Validating the Use of Smartphone-Based Accelerometers for Performance Assessment in a Simulated Neurosurgical Task

2013 ◽  
Vol 10 (1) ◽  
pp. 57-65 ◽  
Author(s):  
Wei Jie Jensen Ang ◽  
Michael Edward Hopkins ◽  
Roland Partridge ◽  
Iain Hennessey ◽  
Paul Martin Brennan ◽  
...  
Keyword(s):  
Simulation Training ◽  
Surgical Simulation ◽  
Working Hours ◽  
Junior Doctors ◽  
Dominant Hand ◽  
Technical Performance ◽  
Dural Closure ◽  
Objective Feedback ◽  
Technical Proficiency ◽  
Economy Of Movement

Abstract BACKGROUND: Reductions in working hours affect training opportunities for surgeons. Surgical simulation is increasingly proposed to help bridge the resultant training gap. For simulation training to translate effectively into the operating theater, acquisition of technical proficiency must be objectively assessed. Evaluating “economy of movement” is one way to achieve this. OBJECTIVE: We sought to validate a practical and economical method of assessing economy of movement during a simulated task. We hypothesized that accelerometers, found in smartphones, provide quantitative, objective feedback when attached to a neurosurgeon's wrists. METHODS: Subjects (n = 25) included consultants, senior registrars, junior registrars, junior doctors, and medical students. Total resultant acceleration (TRA), average resultant acceleration, and movements with acceleration >0.6g (suprathreshold acceleration events) were recorded while subjects performed a simulated dural closure task. RESULTS: Students recorded an average TRA 97.0 ± 31.2 ms−2 higher than senior registrars (P = .03) and 103 ± 31.2 ms−2 higher than consultants (P = .02). Similarly, junior doctors accrued an average TRA 181 ± 31.2 ms−2 higher than senior registrars (P < .001) and 187 ± 31.2 ms−2 higher than consultants (P < .001). Significant correlations were observed between surgical outcome (as measured by quality of dural closure) and both TRA (r = .44, P < .001) and number of suprathreshold acceleration events (r = .33, P < .001). TRA (219 ± 66.6 ms−2; P = .01) and number of suprathreshold acceleration events (127 ± 42.5; P = .02) dropped between the first and fourth trials for junior doctors, suggesting procedural learning. TRA was 45.4 ± 17.1 ms−2 higher in the dominant hand for students (P = .04) and 57.2 ± 17.1 ms−2 for junior doctors (P = .005), contrasting with even TRA distribution between hands (acquired ambidexterity) in senior groups. CONCLUSION: Data from smartphone-based accelerometers show construct validity as an adjunct for assessing technical performance during simulation training.

scholarly journals Simulation training in pancreatico-jejunostomy using an inanimate biotissue model improves the technical skills of hepatobiliary-pancreatic surgical fellows

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244915
Author(s):  
Ryuji Yoshioka ◽  
Hiroshi Imamura ◽  
Hirofumi Ichida ◽  
Yu Gyoda ◽  
Tomoya Mizuno ◽  
...  
Keyword(s):  
Learning Curve ◽  
Simulation Training ◽  
Surgical Simulation ◽  
Technical Skills ◽  
Summary Score ◽  
The Other ◽  
Actual Operating ◽  
Technical Proficiency ◽  
Time Required ◽  
Safe Performance

Background Technical proficiency of the operating surgeons is one of the most important factors in the safe performance of pancreaticoduodenectomy. The objective of the present study was to investigate whether surgical simulation of pancreatico-jejunostomy (PJ) using an inanimate biotissue model could improve the technical proficiency of hepato-biliary pancreatic (HBP) surgical fellows. Methods The biotissue drill consisted of sewing biotissues to simulate PJ. The drill was repeated a total of five times by each of the participant surgical fellows. The improvement of the surgical fellows’ technical proficiency was evaluated by the supervisor surgeons using the Objective Structured Assessment of Technical Skills (OSATS) scale. Results Eight HBP surgical fellows completed all the 5 drills. Both the OSATS 25 score and OSATS summary score, assessed by the two supervisor surgeons, improved steadily with repeated execution of the PJ drill. The average OSATS score, as assessed by both the supervisor surgeons, improved significantly from the first to the final drill, with a P value of 0.003 and 0.014 for the assessment by the two surgeons, respectively. On the other hand, no chronological alteration was observed in time of procedure (P = 0.788). Conclusion Repeated execution of a biotissue PJ drill improved the HBP surgical fellows’ technical proficiency, as evaluated by OSATS. The present study lends support to the evidence that simulation training can contribute to shortening of the time required to negotiate the learning curve for the technique of PJ in the actual operating room.

