Cricothyrotomy Simulator with Computational Skill Assessment for Procedural Skill Training in the Developing World

Abstract Background: With the spread of the coronavirus disease 19 (COVID-19), Sichuan provincial people's hospital, at the frontline fighting this public health crisis, took a lead in the reception, diagnosis and treatment of patients with COVID – 19 in the greater Sichuan area. As an effort to prevent nosocomial infections among the medical staff, we switched from the traditional face-to-face instruction to a web-based multimodal teaching model in our resident training program. Specifically, we explored ways to provide remote training in the proper procedure of donning and doffing of personal protective equipment (PPE). The purpose of the study was to evaluate the effectiveness of various teaching methods in teaching clinical skills of our residents during the epidemic period.Methods: 72 resident anesthesiologists (1st to 3rd year) were recruited to receive remote skill training on donning and doffing of PPE. In this study, all participants received instructional videos/text for the proper protocol, in addition to watching a live-stream instructional video that simulated the procedure of donning and doffing of PPE. We matched the residents by year and divided them into two groups through a WeChat Draw Program. The video feedback (VF) group recorded and submitted videos of simulated donning and removing PPE followed by a debriefing session through a collaborative WeChat learning group. The independent learning (IL) group did not record videos, but were encouraged to consult with their instructors by WeChat or phone if they had any questions. Then the two groups completed questionnaire as well as theory tests and skill assessment. Results: The VF group responded positively to the additional video-recording/debriefing approach. We did not observe any significant difference between the two groups in theoretical test scores. However, the VF group had significantly higher performance than the IL group in skill assessment. Conclusion: The web-based teaching, simulation teaching and video feedback model is an effective alternative to the conventional face-to-face instruction as part of an adapted resident training curriculum involving donning and doffing of protective equipment during an epidemic outbreak.

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Pain medicine fellow neuromodulation surgical skill assessment tool: a pilot

Regional Anesthesia and Pain Medicine ◽

10.1136/rapm-2019-100761 ◽

2019 ◽

Vol 45 (1) ◽

pp. 38-43

Author(s):

Thomas P Pittelkow ◽

Jonathan M Hagedorn ◽

Markus A Bendel ◽

Jason S Eldrige ◽

Matthew J Pingree ◽

...

Keyword(s):

Assessment Tool ◽

Skill Training ◽

Pilot Project ◽

Skill Assessment ◽

Pain Medicine ◽

Cross Sectional Survey ◽

Surgical Performance ◽

Cross Sectional ◽

Surgical Skill Assessment ◽

Primary Specialty

ObjectiveSpinal cord stimulation (SCS) is an evidence-based therapy for the treatment of refractory pain. Current American College of Graduate Medical Education requirements for pain medicine fellowship graduation include observation of five neuromodulation cases. Matriculating fellows have varying degrees of technical skill, training, and experience. The purpose of this study was to use an innovative skill-based assessment tool using the validated Zwisch scale to evaluate fellow surgical performance during SCS cases.DesignCross-sectional surveySettingMayo Clinic, Rochester, Minnesota.SubjectsConsultant faculty (10) in the Division of Pain Medicine and pain medicine fellows (5).MethodsA list of faculty-driven neuromodulation surgical objectives was formed and a rubric was created that focused on technical approach, imaging, epidural access and wound closure. Consultants who perform surgical cases were instructed to use the Zwisch scale as a guide to evaluate fellow surgical performance during a neuromodulation case. Faculty and fellows were surveyed before and after implementation of the tool to determine their satisfaction with use of the skill assessment tool.ResultsThe consultants reported they were more satisfied, consistent, and efficient with feedback provided to the trainee on every aspect of neuromodulation surgical cases. The improvement was most significant during the fellows’ intraoperative skill assessment. The fellows indicated increased satisfaction, improved communication, and increased efficiency of feedback when the tool was utilized. The fellows reported greater intraoperative skill assessment and consistency of feedback provided.ConclusionsThe diverse nature of primary specialty backgrounds observed in pain medicine fellowship training offers a unique opportunity to assess and improve fellow skill and surgical competence in the field of neuromodulation. Both faculty and fellows reported improved satisfaction, consistency and efficiency with feedback provided. Importantly, this pilot project observed that implementation of a skill assessment tool was beneficial for both the faculty and fellow as the feedback received was viewed as strongly beneficial to the educational experience.

