scholarly journals 828 STITCH And B**** - A Novel Programme Combining Pastoral Support and Surgical Skills

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S Lochab ◽  
P Stanier ◽  
J Rooker
Keyword(s):  
Surgical Skills ◽  
Junior Doctors ◽  
Knot Tying ◽  
Orthopaedic Department ◽  
Safe Environment ◽  
Final Session ◽  
Participant Experience ◽  
Key Issues ◽  
Pastoral Support ◽  
Suturing Techniques

Abstract Aim Foundation training can be a challenging time for Junior doctors; though help and support is offered, it is not always taken up. This programme aims to create a safe environment to facilitate discussion and provide pastoral support alongside teaching them new surgical skills. Method Four different sessions were organised over the period of four months (August 2020 – November 2020) and FY1/FY2 doctors working in the Orthopaedic department at the GWH, Swindon were invited to attend. Each session focussed on assorted suturing techniques and knot tying. In addition, the facilitator directed conversation towards opportunities to discuss frustrations, challenges, queries as well as positive occurrences. A questionnaire was distributed at the final session to evaluate participant experience. Results 100% of attendees agreed or strongly agreed that they found their FY1 rotation challenging so far. 100% also scored 9/10 when asked how comfortable they were talking about concerns, worries or issues at these sessions. All the participants recorded ‘yes’ when asked if the session provided them with a listening ear, helpful advice, feeling supported, understanding/empathy and reassurance. 100% of the attendees scored that their confidence at suturing had improved (average: 4 points on a scale of 1-10). Conclusions Through these sessions, practical changes and improvements were achieved in the running of the Trauma and Orthopaedic department. Placement feedback was obtained, suggestions on things to improve or change and key issues were escalated to supervisors. There do not appear to be any similar programmes run that combine directed pastoral support and surgical skills teaching.

scholarly journals Development of an Interactive Remote Basic Surgical Skills Mini-Curriculum for Medical Students During the COVID-19 Pandemic

2021 ◽  
pp. 155335062110035
Author(s):  
Brian R Quaranto ◽  
Michael Lamb ◽  
John Traversone ◽  
Jinwei Hu ◽  
James Lukan ◽  
...  
Keyword(s):  
Medical Students ◽  
Confidence Score ◽  
Surgical Skills ◽  
Surgical Instruments ◽  
First Person ◽  
Knot Tying ◽  
Surgical Equipment ◽  
Person Perspective ◽  
Early Results ◽  
Suturing Techniques

Introduction. Teaching surgical skills has historically been a hands-on activity, with instructors and learners in close physical proximity. This paradigm was disrupted by the COVID-19 pandemic, requiring innovative solutions to surmount the challenges of teaching surgical skills remotely. In this work, we describe our institution’s path and early results of developing an interactive remote surgical skills course for medical students in the surgical clerkship. Methods. 31 third-year medical students were distributed a set of surgical equipment and 3D printed phone dock. Each participant completed a baseline questionnaire and underwent 3 structured interactive remote sessions on surgical instruments, knot tying, and suturing techniques. Students were instructed on sharing their first-person viewpoint and received real-time feedback on their knot tying and suturing techniques from the course instructor. Pre- and post-session surveys were conducted and analyzed. Results. All students were able to complete the remote surgical skills course successfully, as defined by visually demonstrating successful two-handed knot and simple suture techniques. Students’ aggregate confidence score in their knot tying ability (pretest mean 7.9, SD 0.7 vs posttest mean 9.7, SD 0.9, t-statistic −2.3, P = .03) and suturing ability (pretest mean 8.0, SD 1.3 vs posttest mean 13.8, SD 0.9 t-statistic −5.5, P < .001) significantly improved after the intervention. Qualitative feedback from the students underscored the utility of the first-person perspective for teaching surgical technique. Conclusion. This study demonstrates that remote teaching of knot tying and simple suturing to medical students can be effectively implemented using a remote learning curriculum that was well received by the learners.