What is the role of surgical simulation on operative opportunity for the trainee ENT surgeon?

2020 ◽  
pp. 1-4
Author(s):  
E J R Noon ◽  
A Singh ◽  
A Hall
Keyword(s):  
Simulation Training ◽  
Surgical Simulation ◽  
Group Versus ◽  
Active Role ◽  
Junior Doctors ◽  
Level Of Involvement ◽  
Simulation Group ◽  
The Impact ◽  
First Time

Abstract Objective This study sought to assess the impact of simulation training in influencing trainees’ initial surgical participation as perceived by experienced surgeon trainers. Methods Twenty ENT surgeons assessed how much of a given procedure they would expect to allow a trainee to perform for their first time. Responses were provided for trainees who had undergone a relevant simulation course and those who had not, and scored according to the eLogbook levels of involvement in surgery. This was completed for simulated procedures with validated models, across four grades of junior doctors. Results A total of 1120 judgements on the trainees’ intended level of involvement were made. The median involvement score was higher in the simulation group versus the non-simulation group (Mann–Whitney U, p = 0.0001), corresponding to a translation in surgical opportunity from a primarily assisting role to an active role. Conclusion Trainer perception of a relevant ENT simulation course appears to positively impact on the initial surgical opportunities afforded to the trainee.

scholarly journals 187 Improving Awareness of Managing Post-Operative Haemorrhage in Patients Undergoing Thyroid and Parathyroid Surgery: The SCOOP Protocol

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Bhattacharya ◽  
J Jegadeeson ◽  
J Ramsingh ◽  
P Truran
Keyword(s):  
Nursing Staff ◽  
Simulation Training ◽  
Clinical Signs ◽  
Skin Wound ◽  
Junior Doctors ◽  
Parathyroid Surgery ◽  
Surgical Department ◽  
Life Threatening ◽  
Clinical Questions ◽  
Life Threatening Complication

Abstract Introduction Post-operative haemorrhage is a rare but potentially life-threatening complication of thyroid surgery and occurs in 1 in 100 patients. Our aim was to assess current levels of awareness of post-operative haemorrhage in the surgical department and to improve confidence in managing this. Method Questionnaires with a combination of clinical questions were distributed amongst nurses, foundation doctors, senior house officers and registrars in the surgical department. Results There was a clear gap in awareness in all grades. The British Association of Endocrine and Thyroid surgeons (BAETS) have guidance on the management of these patients and in particular the acronym SCOOP (Steristrips removed, Cut subcuticular sutures, Open skin wound, Open strap muscles, Pack wound). 18/24 of participants had not heard of the SCOOP protocol. Most nurses (6/12) all junior doctors (8/8) showed lack of confidence in managing patients with suspected bleeding. Conclusions An informative poster was created for relevant clinical areas as per the BAETS recommendation. These posters outlined the steps in the SCOOP acronymas well as the main clinical signs of haemorrhage. BAETS recommend that all first responders, including nursing staff, junior doctors and the crash team should be aware of the SCOOP protocol. Simulation training sessions are in progress for these members of staff.

Factors relating to working hours restriction that have impacted the professional identity of trainees in the last decade

2021 ◽  
Vol 82 (3) ◽  
pp. 1-10
Author(s):  
Soumya Mukherjee ◽  
James Meacock ◽  
Eleanor Kissane ◽  
Debasish Pal
Keyword(s):  
Identity Development ◽  
Professional Identity ◽  
Medical Training ◽  
Working Hours ◽  
Junior Doctors ◽  
Clinical Experiences ◽  
Postgraduate Medical Training ◽  
European Working ◽  
Working Time Directive ◽  
The Impact

Ever-developing changes to the working hours of junior doctors by the European Working Time Directive, the junior doctor contract of 2019 and most recently the COVID-19 pandemic have impacted the professional identity of doctors. There has been little investigation into its influence on the multifaceted aspects of postgraduate medical training, which feeds into how trainees consider themselves professionally and the concept of professional identity or ‘being a doctor’. A review of the medical, socio-political and educational literature reveals that the impact on the professional identity development of trainees is influenced by several perspectives from the trainee, trainer and the public. Gross reduction in working hours has no doubt decreased the raw volume of clinical experiences. However, to counteract this, smarter learning processes have evolved, including narrative reflection, supervised learning events, and a greater awareness of coaching and training among trainers.

scholarly journals Near-misses and Missed Opportunities: Poor Patient Handover In General Surgery

