Laparoscopic skills training – novel methods

2013 ◽  
Vol 154 (19) ◽  
pp. 745-751 ◽  
Author(s):  
György Fábry ◽  
Tamás Haidegger
Keyword(s):  
Skill Training ◽  
Skills Training ◽  
Subjective Assessment ◽  
Minimal Invasive ◽  
Average Completion Time ◽  
Task Load ◽  
Laparoscopic Skills Training ◽  
Human Cadavers ◽  
Nasa Task Load Index

Introduction: Simulation for skill training has a long history in surgery. Initially, surgeons practiced on animals or human cadavers, which is costly and raises ethical questions. Emerging hygienic requirements lead to the development of “artificial” phantoms, on which suturing, anastomoses and other elements of the procedure could be practiced on. Similarly, in minimal invasive surgery surgeons need extensive practice to learn the correct techniques, and to acquire sufficient skills. Laparoscopy requires specific training devices, ranging from animal models to virtual reality simulators. Aim: This work focused on physical simulators, development of affordable phantoms and adjoin tasks for a personal laparoscopic training box. Authors described five new tasks that were added to the classical curriculum. Methods: The tasks included leading the line, ligation, preparation-ligation, leading a string and camera handling. Data was were derived from a trial with 30 participants. They were categorized into 3 groups: laymen, general practitioner residents (non-surgeons) and surgery residents. Subjective assessment of the new tasks was performed using a 20-points questionnaire (NASA Task Load Index). Participants were asked about the usefulness, mental, physical, temporal demand, performance, effort and frustration. Accomplishment time was also recorded for each task (as well as the number or errors, where applicable). In addition, 10 consecutive task execution sessions were recorded, and in some cases, users’ performance was tracked over a follow-up period of several days. Results: Participants considered the tasks suitable and relevant for education, and also approved them for self-education purposes. The three groups showed statistically significant differences in performance, based on their average completion time. Conclusion: The follow-up studies showed continuous progress in the completion of individual tasks. Orv. Hetil., 2013, 154, 745–751.

scholarly journals Surgery Task Load Index in Cardiac Surgery: Measuring Cognitive Load Among Teams

2020 ◽  
pp. 155335062093493
Author(s):  
Lauren R. Kennedy-Metz ◽  
Hill L. Wolfe ◽  
Roger D. Dias ◽  
Steven J. Yule ◽  
Marco A. Zenati
Keyword(s):  
Cardiac Surgery ◽  
Cognitive Load ◽  
Subjective Assessment ◽  
Team Members ◽  
Task Load ◽  
Surgical Complexity ◽  
General Populations ◽  
Nasa Task Load Index ◽  
The Relationship ◽  
Over Time

Background. The most commonly used subjective assessment of perceived cognitive load, the NASA Task Load Index (TLX), has proven valuable in measuring individual load among general populations. The surgery task load index (SURG-TLX) was developed and validated to measure cognitive load specifically among individuals within a surgical team. Notably, the TLX lacks temporal sensitivity in its typical retrospective administration. Objective. This study sought to expand the utility of SURG-TLX by investigating individual measures of cognitive load over time during cardiac surgery, and the relationship between individual and team measures of cognitive load and proxies for surgical complexity. Materials & Methods. SURG-TLX was administered retrospectively in the operating room immediately following each case to approximate cognitive load before, during, and after cardiopulmonary bypass for cardiac surgery team members (surgeon, anesthesiologist, and perfusionist). Correlations were calculated to determine the relationship of individual and team measures of cognitive load over the entire procedure with bypass length and surgery length. Results. Results suggest that perceived cognitive load varies throughout the procedure such that cognitive load during bypass significantly differs compared to before or after bypass, across all 3 roles. While on bypass, results show that anesthesiologists experience significantly lower levels of perceived cognitive load than both surgeons and perfusionists. Correlational analyses reveal that perceived cognitive load of both the surgeon and the team had significant positive associations with bypass length and surgery length. Conclusion. Our findings support the utility of SURG-TLX in real cardiac cases as a measure of cognitive load over time, and on an individual and team-wide basis.

