The Relationship of Endoscopic Proficiency to Educational Expense for Virtual Reality Simulator Training Amongst Surgical Trainees

2015 ◽  
Vol 81 (7) ◽  
pp. 747-752 ◽  
Author(s):  
Jessica Raque ◽  
Adam Goble ◽  
Veronica M. Jones ◽  
Lindsey E. Waldman ◽  
Erica Sutton
Keyword(s):  
Virtual Reality ◽  
Cost Effective ◽  
Flexible Endoscopy ◽  
Simulator Training ◽  
Training Methods ◽  
Endoscopy Training ◽  
Fundamentals Of Endoscopic Surgery ◽  
Surgical Trainees ◽  
Faculty Time ◽  
The Cost

With the introduction of Fundamentals of Endoscopic Surgery™, training methods in flexible endoscopy are being augmented with simulation-based curricula. The investment for virtual reality simulators warrants further research into its training advantage. Trainees were randomized into bedside or simulator training groups (BED vs SIM). SIM participated in a proficiency-based virtual reality curriculum. Trainees’ endoscopic skills were rated using the Global Assessment of Gastrointestinal Endoscopic Skills (GAGES) in the patient care setting. The number of cases to reach 90 per cent of the maximum GAGES score and calculated costs of training were compared. Nineteen residents participated in the study. There was no difference in the average number of cases required to achieve 90 per cent of the maximum GAGES score for esophagogastroduodenoscopy, 13 (SIM) versus11 (BED) ( P = 0.63), or colonoscopy 21 (SIM) versus 4 (BED) ( P = 0.34). The average per case cost of training for esophagogastroduodenoscopy was $35.98 (SIM) versus $39.71 (BED) ( P = 0.50), not including the depreciation costs associated with the simulator ($715.00 per resident over six years). Use of a simulator appeared to increase the cost of training without accelerating the learning curve or decreasing faculty time spent in instruction. The importance of simulation in endoscopy training will be predicated on more cost-effective simulators.

scholarly journals Does virtual reality simulation have a role in training trauma and orthopaedic surgeons?

2018 ◽  
Vol 100-B (5) ◽  
pp. 559-565 ◽  
Author(s):  
J. D. Bartlett ◽  
J. E. Lawrence ◽  
M. E. Stewart ◽  
N. Nakano ◽  
V. Khanduja
Keyword(s):  
Virtual Reality ◽  
Skill Acquisition ◽  
Shoulder Arthroscopy ◽  
Simulator Training ◽  
Current Evidence ◽  
Future Research ◽  
Financial Investment ◽  
Repeated Use ◽  
Orthopaedic Training ◽  
The Cost

Aims The aim of this study was to assess the current evidence relating to the benefits of virtual reality (VR) simulation in orthopaedic surgical training, and to identify areas of future research. Materials and Methods A literature search using the MEDLINE, Embase, and Google Scholar databases was performed. The results’ titles, abstracts, and references were examined for relevance. Results A total of 31 articles published between 2004 and 2016 and relating to the objective validity and efficacy of specific virtual reality orthopaedic surgical simulators were identified. We found 18 studies demonstrating the construct validity of 16 different orthopaedic virtual reality simulators by comparing expert and novice performance. Eight studies have demonstrated skill acquisition on a simulator by showing improvements in performance with repeated use. A further five studies have demonstrated measurable improvements in operating theatre performance following a period of virtual reality simulator training. Conclusion The demonstration of ‘real-world’ benefits from the use of VR simulation in knee and shoulder arthroscopy is promising. However, evidence supporting its utility in other forms of orthopaedic surgery is lacking. Further studies of validity and utility should be combined with robust analyses of the cost efficiency of validated simulators to justify the financial investment required for their use in orthopaedic training. Cite this article: Bone Joint J 2018;100-B:559–65.