2008 ◽  
Vol 90 (3) ◽  
pp. 96-98 ◽  
Author(s):  
M Tokode ◽  
L Barthelmes ◽  
B O'Riordan
Keyword(s):  
General Surgery ◽  
Working Hours ◽  
Junior Doctors ◽  
Learning Potential ◽  
Missed Opportunities ◽  
Near Misses ◽  
Medical Careers ◽  
European Working ◽  
Working Time Directive ◽  
Patient Handover

Since the introduction of shift systems for junior doctors as part of the European Working Time Directive, different teams of doctors look after patients over the course of a day. This requires ro bust handover mechanisms to pass on inf ormation between differ ent teams of doctors to avoid misses and near-misses in patients' care. Modernising Medical Careers shortens the placements of doctors in foundation programmes in general surgery to four months compared with six-month placements as pre-registration house officers in the past. The reduction in working hours will therefore adv ersely aff ect exposur e and experience of junior doctors in general surg ery unless the learning potential of time spent at work is maximised.

Excessive working hours for junior doctors

BMJ ◽  
1982 ◽  
Vol 284 (6308) ◽  
pp. 55-55
Author(s):  
A. Kaiser
Keyword(s):  
Working Hours ◽  
Junior Doctors

scholarly journals Trainees4trainees: an innovative peer support project for junior doctors across specialties

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S126-S126
Author(s):  
Sophie Behrman ◽  
Aisling Higham ◽  
Haido Vlachos ◽  
Gerti Stegen
Keyword(s):  
Peer Support ◽  
Support Groups ◽  
Psychological Impact ◽  
Working Hours ◽  
Well Being ◽  
Training Programme ◽  
Mental Wellbeing ◽  
Junior Doctors ◽  
Training Programmes ◽  
The Impact

AimsThe BMA's survey results (Caring for the Mental Health of the Medical Workforce, 2019) and HEE's NHS Staff and Learners’ Mental Wellbeing Commission report (2019) highlighted declining staff wellbeing. The COVID-19 pandemic has sharpened focus on this and the effects of moral injury on healthcare professionals. Shielding, social distancing and redeployment led to many medical trainees being increasingly isolated at a time of heightened anxiety and adversity. Psychiatry trainees tend to have good access to reflective groups, but this is not customary in other training programmes.MethodIntervention“Trainees4trainees” was set up by trainees across specialties as a HEE-TV well-being project, led by the Deanery Trainee Improvement Fellow. Peer support groups are run on Zoom, facilitated by 2 trainees with special training in peer support. Psychiatry trainees have been involved in designing and facilitating groups and training facilitators from other specialties; facilitators have regular supervision from a consultant psychiatrist in medical psychotherapy. Trainees are supported to discuss challenging experiences and think about their emotional responses in a supportive and validating group.ResultFeedbackWe are in the process of formal data collection to assess the impact of the intervention. Informal feedback suggests the groups are a powerful support to individuals who otherwise have no avenue to think about the psychological impact of their experiences. The groups have supported trainees to feel less isolated and bolstered their resilience.ConclusionFuture plansWe have faced challenges in the practicalities of establishing and maintaining groups. We are working with Training Programme Directors to move towards running the groups in protected time within working hours and advocate that reflective groups, such as our peer support groups, are a key part of future medical and surgical Training Programmes.

scholarly journals Sonographic Measurement of Cross-sectional Area of the Median Nerve in Academic Dentists Without Symptoms or Signs of Carpal Tunnel Syndrome

2018 ◽  
Vol 35 (2) ◽  
pp. 105-111
Author(s):  
Akram Asbeutah ◽  
Mohsen Dashti ◽  
Abdullah AlMajran ◽  
Aref Ghayyath
Keyword(s):  
Median Nerve ◽  
Statistical Significance ◽  
Working Hours ◽  
Cross Sectional Area ◽  
Dominant Hand ◽  
Sectional Area ◽  
Cross Sectional ◽  
Increased Risk ◽  
Bone Level ◽  
The Right

The objective was to evaluate the distribution of the cross-sectional area (CSA) and flattening ratio (FR) of the median nerve (MN) in asymptomatic academic dentists using ultrasonography (US). Fifty academic dentists underwent US of the MN in transverse section at the pisiform bone level and the CSA (mm2) and FR were measured bilaterally. A CSA of <10 mm2 was considered normal. Paired t-test showed no statistical significance between either hand for CSA and FR ( P> .05). Two independent t-tests showed significant statistical differences ( P= .023) between males and females in the right dominant hand for CSA. Linear correlation analysis showed no significant correlation between CSA and FR for number of years of experience or number of working hours per day in either hand ( P>.05). The CSA was abnormal in the right dominant hand in 20 (40%) of the subjects. These male academic dentists were at increased risk of having an enlarged MN without symptoms.

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