scholarly journals Colonoscopy Trainers Experience Greater Stress During Insertion than Withdrawal: Implications for Endoscopic Curricula

2019 ◽  
Author(s):  
Madeline Lemke ◽  
Alison Banwell ◽  
Natalie Rubinger ◽  
Michelle Wiepjes ◽  
Mark Ropeleski ◽  
...  
Keyword(s):  
Phase I ◽  
Cognitive Load ◽  
Phase Ii ◽  
Simulation Training ◽  
Skills Training ◽  
Task Load ◽  
Simulated Environment ◽  
Competency Based ◽  
Insertion Techniques ◽  
Nasa Task Load Index

Abstract Background Optimal colonoscopy training curricula should minimize stress and cognitive load. This study aimed to determine whether withdrawal or insertion colonoscopy skills training is associated with less stress or cognitive load for trainees or trainers. Methods In Phase I, participants were randomized to train on either insertion or withdrawal in a simulated environment. In Phase II, participants were randomized to begin with either insertion or withdrawal in patient encounters. Salivary cortisol levels, heart rate, and State-Trait Anxiety Inventory (STAI) surveys were used to assess stress in trainees and trainers. NASA Task Load Index (TLX) survey was used to assess cognitive workload in trainees. Results In Phase I, trainee stress increased during the simulation training during both withdrawal and insertion compared to baseline, while trainer stress changed minimally. Cognitive load was higher for trainees during withdrawal (P = 0.005). In Phase II, trainers’ STAI scores were greater during insertion training (P = 0.013). Trainees’ stress was highest prior to beginning patient training and decreased during training, while trainer’s stress increased during training. Trainees reported insertion training being of greater value (70.0%), while trainers reported withdrawal was preferred (77.8%). Conclusion Trainees and trainers exhibit important differences in stress during colonoscopy skills training. Trainees reported more stress during simulation training and greatest cognitive load during simulation withdrawal, whereas trainers reported greatest stress during patient encounters, particularly training of insertion techniques. Attention to the effect of stress on trainees and trainers and the drivers of stress is warranted and could be incorporated in competency based medical education.

The effects of an emotional intelligence skills training program on the consistent anger levels of Turkish university students

2009 ◽  
Vol 37 (4) ◽  
pp. 565-576 ◽  
Author(s):  
Müge Yilmaz
Keyword(s):  
Emotional Intelligence ◽  
University Students ◽  
Training Program ◽  
Skill Training ◽  
Skills Training ◽  
Control Group ◽  
Study Group ◽  
Skill Training Program ◽  
Significant Difference

The effect of an emotional intelligence skill training program on the levels of consistent anger of university students was investigated in 32 volunteers. A pretest, posttest model with a control group as study design was used and 16 individuals made up the study group and 16 individuals were in the control group. Levels of consistent anger were assessed by the State Trait Anger Scale (Spielberger, Jacobs, Russell, & Crane, 1983, adapted by Özer, 1994). In the data analysis, Mann-Whitney U Test, Wilcoxon Matched-Pairs Signed Ranks Test, and One-Way ANOVA for Repeated Measures were used. Results indicate that the level of consistent anger of those who attended the 12-session emotional intelligence skill training program was lower than for those who did not attend this program (p < .001). In the follow-up study conducted 3 months later with the study group, there was no significant difference between consistent anger posttest scores and follow-up test scores. The data gathered indicate that an emotional intelligence skill training program may lower the levels of consistent anger for university students. Students whose consistent anger level is high would benefit from psychological counseling.

scholarly journals Aptitude and attitude: predictors of performance during and after basic laparoscopic skills training