Implementing Cognitive Training Into a Surgical Skill Course: A Pilot Study on Laparoscopic Suturing and Knot Tying

2018 ◽  
Vol 25 (6) ◽  
pp. 625-635 ◽  
Author(s):  
Benjamin De Witte ◽  
Franck Di Rienzo ◽  
Xavier Martin ◽  
Ye Haixia ◽  
Christian Collet ◽  
...  
Keyword(s):  
Cognitive Training ◽  
Spatial Orientation ◽  
Mental Workload ◽  
Surgical Skills ◽  
Training Period ◽  
Control Group ◽  
Surgical Skill ◽  
Knot Tying ◽  
Laparoscopic Suturing ◽  
Skill Group

Mini-invasive surgery—for example, laparoscopy—has challenged surgeons’ skills by extending their usual haptic space and displaying indirect visual feedback through a screen. This may require new mental abilities, including spatial orientation and mental representation. This study aimed to test the effect of cognitive training based on motor imagery (MI) and action observation (AO) on surgical skills. A total of 28 postgraduate residents in surgery took part in our study and were randomly distributed into 1 of the 3 following groups: (1) the basic surgical skill, which is a short 2-day laparoscopic course + MI + AO group; (2) the basic surgical skill group; and (3) the control group. The MI + AO group underwent additional cognitive training, whereas the basic surgical skill group performed neutral activity during the same time. The laparoscopic suturing and knot tying performance as well as spatial ability and mental workload were assessed before and after the training period. We did not observe an effect of cognitive training on the laparoscopic performance. However, the basic surgical skill group significantly improved spatial orientation performance and rated lower mental workload, whereas the 2 others exhibited lower performance in a mental rotation test. Thus, actual and cognitive training pooled together during a short training period elicited too high a strain, thus limiting potential improvements. Because MI and AO already showed positive outcomes on surgical skills, this issue may, thus, be mitigated according to our specific learning conditions. Distributed learning may possibly better divide and share the strain associated with new surgical skills learning.

From Music to Medicine: Are Pianists at an Advantage When Learning Surgical Skills?

2020 ◽  
Vol 12 (1) ◽  
pp. 06
Author(s):  
Gilles Comeau ◽  
Kuan-chin Jean Chen ◽  
Mikael Swirp ◽  
Donald Russell ◽  
Yixiao Chen ◽  
...  
Keyword(s):  
Musical Training ◽  
Surgical Techniques ◽  
Surgical Skills ◽  
Fine Motor ◽  
Knot Tying ◽  
Initial Stage ◽  
Test Parameters ◽  
Hand Eye Coordination ◽  
The Difference ◽  
Objective Structures

Background: The acquisition of procedural competence is of vital importance in the training of physicians. It has been observed that medical students with extensive musical backgrounds often learn surgical techniques more rapidly than other students, raising the question of motor skill transfer from one area to another. Objective: It is the aim of this project to explore whether musicians can learn and perform surgical skills more rapidly than non-musicians. This study explores the claims that musicians’ proficiency in playing their instrument can translate into benefits when learning complex and refined motor skills in another domain. Even basic surgical skills, such as suturing, become difficult in cognitively demanding environments such as the operating room, containing a barrage of multisensory stimuli where the surgeon must triage and respond to clinically salient information. Method: Participants with piano expertise and participants with no formal music training learned how to do a surgical knot and sutures. They had two practice sessions and were tested after each session. The two test parameters measured were time to complete the task and an OSATS (Objective Structures Assessment of Technical Skills) score. Results for each group (musicians and non-musicians) were analysed and compared. Results: Musician participants performed the surgical tasks faster and received higher scores than the controls; for knot tying, the difference between the two groups was statistically significant. Gender and proficiency using chopsticks also exhibited some influence on test times and scores. Conclusion: Musical training in piano appeared to be of benefit in the initial stage of learning new simple surgical skills. This indicates that at least some aspects of a musicians’ skillset (such as fine motor control, bimanual dexterity and good hand-eye coordination) might be transferrable to an ostensibly disparate domain, and may be important for incorporation in surgical training where the skill of suturing can impact both surgical outcomes, patient safety, and patient satisfaction.