Endoscopy Training in Small Animal Internal Medicine: A Survey of Residency Training Programs in North America

2021 ◽  
pp. e20200165
Author(s):  
Katherine E. McCool ◽  
Steven L. Marks ◽  
Eleanor C. Hawkins
Keyword(s):  
Internal Medicine ◽  
Virtual Reality ◽  
Small Animal ◽  
Physical Models ◽  
Endoscopy Training ◽  
Endoscopic Techniques ◽  
Electronic Survey ◽  
Time Commitment ◽  
Hands On ◽  
Faculty Time

Competency in multiple endoscopic techniques is a major goal of small animal internal medicine (SAIM) residency programs. Training relies predominantly on mentored supervision of procedures performed on patients. Supplementation of this apprenticeship model with classroom sessions and hands-on laboratories can be advantageous to trainees and patients. Few veterinary resources describe supplemental training options, and no single source exists for mentors to consult for program development. The purpose of this study was to describe the supplemental training opportunities currently available to SAIM residents at academic hospitals in the US and Canada and to compare their timing during the residency, resident and faculty time commitment, and perceived helpfulness. Data were collected by an electronic survey distributed to one faculty member per institution. The response rate was 80% (24/30). Most programs (22/24; 92%) offered some form of supplemental training, including classroom sessions (9/24), and hands-on laboratories using physical models (7/24), virtual reality simulators (2/24), and cadaver (2/24) and anesthetized (2/24) dogs. Fifteen programs provided residents with the opportunity to attend external endoscopy workshops. Only three programs required any training prior to residents performing procedures on patients. There was considerable variability in training between programs, precluding statistical comparisons. The survey identified topics for classroom sessions and several inexpensive physical models, rated very or extremely helpful, that would be suitable for programs with limited budgets. A human-based virtual reality simulator was also rated highly by two programs. Comprehensive, external workshops evoked numerous positive comments with perceived value ranging from somewhat to extremely helpful.

Retention of Colonoscopy Skills after Virtual Reality Simulator Training by Independent and Proctored Methods

2010 ◽  
Vol 76 (7) ◽  
pp. 743-746 ◽  
Author(s):  
Christopher W. Snyder ◽  
Marianne J. Vandromme ◽  
Sharon L. Tyra ◽  
Mary T. Hawn
Keyword(s):  
Virtual Reality ◽  
Simulator Training ◽  
Training Methods ◽  
Median Score ◽  
Excessive Force ◽  
Surgical Resident ◽  
Skill Retention ◽  
Retention Testing ◽  
Error Avoidance ◽  
Better Than

Virtual reality (VR) simulators may enhance surgical resident colonoscopy skills, but the duration of skill retention and the effects of different simulator training methods are unknown. Medical students participating in a randomized trial of independent (automated simulator feedback only) versus proctored (human expert feedback plus simulator feedback) simulator training performed a standardized VR colonoscopy scenario at baseline, at the end of training (posttraining), and after a median 4.5 months without practice (retention). Performances were scored on a 10-point scale based on expert proficiency criteria and compared for the independent and proctored groups. Thirteen trainees (8 proctored, 5 independent) were included. Performance at retention testing was significantly better than baseline (median score 10 vs 5, P < 0.0001), and no different from posttraining (median score 10 vs 10, P = 0.19). Score changes from baseline to retention and from posttraining to retention were no different for the proctored and independent groups. Over-insufflation and excessive force were the most common reasons for nonproficiency at retention. After proficiency-based VR simulator training, colonoscopy skills are retained for several months, regardless of whether an independent or proctored approach is used. Error avoidance skills may not be retained as well as speed and efficiency skills.

Development of Simulator Guidelines for Resident Assessment in Flexible Endoscopy

2013 ◽  
Vol 79 (1) ◽  
pp. 14-22 ◽  
Author(s):  
Erica Sutton ◽  
Sheree Carter Chase ◽  
Rosemary Klein ◽  
Yue Zhu ◽  
Carlos Godinez ◽  
...  
Keyword(s):  
Medical Education ◽  
Virtual Reality ◽  
Flexible Endoscopy ◽  
Course Evaluation ◽  
Upper Endoscopy ◽  
Surgical Trainees ◽  
The Subject ◽  
Resident Assessment ◽  
The Relationship ◽  
Faculty Instruction

Virtual reality (VR) simulators may hold a role in the assessment of trainee abilities independent of their role as instructional instruments. Thus, we piloted a course in flexible endoscopy to surgical trainees who had met Accreditation Council for Graduate Medical Education endoscopy requirements to establish the relationship between metrics produced by a VR endoscopic simulator and trainee ability. After a didactic session, we provided faculty instruction to senior residents for Case 1 upper endoscopy and colonoscopy modules on the CAE Endoscopy VR. Course conclusion was defined as a trainee meeting all proficiency standards in basic endoscopic procedures on the simulator. Simulator metrics and course evaluation comprised data. Eleven and eight residents participated in the colonoscopy and upper endoscopy courses, respectively. Average time to reach proficiency standards for esophagogastroduodenoscopy was 6 and 13 minutes for colonoscopy after a median of one (range, one to two) and one (range, one to four) task repetitions, respectively. Faculty instruction averaged 7.5 minutes of instruction per repetition. A subjective course evaluation demonstrated that the course improved learners’ knowledge of the subject and comfort with endoscopic equipment. Within a VR-based curriculum, experienced residents rapidly achieved task proficiency. The resultant scores may be used as simulator guidelines for resident assessment and readiness to perform flexible endoscopy.