2021 ◽  
Author(s):  
Kirsty L. Beattie ◽  
Andrew Hill ◽  
Mark S. Horswill ◽  
Philip M. Grove ◽  
Andrew R. L. Stevenson
Keyword(s):  
Performance Metrics ◽  
Skills Training ◽  
Testing Session ◽  
Laparoscopic Skills ◽  
Surgical Performance ◽  
Psychological Variables ◽  
Laparoscopic Skills Training ◽  
Visual Spatial ◽  
Surgical Trainees

Abstract Background Manual dexterity and visual-spatial ability are considered key to the development of superior laparoscopic skills. Nevertheless, these abilities do not reliably explain all the variance found in the technical performance of surgical trainees. Consequently, we must look beyond these abilities to improve our understanding of laparoscopic skills and to better identify/develop surgical potential earlier on. Purpose To assess the individual and collective impact of physical, cognitive, visual, and psychological variables on performance during and after basic simulation-based laparoscopic skills training. Method Thirty-four medical students (laparoscopic novices) completed a proficiency-based laparoscopic skills training program (using either a 2D or 3D viewing mode). This was followed by one testing session, a follow-up testing session with new (yet similar) tasks, and a series of physical, cognitive, visual, and psychological measures. Results The statistical models that best predicted variance in training performance metrics included four variables: viewingmode (2D vs 3D), psychologicalflexibility, perceivedtaskdemands, and manualdexterity (bimanual). In subsequent testing, a model that included viewingmode and manualdexterity (assembly) best predicted performance on the pre-practiced tasks. However, for a highly novel, spatially complex laparoscopic task, performance was best predicted by a model that comprised viewingmode, visual-spatialability, and perceivedtaskdemands. At follow-up, manualdexterity (assembly) alone was the best predictor of performance on new (yet similar) tasks. Conclusion By focussing exclusively on physical/cognitive abilities, we may overlook other important predictors of surgical performance (e.g. psychological variables). The present findings suggest that laparoscopic performance may be more accurately explained through the combined effects of physical, cognitive, visual, and psychological variables. Further, the results suggest that the predictors may change with both task demands and the development of the trainee. This study highlights the key role of psychological skills in overcoming initial training challenges, with far-reaching implications for practice.

ASSESSMENT RESULTS OF SINGLE-PORT LAPAROSCOPIC APPENDECTOMY AT HUE CENTRAL HOSPITAL

2011 ◽  
pp. 114-118
Author(s):  
Nhu Hiep Pham ◽  
Huu Thien Ho ◽  
Anh Vu Pham ◽  
Van Nghia Tran
Keyword(s):  
Laparoscopic Appendectomy ◽  
Single Port ◽  
Operation Time ◽  
Invasive Procedure ◽  
Minimal Invasive ◽  
Central Hospital ◽  
Surgical Department ◽  
A New Technique ◽  
Rate Female

Objectives: Laparoscopic appendectomy (LA) is becoming popular for the treatment of acute appendicitis. Since it was the first described, LA has been modified various times. We present the results of a new technique of LA conducted through a single port. Materials and methods: From March 2011 to November 2011, we have performed 28 operations Single Port Laparoscopic Appendectomy at the Surgical Department of Hue Central Hospital. Results: There were 28 patients, 57.1% were female, 42.9% were male, rate female/male was 1.3. The mean age is 36.4. The second port insertion was required in 2 patients (7.2%). Mean operation time was 44.6 minutes and postoperative hospital stay 3-5 days took 71.4%. Postoperative compications occurred in 1 case (3.6%) was of omphalitis. During 2-4 weeks follow up no problem related to the appendectomy have been reported. Conclusions: Single - port intracorporeal appendectomy procedure is a safe, minimal invasive procedure with excellent cosmetic results.