Mindfulness Groups for Psychosis; Key Issues for Implementation on an Inpatient Unit

2010 ◽  
Vol 39 (3) ◽  
pp. 349-353 ◽  
Author(s):  
Pamela Jacobsen ◽  
Eric Morris ◽  
Louise Johns ◽  
Kathleen Hodkinson
Keyword(s):  
Inpatient Unit ◽  
Treatment Resistant ◽  
Inpatient Ward ◽  
Participant Experience ◽  
Key Issues

Background: There is emerging evidence that mindfulness groups for people with distressing psychosis are safe and therapeutic. Aims: The present study aimed to investigate the feasibility of running and evaluating a mindfulness group on an inpatient ward for individuals with chronic and treatment resistant psychosis. Method: Eight participants attended a 6-week mindfulness group on a specialist tertiary inpatient ward. Results: This study demonstrated that mindfulness exercises were acceptable and well-tolerated by participants. Measuring outcome, systemic challenges and participant experience are discussed.

scholarly journals TP8.2.19 Virtual versus In-Person Education Research (VIPER) in Surgical Skills Teaching: A crossover randomised controlled trial

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Jih Dar Yau ◽  
Radheswari Measuria ◽  
Professor Mahmoud Loubani
Keyword(s):  
Controlled Trial ◽  
Training Needs ◽  
Surgical Skills ◽  
Student Feedback ◽  
Written Feedback ◽  
Initial Experience ◽  
Knot Tying ◽  
Group A ◽  
Group B ◽  
Randomised Controlled

Abstract Aims To compare effectiveness of virtual versus in-person teaching of one-handed reef knot to medical students. Methodology 20 students were randomised into 2 groups of 10, to learn to tie one-handed reef knot. Group A attended a 15-minute virtual session followed by a 15-minute in-person session; vice versa for Group B simultaneously. For the virtual session, trainer and students used online platform, Zoom, on an overhead webcam-laptop workstation in separate rooms. For the in-person session, trainer and students were in one room. Anonymous written feedback was collected from all students. Results 50% of the students had previous experience in knot-tying. On average, the instruction clarity and support received during the virtual session were reported to be less by Group A than Group B. 30% reported non-inferiority in the virtual method to in-person in fulfilling their training needs to learn this skill. 80% said they could have benefited from more time during the virtual session when compared to learning the same skill in-person. During the virtual sessions, 60% encountered technical difficulties relating to internet (20%), Zoom (25%), trainer availability (10%), and hardware (5%). 35% felt that a fully virtual session is suitable for learning one-handed reef knot. 30% stated they would attend a fully virtual basic surgical skills course whilst 40% would attend a partially virtual one. Conclusion Initial experience with virtual surgical skills teaching revealed promising potential based on student feedback. Further focused studies with targeted optimisation are warranted for it to be a viable alternative to traditional in-person teaching.

scholarly journals Perceptions of medical students towards and effectiveness of online surgical curriculum: a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shye-Jao Wu ◽  
Ya-Fen Fan ◽  
Shen Sun ◽  
Chen-Yen Chien ◽  
Yih-Jer Wu
Keyword(s):  
Medical Students ◽  
Online Education ◽  
Surgical Education ◽  
Online Teaching ◽  
Role Playing ◽  
Surgical Skills ◽  
Online Course ◽  
Knot Tying ◽  
Online Curriculum ◽  
Teaching Group

