642-38079-2_11 ◽

2013 ◽

pp. 83-90

Author(s):

Cristina Suárez-Mejías ◽

Gorka Gómez-Ciriza ◽

Purificación Gacto-Sánchez ◽

Tomás Gómez-Cía ◽

Carlos Parra-Calderón

Keyword(s):

Surgical Planning ◽

Training Of Surgeons ◽

And Training

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Understanding ACGME Scholarly Activity Requirements for General Surgery Programs in the Era of Single Accreditation and the Next Accreditation System

The American Surgeon ◽

10.1177/000313481808400201 ◽

2018 ◽

Vol 84 (2) ◽

pp. 40-43 ◽

Cited By ~ 3

Author(s):

Joseph J. Stella ◽

Donna L. Lamb ◽

Steven C. Stain ◽

Paula M. Termuhlen

Keyword(s):

Medical Education ◽

Graduate Medical Education ◽

General Surgery ◽

Scholarly Activity ◽

Accreditation System ◽

Graduate Medical ◽

Show Evidence ◽

Next Accreditation System ◽

Training Of Surgeons ◽

To Receive

Becoming compliant with the Accreditation Council for Graduate Medical Education (ACGME) requirements for scholarly activity and remaining compliant over time requires time and attention to the development of an environment of inquiry, which is reflected in detailed documentation submitted in program applications and annual updates. Since the beginning of the next accreditation system, all ACGME programs have been required to submit evidence of scholarly activity of both residents and faculty on an annual basis. Since 2014, American Osteopathic Association–accredited programs have been able to apply for ACGME accreditation under the Single Graduate Medical Education Accreditation initiative. The Residency Program Director, Chair, Designated Institutional Official, Faculty, and coordinator need to work cohesively to ensure compliance with all program requirements, including scholarly activity in order for American Osteopathic Association–accredited programs to receive Initial ACGME Accreditation and for current ACGME-accredited programs to maintain accreditation. Fortunately, there are many ways to show the type of scholarly activity that is required for the training of surgeons. In this article, we will review the ACGME General Surgery Program Requirements and definitions of scholarly activity. We will also offer suggestions for how programs may show evidence of scholarly activity.

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COMPETENCY AND TRAINING OF GENERAL SURGERY SPECIALIST REGISTRARS IN EMERGENCY UROLOGY

BJU International ◽

10.1111/j.1464-410x.2006.06243.x ◽

2006 ◽

Vol 98 (1) ◽

pp. 6-7 ◽

Cited By ~ 1

Author(s):

NIKESH THIRUCHELVAM ◽

ANDREW S. ADAMSON

Keyword(s):

General Surgery ◽

And Training

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Assessing resident performance and training of colonoscopy in a general surgery training program

Surgical Endoscopy ◽

10.1007/s00464-012-2660-2 ◽

2012 ◽

Vol 27 (5) ◽

pp. 1706-1710 ◽

Cited By ~ 7

Author(s):

William W. Hope ◽

W. Borden Hooks ◽

S. Nicole Kilbourne ◽

Ashley Adams ◽

Cyrus A. Kotwall ◽

...

Keyword(s):

Training Program ◽

General Surgery ◽

Resident Performance ◽

Surgery Training ◽

And Training ◽

General Surgery Training

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Deployment of a New CRRT/PIRRT Device during the COVID-19 Pandemic Emergency: Organizational Challenges and Implementation Results

Blood Purification ◽

10.1159/000511726 ◽

2020 ◽

pp. 1-9

Author(s):

Lenar T. Yessayan ◽

Michael Heung ◽

Francine A. Girard ◽

Salma Shaikhouni ◽

Balazs Szamosfalvi

Keyword(s):

Balance Control ◽

Training Session ◽

Virtual Training ◽

Organizational Challenges ◽

States Of Emergency ◽

Replacement Treatment ◽

Remote Training ◽

Remote Assistance ◽

Implementation Data ◽

And Training

Introduction: The coronavirus disease 2019 (COVID-19) pandemic led to increased demand nationwide for dialysis equipment, including supplies and machines. To meet the demand in our institution, our surge plan included rapid mobilization of a novel continuous renal replacement treatment (CRRT) machine named SAMI. The SAMI is a push-pull filtration enhanced dialysis machine that can conjugate extremely high single-pass solute removal efficiency with very precise fluid balance control. Material and Methods: Machine assembly was conducted on-site by local biomedical engineers with remote assistance by the vendor. One 3-h virtual training session of 3 dialysis nurses was conducted before SAMI deployment. The SAMI was deployed in prolonged intermittent replacement therapy (PIRRT) mode to maximize patients covered per machine per day. Live on-demand vendor support was provided to troubleshoot any issues for the first few cases. After 4 weeks of the SAMI implementation, data on treatments with the SAMI were collected, and a questionnaire was provided to the nurse trainees to assess device usability. Results: On-site installation of the SAMI was accomplished with remote assistance. Delivery of remote training was successfully achieved. 23 PIRRT treatments were conducted in 10 patients. 7/10 of patients had COVID-19. The median PIRRT dose was 50 mL/kg/h (IQR [interquartile range] 44 – 62 mL/kg/h), and duration of the treatment was 8 h (IQR 6.3 – 8 h). Solute control was adequate. The user response was favorable to the set of usability questions involving user interface, on-screen instructions, machine setup, troubleshooting, and the ease of moving the machine. Conclusion: Assembly of the SAMI and training of nurses remotely are possible when access to vendor employees is restricted during states of emergency. The successful deployment of the SAMI in our institution during the pandemic with only 3-h virtual training supports that operating the SAMI is simple and safe.

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Repurposing a Small Community Hospital Surgical Residency Program in an Epicenter of the COVID-19 Pandemic

The American Surgeon ◽

10.1177/0003134820956355 ◽

2020 ◽

pp. 000313482095635

Author(s):

Melissa K. Meghpara ◽

Amulya Alapati ◽

Bhavana Devanabanda ◽

Martine A. Louis ◽

Neil Mandava

Keyword(s):

Electronic Medical Records ◽

General Surgery ◽

Medical Records ◽

Community Hospital ◽

Small Community ◽

Hemodialysis Catheter ◽

Surgical Department ◽

Surgical Residents ◽

Lumen Catheter ◽

Small Community Hospital

Background COVID-19 put a stop to the operative experience of surgical residents, leaving reassignment of the team, to the frontlines. Each program has adapted uniquely; we discuss how our surgical education changed in our hospital. Study Design A retrospective review of changes in general surgery cases, bedside procedures, and utilization of residents before and during the pandemic. Procedures were retrieved from electronic medical records. Operating room (OR) cases 1 month before and 5 weeks after the executive order were collected. Triple lumen catheter (TLC), temporary hemodialysis catheter (HDC), and pneumothorax catheter (PC) insertions by surgical residents were recorded for 5 weeks. Results Before the pandemic, an average of 27.9 cases were done in the OR, with an average of 10.1 general surgery cases. From March 23 to April 30, 2020, the average number of cases decreased to 5.1, and general surgery cases decreased to 2.2. Elective, urgent, and emergent cases represented 83%, 14.6%, and 2.4% prior to the order and 66.7%, 15.1%, and 18.2%, respectively, after the order. Bedside procedures over 5 weeks totaled to 153, 93 TLCs, 39 HDCs, and 21 PCs. Conclusion Repurposing the surgical department for the concerns of the pandemic has involved all surgical staff. We worked with other departments to allocate our team to areas of need and re-evaluated daily. The strengths of our team to deliver care and perform many bedside procedures allowed us to meet the demands posed by this disease while remaining as a cohesive unit.

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