PENGARUH SOCIAL SKILL TRAINING (SST) TERHADAP KETERAMPILAN SOSIAL: KEBIASAAN POSITIF REMAJA TUNARUNGU KLASIFIKASI RINGAN DI SLB N I BANTUL YOGYAKARTA

1970 ◽  
Vol 4 (2) ◽  
Author(s):  
Yokhanan Muryadi ◽  
Laurentia Ajeng Isdiana ◽  
Vivi Retno Intening
Keyword(s):  
Social Skills ◽  
Social Skill ◽  
Social Skills Training ◽  
Skill Training ◽  
Skills Training ◽  
Social Skill Training ◽  
Quasi Experimental

Latar belakang: Hambatan fsik yang dimiliki anak tunarungu dapat berpengaruh pada perkembangan psikologis dan sosial. Mereka akan mengalami kesulitan saat berkomunikasi dengan orang lain, dan sulit untuk mengungkapkan perasaan yang dia rasakan. Hal ini kadang membentuk kepribadian anak dengan hambatan fsik ini lebih memilih untuk sendiri. Tujuan: Mengetahui pengaruh SST terhadap keterampilan sosialisasi remaja tunarungu di SLB N I Bantul. Metode: Penelitian ini menggunakan metode Quasi-Experimental dengan rancangan one group pre-test dan post-testdesign. Hasil: Rata-rata peningkatan keterampilan sosialisasi sebesar 2,00%. Hasil penelitian diketahui perbedaan yang bermakna skor keterampilan sosial pada remaja tunarungu sebelum dan setelah diberikan terapi SST. Kesimpulan: SST dapat digunakan sebagai media untuk membentuk karaktristik, dan pergaulan seseorang dalam bersosialisasi. Saran: Dapat menjadi masukan SLB N I Bantul, meningkatkkan terapi sosial bagi murid- muridnya. Kata kunci: Keterampilan sosialisasi - social skills training - remaja tunarungu

A Canadian Perspective of simulation-based skill attainment in Internal Medicine Residency (Preprint)

2018 ◽  
Author(s):  
Tamer Abdel Moaein ◽  
Chirsty Tompkins ◽  
Natalie Bandrauk ◽  
Heidi Coombs-Thorne
Keyword(s):  
Internal Medicine ◽  
Residency Training ◽  
Training Programs ◽  
Skill Training ◽  
Skills Training ◽  
Skill Learning ◽  
Comfort Level ◽  
Procedural Skills ◽  
Internal Medicine Training ◽  
Simulation Based

BACKGROUND Clinical simulation is defined as “a technique to replace or amplify real experiences with guided experiences, often immersive in nature, that evoke or replicate substantial aspects of the real world in a fully interactive fashion”. In medicine, its advantages include repeatability, a nonthreatening environment, absence of the need to intervene for patient safety issues during critical events, thus minimizing ethical concerns and promotion of self-reflection with facilitation of feedback [1] Apparently, simulation based education is a standard tool for introducing procedural skills in residency training [3]. However, while performance is clearly enhanced in the simulated setting, there is little information available on the translation of these skills to the actual patient care environment (transferability) and the retention rates of skills acquired in simulation-based training [1]. There has been significant interest in using simulation for both learning and assessment [2]. As Canadian internal medicine training programs are moving towards assessing entrustable professional activities (EPA), simulation will become imperative for training, assessment and identifying opportunities for improvement [4, 5]. Hence, it is crucial to assess the current state of skill learning, acquisition and retention in Canadian IM residency training programs. Also, identifying any challenges to consolidating these skills. We hope the results of this survey would provide material that would help in implementing an effective and targeted simulation-based skill training (skill mastery). OBJECTIVE 1. Appraise the status and impact of existing simulation training on procedural skill performance 2. Identify factors that might interfere with skill acquisition, consolidation and transferability METHODS An electronic bilingual web-based survey; Fluid survey platform utilized, was designed (Appendix 1). It consists of a mix of closed-ended, open-ended and check list questions to examine the attitudes, perceptions, experiences and feedback of internal medicine (IM) residents. The survey has been piloted locally with a sample of five residents. After making any necessary corrections, it will be distributed via e-mail to the program directors of all Canadian IM residency training programs, then to all residents registered in each program. Two follow up reminder e-mails will be sent to all participating institutions. Participation will be voluntarily and to keep anonymity, there will be no direct contact with residents and survey data will be summarized in an aggregate form. SPSS Software will be used for data analysis, and results will be shared with all participating institutions. The survey results will be used for display and presentation purposes during medical conferences and forums and might be submitted for publication. All data will be stored within the office of internal medicine program at Memorial University for a period of five years. Approval of Local Research Ethics board (HREB) at Memorial University has been obtained. RESULTS Pilot Results Residents confirmed having simulation-based training for many of the core clinical skills, although some gaps persist There was some concern regarding the number of sim sessions, lack of clinical opportunities, competition by other services and lack of bed side supervision Some residents used internet video to fill their training gaps and/or increase their skill comfort level before performing clinical procedure Resident feedback included desire for more corrective feedback, and more sim sessions per skill (Average 2-4 sessions) CONCLUSIONS This study is anticipated to provide data on current practices for skill development in Canadian IM residency training programs. Information gathered will be used to foster a discourse between training programs including discussion of barriers, sharing of solutions and proposing recommendations for optimal use of simulation in the continuum of procedural skills training.