Abstract Background Online education has been used as an adjunct modality for teaching and it attracts attention in recent years as many medical students can not accomplish their clerkship in the hospital due to COVID-19 pandemic. This study aims to collect the articles related to online surgical education for medical students, and to analyze the effectiveness of online education and the perceptions of the medical students. Method We performed a systemic literature search in PubMed, MEDLINE, EMBASE, ERIC and Cochrane library. Keywords used for searching included “medical student”, “online education”, “online teaching”, “online learning”, “distance learning”, “electronic learning”, “virtual learning” and “surgical”. Medical education research study quality instrument (MERSQI) was used for the evaluation of the quality of the searched articles. Results From 1240 studies retrieved from the databases, 13 articles were included in this study after screening. The publication year was from 2007 to 2021. The mean MERSQI score of the 13 searched articles was 12.5 +/− 1.7 (range 10.0-14.5). There were totally 2023 medical students who attended online surgical curriculum. By online course, improvement of understanding and knowledge on the studied topics could be reached. The confidence in patient encounters could be improved by online curriculum with sharing experiences, discussing, and role playing. However, students felt concentration was poor during online course. Medical students studying through video platform could get better test scores than those studying with textbooks. Regarding basic surgical skills, online teaching of suturing and knot-tying could be possible and was appreciated by the students who could practice away from the hospital and get feedbacks by instructors through online environment. The scores for the clinical competence assessment for incision, suturing and knot-tying were found to be no significant difference between the online teaching group and face-to-face teaching group. Conclusion Online surgical curriculum for medical students is not easy but inevitable in the era of COVID-19 pandemic. Although online course is not the same as physical course, there are some efforts which could be tried to increase the effectiveness. Basic surgical skills could also be taught effectively through online platform. Even if the COVID-19 pandemic is over in the future, online curriculum could still be a helpful adjunct for surgical education.

SP10.2.2 Improving undergraduate surgical education: Comparing findings from the ASiT consensus report with the RCS Undergraduate Surgical Curriculum and GMC Outcomes for Graduates

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Praveena Deekonda ◽  
Daniel Baker ◽  
Deirdre Nally ◽  
Nisaharan Srikandararajah ◽  
Gemma Humm ◽  
...  
Keyword(s):  
Surgical Education ◽  
Postgraduate Training ◽  
Consensus Meeting ◽  
Advisory Group ◽  
Junior Doctors ◽  
Knot Tying ◽  
Face To Face ◽  
Consensus Document ◽  
Surgical Career ◽  
Consensus Report

Abstract Aims Previous work by ASiT has shown that undergraduate years can have a significant impact on the decision to pursue a surgical career. The Royal College of Surgeons England launched their recommendations in the undergraduate surgical curriculum in 2015. Our aim was to ascertain whether any additional areas of importance could be highlighted. Methods A consensus document was developed, using the RCS undergraduate surgical curriculum and GMC Outcomes for Graduates as baseline guides. An external advisory group made additional recommendations for inclusion which was then presented and discussed at a face-to-face consensus session at the 2019 ASiT International Surgical Conference. A consensus threshold of 80% was accepted. Results A total of 69 ‘core’ topics were reviewed and discussed, of which 10 did not reach consensus. These topics were predominantly considered to be ‘specialist’ in nature, and were under the domains of Head and Neck/ENT, neurosurgery, paediatric or vascular surgery. Of note, knot tying, which is included in the GMC guidance, was considered beyond the required level of a graduate and more suitable for those with the interest or intent to pursue a career in surgery. Conclusions Our consensus meeting and subsequent report has highlighted differences between the current available guidance and what medical students and junior doctors consider to be ‘core’ undergraduate surgical knowledge and skills. Topics that did not meet consensus may form areas of need in early postgraduate training. Our findings should be used in addition to the RCS and GMC guidance for undergraduate surgical education.

Cardiac surgery simulation - Part 1: Basic Surgical Skills

2020 ◽  
Keyword(s):  
Cardiac Surgery ◽  
Surgical Technique ◽  
Operating Room ◽  
Surgical Skills ◽  
Surgery Simulation ◽  
Knot Tying ◽  
Video Tutorial ◽  
Do It Yourself ◽  
And Performance ◽  
Surgery Simulator

Simulation and dedicated practice outside the operating room can improve surgical technique and enhance intraoperative learning and performance. We designed a "do-it-yourself" simulator for use at home made from inexpensive, readily accessible materials that faithfully recreates multiple operative scenarios in cardiac surgery. This video tutorial demonstrates how to build our modular cardiac surgery simulator and to practice drills using our Basic Surgical Skills Module, which helps hone basic linear suturing, needle angles, and knot tying.