The IBM-PC in electron microscopy

1996 ◽  
Vol 54 ◽  
pp. 612-613
Author(s):  
James F. Mancuso
Keyword(s):  
Head Start ◽  
Image Acquisition ◽  
Cost Effective ◽  
Financial Applications ◽  
Number Of Factors ◽  
Instrument Control ◽  
The Cost ◽  
Training And Support ◽  
Control Image ◽  
Ibm Pc

IBM PC compatible computers are widely used in microscopy for applications ranging from control to image acquisition and analysis. The choice of IBM-PC based systems over competing computer platforms can be based on technical merit alone or on a number of factors relating to economics, availability of peripherals, management dictum, or simple personal preference.IBM-PC got a strong “head start” by first dominating clerical, document processing and financial applications. The use of these computers spilled into the laboratory where the DOS based IBM-PC replaced mini-computers. Compared to minicomputer, the PC provided a more for cost-effective platform for applications in numerical analysis, engineering and design, instrument control, image acquisition and image processing. In addition, the sitewide use of a common PC platform could reduce the cost of training and support services relative to cases where many different computer platforms were used. This could be especially true for the microscopists who must use computers in both the laboratory and the office.

Sonographically guided, transcatheter foam sclerotherapy of the great saphenous vein

Phlebologie ◽  
2007 ◽  
Vol 36 (06) ◽  
pp. 309-312 ◽  
Author(s):  
T. Schulz ◽  
M. Jünger ◽  
M. Hahn
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Clinical Stage ◽  
Clinical Signs ◽  
Cost Effective ◽  
Duplex Sonography ◽  
Foam Sclerotherapy ◽  
Average Loss ◽  
One Year ◽  
The Cost

Summary Objective: The goal of the study was to assess the effectiveness and patient tolerability of single-session, sonographically guided, transcatheter foam sclerotherapy and to evaluate its economic impact. Patients, methods: We treated 20 patients with a total of 22 varicoses of the great saphenous vein (GSV) in Hach stage III-IV, clinical stage C2-C5 and a mean GSV diameter of 9 mm (range: 7 to 13 mm). We used 10 ml 3% Aethoxysklerol®. Additional varicoses of the auxiliary veins of the GSV were sclerosed immediately afterwards. Results: The occlusion rate in the treated GSVs was 100% one week after therapy as demonstrated with duplex sonography. The cost of the procedure was 207.91 E including follow-up visit, with an average loss of working time of 0.6 days. After one year one patient showed clinical signs of recurrent varicosis in the GSV; duplex sonography showed reflux in the region of the saphenofemoral junction in a total of seven patients (32% of the treated GSVs). Conclusion: Transcatheter foam sclerotherapy of the GSV is a cost-effective, safe method of treating varicoses of GSV and broadens the spectrum of therapeutic options. Relapses can be re-treated inexpensively with sclerotherapy.

A Digital Economy Model for Talent Prediction Data Analytic

2019 ◽  
Vol 2 (4) ◽  
pp. 260-266
Author(s):  
Haru Purnomo Ipung ◽  
Amin Soetomo
Keyword(s):  
Business Model ◽  
Industrial Revolution ◽  
Technology Innovation ◽  
Cost Effective ◽  
Sharing Economy ◽  
Token Economy ◽  
Economy Model ◽  
New Business ◽  
The Cost ◽  
Data Analytic

This research proposed a model to assist the design of the associated data architecture and data analytic to support talent forecast in the current accelerating changes in economy, industry and business change due to the accelerating pace of technological change. The emerging and re-emerging economy model were available, such as Industrial revolution 4.0, platform economy, sharing economy and token economy. Those were driven by new business model and technology innovation. An increase capability of technology to automate more jobs will cause a shift in talent pool and workforce. New business model emerge as the availabilityand the cost effective emerging technology, and as a result of emerging or re-emerging economic models. Both, new business model and technology innovation, create new jobs and works that have not been existed decades ago. The future workers will be faced by jobs that may not exist today. A dynamics model of inter-correlation of economy, industry, business model and talent forecast were proposed. A collection of literature review were conducted to initially validate the model.