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Determinants of Nursing Students’ Confidence in Peripheral Intravenous Catheter Insertion and Management

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.5775 ◽

2021 ◽

Vol 9 (T4) ◽

pp. 152-157

Author(s):

Ferika Indarwati ◽

Yanuar Primanda

Keyword(s):

Nursing Students ◽

Direct Observation ◽

Adult Patients ◽

Skill Assessment ◽

General Linear ◽

Procedural Skill ◽

Bedside Teaching ◽

Contributing Factors ◽

Intravenous Catheter ◽

Peripheral Intravenous Catheter

BACKGROUND: Peripheral intravenous catheter (PIVC) is one of the medical devices commonly inserted in hospitalized patients, both adults and pediatrics. PIVC has crucial functions for delivering drugs, fluids, blood transfusions, and diagnostic tests for patients. Thus, nursing students must be confident in terms of insertion and management of this device. However, studies assessing nursing students’ confidence and its determinants are still limited. AIM: This study aims to examine the internship nursing student’s confidence in PIVC insertion and management in adult patients and its contributing factors. METHODS: A cross-sectional study was conducted to measure internship nursing students’ confidence in PIVC cannulation and management in adult patients as well as its contributing factors. Purposive samples of 100 nursing students in Yogyakarta were recruited, and a 5-point Likert scale questionnaire consisting of 19 questions was used. Kruskal–Wallis test was utilized to investigate the association of the internship nursing student confidence on PIVC insertion and maintenance with the factors. A general linear regression analysis was performed to obtain adjusted estimates of the potential factors with students’ confidence. RESULTS: Results indicated that the internship nursing student’s confidence score ranged from 57 to 95, with a mean value of 75 (±8.1). Among determinants of the student’s confidence investigated in this study, t-test analysis showed that the students’ confidence was associated with their participation in expert lecture, bedside teaching, and direct observation of procedural skill assessment of PIVC insertion and care (p < 0.05). The general linear analysis showed that only bedside teaching and interaction of bedside teaching and direct observation procedural skill assessment were significant predictors of the internship nursing student’s confidence on PIVC insertion and care (β = 10.99, 95% confidence interval [CI] 2.00–20.00 and β = 13.15, 95% CI 1.20–25.15, p < 0.05, respectively). CONCLUSION: This result indicated that nursing students need direct simulation and assessment of PIVC insertion and care to the patients to improve their confidence in PIVC insertion and management in adult patients.

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Pilot Evaluation Study of a Virtual Paracentesis Simulator for Skill Training and Assessment: The Beneficial Effect of Haptic Display

Presence Teleoperators & Virtual Environments ◽

10.1162/pres.17.2.212 ◽

2008 ◽

Vol 17 (2) ◽

pp. 212-229 ◽

Cited By ~ 10

Author(s):

Costas S. Tzafestas ◽

Kostas Birbas ◽

Yiannis Koumpouros ◽

Dimitris Christopoulos

Keyword(s):

Pilot Study ◽

Beneficial Effect ◽

Health Care Professionals ◽

Surgical Simulation ◽

Skill Training ◽

Skill Assessment ◽

Human Anatomy ◽

Haptic Display ◽

Invasive Procedures ◽

Novice Users

Effective, real-time training of health care professionals in invasive procedures is a challenging task. Furthermore, assessing in practice the acquisition of the dexterity and skills required to safely perform such operations is particularly difficult to perform objectively and reliably. The development of virtual reality (VR) simulators offers great potential toward these objectives, and can help bypass some of the difficulties associated with classical surgical training and assessment procedures. In this context, we have developed a prototype VR simulator platform for training in a class of invasive procedures, such as accessing central vessels. This paper focuses more particularly on a pilot study treating the specific application case of subclavian vein paracentesis. The simulation incorporates 3D models of all the human anatomy structures involved in this procedure, where collision detection and response algorithms are implemented to simulate most of the potential complications in accordance with the situations encountered in real clinical practice. Furthermore, haptic display is integrated using a typical force feedback device providing the user with a sense of touch during the simulated operations. Our main objective in this study was to obtain quantitative evaluation results regarding the effect of haptic display on performance. Two user groups participated in the study: (I) novice users and (II) experienced surgeons. The system automatically provides quantitative assessment scores of users' performance, applying a set of objective measures that also involve the optimality of the needle insertion path and indicators of maneuvering errors. Training and skill assessment performance of the system is evaluated in a twofold manner, regarding respectively: (a) the learning curve of novice users, and (b) the correlation of the system-generated scores with the actual surgical experience of the user. These performance indicators are assessed with respect to the activation of the haptic display and to whether this has any beneficial effect (or not). The experimental findings of this first pilot study provide quantitative evidence about the significance of haptic display, not only as a means to enhance the realism of the surgical simulation, but especially as an irreplaceable component for achieving objective and reliable skill assessment. Further larger-scale and long-term clinical studies are needed to validate the effectiveness of such platforms for actual training and dexterity enhancement, particularly when more complex sensorimotor skills are involved.

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