Decline in surgeon volume after successful implementation of advanced laparoscopic surgery in gynecology: An undesired side effect?

Laparoscopic surgery has the potential to improve care in resource-deprived low- and-middle-income countries (LMICs). This study aims to analyse the barriers to training in laparoscopic surgery in LMICs. Medline, Embase, Global Health and Web of Science were searched using ‘LMIC’, ‘Laparoscopy’ and ‘Training’. Two researchers screened results with mutual agreement. Included papers were in English, focused on abdominal laparoscopy and training in LMICs. PRISMA guidelines were followed; 2992 records were screened, and 86 full-text articles reviewed to give 26 key papers. Thematic grouping identified seven key barriers: funding; availability and maintenance of equipment; local access to experienced laparoscopic trainers; stakeholder dynamics; lack of knowledge on effective training curricula; surgical departmental structure and practical opportunities for trainees. In low-resource settings, technological advances may offer low-cost solutions in the successful implementation of laparoscopic training and improve access to surgical care.

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Patients and hospital managers want laparoscopic simulation training to become mandatory before live operating: a multicentre qualitative study of stakeholder perceptions

BMJ Simulation and Technology Enhanced Learning ◽

10.1136/bmjstel-2017-000270 ◽

2018 ◽

Vol 5 (1) ◽

pp. 39-45 ◽

Cited By ~ 1

Author(s):

Jessica Preshaw ◽

Dimitrios Siassakos ◽

Mark James ◽

Timothy Draycott ◽

Sanjay Vyas ◽

...

Keyword(s):

Patient Safety ◽

Laparoscopic Surgery ◽

Qualitative Study ◽

Human Error ◽

Simulation Training ◽

Surgical Simulation ◽

Successful Implementation ◽

Hospital Managers ◽

Initial Learning ◽

Competency Based

BackgroundSurgical procedures are complex and susceptible to human error. Individual surgical skill correlates with improved patient outcomes demonstrating that surgical proficiency is vitally important for patient safety. Evidence demonstrates that simulation training improves laparoscopic surgical skills; however, projects to implement and integrate laparoscopic simulation into core surgical curricula have had varied success. One barrier to successful implementation has been the lack of awareness and prioritisation of simulation initiatives by key stakeholders.ObjectiveTo determine the knowledge and perceptions of patients and hospital managers on laparoscopic surgery and simulation training in patient safety and healthcare.MethodA qualitative study was conducted in the Southwest of England. 40 semistructured interviews were undertaken with patients attending general gynaecology clinics and general surgical and gynaecology hospital managers.ResultsSix key themes identified included: positive expectations of laparoscopic surgery; perceptions of problems and financial implications of laparoscopic surgery; lack of awareness of difficulties with surgical training; desire for laparoscopic simulation training and competency testing for patient benefit; conflicting priorities of laparoscopic simulation in healthcare; and drawbacks of surgical simulation training. Patients and managers were largely unaware of the risks of laparoscopic surgery and challenges for training. Managers highlighted conflicting financial priorities when purchasing educational equipment. Patients stated that they would have greater confidence in a surgeon who had undertaken mandatory surgical simulation training and perceived purchasing simulation equipment to be a high priority in the National Health Services. Most patients and hospital managers believed trainees should pass an examination on a simulator prior to live operating.ConclusionsCompetency-based mandatory laparoscopic simulation was strongly supported by the majority of stakeholders to augment the initial learning curve of surgeons.

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Some applications of electron beam microanalysis techniques in VLSI process evaluation

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s042482010007463x ◽

1983 ◽

Vol 41 ◽

pp. 160-161

Author(s):

Simon Thomas

Keyword(s):

Integrated Circuits ◽

Process Evaluation ◽

Large Scale ◽

Technology Development ◽

Analytical Techniques ◽

Successful Implementation ◽

Analysis Of Failures ◽

Characterization Of Materials ◽

Circuits Vlsi

Trends in the technology development of very large scale integrated circuits (VLSI) have been in the direction of higher density of components with smaller dimensions. The scaling down of device dimensions has been not only laterally but also in depth. Such efforts in miniaturization bring with them new developments in materials and processing. Successful implementation of these efforts is, to a large extent, dependent on the proper understanding of the material properties, process technologies and reliability issues, through adequate analytical studies. The analytical instrumentation technology has, fortunately, kept pace with the basic requirements of devices with lateral dimensions in the micron/ submicron range and depths of the order of nonometers. Often, newer analytical techniques have emerged or the more conventional techniques have been adapted to meet the more stringent requirements. As such, a variety of analytical techniques are available today to aid an analyst in the efforts of VLSI process evaluation. Generally such analytical efforts are divided into the characterization of materials, evaluation of processing steps and the analysis of failures.