scholarly journals Desktop lighting for comfortable use of a computer screen

Work ◽  
2021 ◽  
Vol 68 (s1) ◽  
pp. S209-S221
Author(s):  
Lu Han ◽  
Hechen Zhang ◽  
Zhongxia Xiang ◽  
Jinze Shang ◽  
Shabila Anjani ◽  
...  
Keyword(s):  
High Intensity ◽  
Motion Tracking ◽  
Tracking System ◽  
Computer User ◽  
Eye Tracker ◽  
Computer Screen ◽  
Task Load ◽  
Trunk Movements ◽  
Motion Tracking System ◽  
Nasa Task Load Index

BACKGROUND: The contrast between a bright computer screen and a dark ambient environment may influence comfort of the users, especially on their eyes. OBJECTIVE: The objective of this research is to identify the optimal desktop lighting for the comfortable use of the computer screen in a dark environment. METHODS: An experiment was designed where seven illumination setups were introduced for the users to perform their leisure tasks on a computer screen. Fifteen healthy subjects participated in the experiments. During each session, durations of the eye blinks, fixations and saccades of the user were recorded by an eye tracker. His/her neck and trunk movements were recorded by a motion tracking system as well. The comfort/discomfort questionnaire, localized postural discomfort questionnaire, NASA task load index and computer user questionnaire were used to record the overall comfort/discomfort, the local perceived physical discomfort, the cognitive workload, and general/eye health problems, respectively. RESULTS: Subjective and objective measurement results indicated that users felt more comfortable with high intensity warm lights using a computer screen. We also identified that the eye fixation durations, as well as the scores of two questions in the computer user questionnaire, have significant negative correlations with comfort. On the other side, the durations of blinks and the scores of three questions in the computer user questionnaire, were significantly correlated with discomfort. CONCLUSION: The warm (3000K) and high intensity (1500 lux) light reduced the visual and cognitive fatigue of the user and therefore improve the comfort of the user during the use of a computer screen.

scholarly journals Determinants of student’s physical activity: a 12-month follow-up study in Ningxia province

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wei Huang ◽  
Xiangrong Shi ◽  
Yujie Wang ◽  
Xiaoling Li ◽  
Pengpeng Gao ◽  
...  
Keyword(s):  
Physical Activity ◽  
Children And Adolescents ◽  
Vigorous Physical Activity ◽  
Skill Training ◽  
Critical Role ◽  
School Factors ◽  
Factors Associated ◽  
Students Attitudes ◽  
Sport Events