CAD Of Anticorrosive Protection Of Steel Structures

2019 ◽  
pp. 18-23
Keyword(s):  
Protective Coating ◽  
Computer Aided Design ◽  
Steel Structures ◽  
Cost Effective ◽  
Operating Conditions ◽  
Computational Tool ◽  
Protection Method ◽  
Cost Effective Method ◽  
The Cost ◽  
Aided Design

The choice of cost-effective method of anticorrosive protection of steel structures is an urgent and time consuming task, considering the significant number of protection ways, differing from each other in the complex of technological, physical, chemical and economic characteristics. To reduce the complexity of solving this problem, the author proposes a computational tool that can be considered as a subsystem of computer-aided design and used at the stage of variant and detailed design of steel structures. As a criterion of the effectiveness of the anti-corrosion protection method, the cost of the protective coating during the service life is accepted. The analysis of existing methods of steel protection against corrosion is performed, the possibility of their use for the protection of the most common steel structures is established, as well as the estimated period of effective operation of the coating. The developed computational tool makes it possible to choose the best method of protection of steel structures against corrosion, taking into account the operating conditions of the protected structure and the possibility of using a protective coating.

Production of Asbestos-free Brake Pad Using Groundnut Shell as Filler Material

2018 ◽  
Vol 4 (12) ◽  
Author(s):  
W. C. Solomon ◽  
M. T. Lilly ◽  
J. I. Sodiki
Keyword(s):  
Phenolic Resin ◽  
Cost Effective ◽  
Filler Material ◽  
Particle Sizes ◽  
Brake Pad ◽  
Brake Pads ◽  
Environmental Friendly ◽  
Sieve Size ◽  
Groundnut Shell ◽  
The Cost

The development and evaluation of brake pads using groundnut shell (GS) particles as substitute material for asbestos were carried out in this study. This was with a view to harnessing the properties of GS, which is largely deposited as waste, and in replacing asbestos which is carcinogenic in nature despite its good tribological and mechanical properties. Two sets of composite material were developed using varying particle sizes of GS as filler material, with phenolic resin as binder with percentage compositions of 45% and 50% respectively. Results obtained indicate that the compressive strength and density increase as the sieve size of the filler material decreases, while water and oil absorption rates increase with an increase in sieve size of GS particle. This study also indicates that the cost of producing brake pad can be reduced by 19.14 percent if GS is use as filler material in producing brake pad. The results when compared with those of asbestos and industrial waste showed that GS particle can be used as an effective replacement for asbestos in producing automobile brake pad. Unlike asbestos, GS-based brake pads are environmental friendly, biodegradable and cost effective.

Janus – A New Approach to Air Combat Pilot Training

2019 ◽  
Vol 2019 (4) ◽  
pp. 7-22
Author(s):  
Georges Bridel ◽  
Zdobyslaw Goraj ◽  
Lukasz Kiszkowiak ◽  
Jean-Georges Brévot ◽  
Jean-Pierre Devaux ◽  
...  
Keyword(s):  
Low Cost ◽  
Cost Effective ◽  
High Energy ◽  
Training System ◽  
Embedded Sensors ◽  
Pilot Training ◽  
New Approach ◽  
Combat Aircraft ◽  
Air Combat ◽  
The Cost

Abstract Advanced jet training still relies on old concepts and solutions that are no longer efficient when considering the current and forthcoming changes in air combat. The cost of those old solutions to develop and maintain combat pilot skills are important, adding even more constraints to the training limitations. The requirement of having a trainer aircraft able to perform also light combat aircraft operational mission is adding unnecessary complexity and cost without any real operational advantages to air combat mission training. Thanks to emerging technologies, the JANUS project will study the feasibility of a brand-new concept of agile manoeuvrable training aircraft and an integrated training system, able to provide a live, virtual and constructive environment. The JANUS concept is based on a lightweight, low-cost, high energy aircraft associated to a ground based Integrated Training System providing simulated and emulated signals, simulated and real opponents, combined with real-time feedback on pilot’s physiological characteristics: traditionally embedded sensors are replaced with emulated signals, simulated opponents are proposed to the pilot, enabling out of sight engagement. JANUS is also providing new cost effective and more realistic solutions for “Red air aircraft” missions, organised in so-called “Aggressor Squadrons”.

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