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Moving From Interprofessional Education Toward Interprofessional Practice: Bridging the Translation Gap

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_pers-sig10-2018-0020 ◽

2019 ◽

Vol 4 (5) ◽

pp. 971-976

Author(s):

Imran Musaji ◽

Trisha Self ◽

Karissa Marble-Flint ◽

Ashwini Kanade

Keyword(s):

Interprofessional Education ◽

Interprofessional Collaboration ◽

Evaluation Model ◽

Implementation Strategies ◽

Future Research ◽

Successful Implementation ◽

Interprofessional Practice ◽

Translational Model ◽

Key Stakeholders ◽

Clear Identification

Purpose The purpose of this article was to propose the use of a translational model as a tool for identifying limitations of current interprofessional education (IPE) research. Translational models allow researchers to clearly define next-step research needed to translate IPE to interprofessional practice (IPP). Method Key principles, goals, and limitations of current IPE research are reviewed. A popular IPE evaluation model is examined through the lens of implementation research. The authors propose a new translational model that more clearly illustrates translational gaps that can be used to direct future research. Next steps for translating IPE to IPP are discussed. Conclusion Comprehensive reviews of the literature show that the implementation strategies adopted to date have fostered improved buy-in from key stakeholders, as evidenced by improved attitudes and perceptions toward interprofessional collaboration/practice. However, there is little evidence regarding successful implementation outcomes, such as changed clinician behaviors, changed organizational practices, or improved patient outcomes. The authors propose the use of an IPE to IPP translational model to facilitate clear identification of research gaps and to better identify future research targets.

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A Qualitative Examination of User Perceptions of User-Driven and App-Controlled Hearing Technologies

American Journal of Audiology ◽

10.1044/2019_aja-19-0022 ◽

2019 ◽

Vol 28 (4) ◽

pp. 993-1005 ◽

Cited By ~ 2

Author(s):

Gitte Keidser ◽

Nicole Matthews ◽

Elizabeth Convery

Keyword(s):

Hearing Aids ◽

Care Delivery ◽

Hearing Aid ◽

New Technology ◽

Successful Implementation ◽

Semistructured Interview ◽

User Perceptions ◽

Template Analysis ◽

Training And Support ◽

And Training

Purpose The aim of this study was to examine how hearing aid candidates perceive user-driven and app-controlled hearing aids and the effect these concepts have on traditional hearing health care delivery. Method Eleven adults (3 women, 8 men), recruited among 60 participants who had completed a research study evaluating an app-controlled, self-fitting hearing aid for 12 weeks, participated in a semistructured interview. Participants were over 55 years of age and had varied experience with hearing aids and smartphones. A template analysis was applied to data. Results Five themes emerged from the interviews: (a) prerequisites to the successful implementation of user-driven and app-controlled technologies, (b) benefits and advantages of user-driven and app-controlled technologies, (c) barriers to the acceptance and use of user-driven and app-controlled technologies, (d) beliefs that age is a significant factor in how well people will adopt new technology, and (e) consequences that flow from the adoption of user-driven and app-controlled technologies. Specifically, suggested benefits of the technology included fostering empowerment and providing cheaper and more discrete options, while challenges included lack of technological self-efficacy among older adults. Training and support were emphasized as necessary for successful adaptation and were suggested to be a focus of audiologic services in the future. Conclusion User perceptions of user-driven and app-controlled hearing technologies challenge the audiologic profession to provide adequate support and training for use of the technology and manufacturers to make the technology more accessible to older people.

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Success Strategies: Implementing the Professional Performance Review Process for School-Based Speech-Language Pathologists

Perspectives on Administration and Supervision ◽

10.1044/aas19.1.4 ◽

2009 ◽

Vol 19 (1) ◽

pp. 4-9

Author(s):

Jill Parmenter ◽

Sheryl Amaral ◽

Julia Jackson

Keyword(s):

Review Process ◽

Successful Implementation ◽

Speech Language Pathologists ◽

Self Advocacy ◽

Professional Performance ◽

Performance Review ◽

Roles And Responsibilities ◽

Speech Language Pathologist ◽

School Based ◽

Review Management

Abstract The Professional Performance Review Process for School-Based Speech-Language Pathologists (PPRP) (ASHA, 2006) was developed in response to the need for a performance review tool that fits school district requirements for performance review management while addressing the specific roles and responsibilities of a school-based speech-language pathologist (ASHA, 2006). This article will examine the purpose and components of the PPRP. A description of its use as a tool for self-advocacy will be discussed. Strategies for successful implementation of the PPRP will be explained using insight from speech-language pathologists and other professionals familiar with the PPRP.

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