Abstract Background Physical activity has many health benefits for children and adolescents. However, the prevalence of physical inactivity in school-aged children and adolescents remains high in China. Many factors impact the levels of moderate and vigorous physical activity (MVPA) among students. This study investigated the factors associated with students’ MVPA levels and the determinants of changes in their MVPA behaviour. Methods This is a longitudinal study with a 12-month follow-up. The study samples were obtained from 2016 and 2017 Physical Activity and Fitness in China—The Youth Study, and they included 1597 students (aged 9–18 years) from 31 primary, junior high, and high schools in Ningxia Province. Factors related to the individual (Age, Sex, BMI and attitude to PA), school (school exercise facility, PE class, teacher support, PA time and PA environment) and neighbourhood (free skill training, sport events, sport organization, sport facility) factors were measured via questionnaire at baseline and after 12 months. Multiple logistic regression was performed to examine the factors that impact students’ MVPA level and the determinants of changes in students’ MVPA behaviour. Results There was no difference in students’ MVPA levels between 2016 and 2017. Boys were more physically active than girls at baseline (RR 1.55, 95% CI 1.10, 2.20). Neighbourhood factors associated students’ MVPA levels were significant, but all of these factors (neighbourhood sport events, organizations, facilities, etc.) were removed from the longitudinal model. Individual and school factors were important for students’ MVPA maintenance and positive development (e.g., gender, attitude, school PE class and PA time). Conclusions In conclusion, both neighbourhood and school factors may affect students’ MVPA, but school appears to plays a more critical role in maintaining and promoting students’ MVPA levels. In addition, individual factors may be more important than school and neighbourhood factors in influencing students’ MVPA levels. Our research demonstrates that students’ attitudes towards PA and school factors should be considered targets for future intervention programmes to promote MVPA. More education programmes may help enhance students’ attitudes towards PA, but more studies with large samples and objective assessments are needed to explore the determinants of MVPA.

scholarly journals Results of minimal invasive coracoclavicular fixation by double button lift-up system in Neer type II distal clavicle fractures

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901668472 ◽  
Author(s):  
Süleyman Semih Dedeoğlu ◽  
Yunus İmren ◽  
Haluk Çabuk ◽  
Murat Çakar ◽  
Samet Murat Arslan ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Clavicle Fracture ◽  
Rehabilitation Program ◽  
Minimal Invasive ◽  
X Rays ◽  
Distal Clavicle ◽  
Distal Clavicle Fracture ◽  
Shoulder Scores ◽  
Coracoclavicular Fixation

Aim: We aimed to evaluate clinical and functional outcomes of indirect fracture reduction performed by coracoclavicular fixation with minimal invasive double button lift-up system in Neer type IIa unstable fractures of distal clavicle. Material and methods: 22 patients with Neer type 2 distal clavicle fracture were enrolled in that prospective study. All patients underwent indirect reduction and osteosynthesis performed by coracoclavicular fixation with minimal invasive double button lift-up system. Postoperative follow-up was carried out clinically and radiologically with plain X-rays and utilization of Constant and American Shoulder and Elbow Surgeons Standardized Shoulder Assessment (ASES) shoulder scores. Mean follow-up time was 15 months. A standard sling was applied for 2 weeks, postoperatively. Rehabilitation program was started on postoperative day 1. Results: Mean age was 39 (range: 21–60), 18 of the patients were male. Right dominant extremity was affected in 14 patients. Mean duration of the surgical intervention was 40 min (range: 30–55 min). Mean union time was found to be 14 weeks (range: 7–21 weeks). Mean postoperative ASES and Constant scores were 79.9 (66.9–88.3) and 82.2 (71–100), respectively. The duration of return to normal daily activities were found to be 4.5 months. Any loss of reduction, AC joint arthrosis, and clavicular shortening were not detected in X-rays. Conclusion: This study has demonstrated that indirect osteosynthesis performed by coracoclavicular fixation with double button lift-up system in the treatment of unstable Neer type IIa fractures of the distal clavicle had successful clinical, radiological, and functional outcomes.

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