scholarly journals Effectivity of Near-Peer Teaching in Training of Basic Surgical Skills – A Randomized Controlled Trial

2020 ◽  
Author(s):  
Zsolt Pintér ◽  
Dániel Kardos ◽  
Péter Varga ◽  
Eszter Kopjár ◽  
Anna Kovács ◽  
...  
Keyword(s):  
Student Performance ◽  
Student Development ◽  
Positive Impact ◽  
Controlled Trial ◽  
Surgical Skills ◽  
Peer Teaching ◽  
Knot Tying ◽  
The Difference ◽  
High Degree ◽  
Students Satisfaction

Abstract BackgroundNear-peer teaching (NPT) is a special way of teaching where the tutor is one or more academic years ahead of the person being tutored. The literature agrees on the benefits of the method, but there are only a few publications examining its effectiveness using objective methods. The aim of our study was to examine the effectiveness of NPT in the training of basic surgical skills.MethodsWe included 60 volunteer students who participated in a 24-hour basic surgical skills course. Based on the results of a pre-course test, we randomly divided the students into six equal groups. All groups completed the same curriculum, with three groups being assisted by a NPT tutor. After the course, they completed the same test as at the beginning. The exams were recorded on anonymized videos and were blindly evaluated. The students’ satisfaction was monitored using a self-administered online anonymous questionnaire. Statistical analysis was performed using the Mann-Whitney and Wilcoxon tests.ResultsOverall, student performance improved with completion of the course (from 119.86 to 153.55 points, p<0.01). In groups where a NPT tutor assisted, students achieved a significantly better score (37.20 vs. 30.18 points, p=0.036). The difference was prominent in surgical knotting tasks (14.73 vs. 9.30 points improvement, p<0.01). In cases of suturing (15.90 vs. 15.46 points) and laparoscopy (7.00 vs. 4.98 points), the presence of the NPT tutor did not significantly affect development. Based on student feedback, although students positively assessed the presence of NPT, it did not significantly improve students’ overall satisfaction.ConclusionsOverall, the use of NPT had a positive impact on student development. An outstanding difference was observed in connection with knotting techniques. The teaching of knot tying requires a high degree of personalized attention, which can be better realized with the assistance of a NPT tutor.

Needle Parking Interrupted Suturing Technique for Microvascular Anastomosis: A Technical Note

2021 ◽  
Author(s):  
Shyle H Mehta ◽  
Evgenii Belykh ◽  
Dara S Farhadi ◽  
Mark C Preul ◽  
Ken-ichiro Kikuta
Keyword(s):  
In Vitro Study ◽  
Senior Author ◽  
Technical Note ◽  
Vitro Study ◽  
Microvascular Anastomosis ◽  
Knot Tying ◽  
Suturing Technique ◽  
Cerebrovascular Surgery ◽  
Suturing Techniques

Abstract BACKGROUND Interrupted and continuous suturing are 2 common techniques for microvascular anastomosis in cerebrovascular surgery. One of the technical complexities of interrupted suturing includes the risk of losing the needle in between interrupted sutures during knot tying, which may result in unnecessary movements and wasted time. OBJECTIVE To report a new needle parking technique for microvascular anastomosis that addresses a needle control problem during interrupted suturing. METHODS The needle parking technique involves puncturing both vessel walls at the site of the next provisional suture and leaving the needle parked in place while the knots at the first suture are being made. The thread is then cut, the needle is pulled through, and the process is repeated. Illustrative cases in which the needle parking technique was used are presented. We also compared time of anastomosis completion between the conventional interrupted, needle parking interrupted, and continuous suturing techniques during an in vitro study on standardized artificial vessels. RESULTS This technique is being used successfully by the senior author for various cerebrovascular bypass surgeries. The in vitro study demonstrated that the needle parking technique can be significantly faster than the conventional interrupted suturing technique and may be as fast as continuous suturing. CONCLUSION Needle parking technique is a modification of conventional interrupted suturing and solves the problem of losing the needle during knot tying. This technique is simple, prevents unnecessary movements, and may result in a faster anastomosis time.

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