scholarly journals Validação de Modelo de Treinamento para Realização de Nós e Pontos Laparoscópicos em Ambiente de Simulação

2020 ◽  
Vol 44 (2) ◽  
Author(s):  
Grijalva Otávio Ferreira da Costa ◽  
Hermano Alexandre Lima Rocha ◽  
Cândida Mayara Rodrigues Carvalho ◽  
Luiz Gonzaga de Moura Junior ◽  
Francisco das Chagas Medeiros
Keyword(s):  
Learning Curve ◽  
Student Satisfaction ◽  
Linear Models ◽  
Statistical Significance ◽  
Abdominal Cavity ◽  
Total Duration ◽  
Training Model ◽  
Categorical Variables ◽  
Prospective Longitudinal

Abstract: Introduction: To evaluate the progression of competence, learning curve and degree of satisfaction with the training model of medical students undergoing training to perform laparoscopic knots in a simulator. Methods: This was a prospective, longitudinal, interventional study, carried out from April 2016 to July 2017, with the participation of 52 students from the Centro Universitário Christus, Fortaleza, Brazil, from the first to the third year of medical school, undergoing theoretical practical, systematic, and methodized training, with progression of skills to perform laparoscopic knots in a simulation environment in four stages, with a total duration of 16 hours. It was established the task of performing laparoscopic stitches, with five simple knots, in the beginning and in the end, in a suture mold, in an abdominal cavity simulator, in 18 minutes. The main outcomes were time and quality of performance. The students were evaluated before the first and after all stages of the training regarding the quantity and quality of the knots or the subject of the stage and satisfaction with the training model. ANOVA and Student’s t tests were performed for the independent samples and the chi-square test for the categorical variables. For variables with serial measurements, general linear models were used. Univariate binomial models were used in the evaluation variables of the training model. P values <0.05 were considered significant. Results: The values of the medians were analyzed between the first and last stages of the training; of the number of simple knots (0.0 and 15.0) and laparoscopic knots (0.0 and 3.0), the adequacy of the sizes of the suture tail ends (0.0 and 11.0), the number of adjusted initial simple knots ( 0.0 and 3.0) and adjusted sequential ones (0.0 and 24.0). There was statistical significance in all evaluated parameters (p< 0.001). The learning curve showed that 99.1% of the students attained competence. The degree of satisfactory evaluation of the training model was considered good or great in 97% or more, with statistical relevance in 8 of the 10 evaluated statements. Conclusions: The study demonstrated that the students showed competence progression and learning curve evolution. The degree of student satisfaction in relation to the training model stages was very significant.

scholarly journals Validation of a Training Model for Performing Laparoscopic Knots and Stitches in a Simulation Environment

2020 ◽  
Vol 44 (2) ◽  
Author(s):  
Grijalva Otávio Ferreira da Costa ◽  
Hermano Alexandre Lima Rocha ◽  
Cândida Mayara Rodrigues Carvalho ◽  
Luiz Gonzaga de Moura Junior ◽  
Francisco das Chagas Medeiros
Keyword(s):  
Learning Curve ◽  
Student Satisfaction ◽  
Statistical Significance ◽  
Abdominal Cavity ◽  
Total Duration ◽  
Training Model ◽  
Categorical Variables ◽  
Simulation Environment ◽  
Prospective Longitudinal

Abstract: Introduction: To evaluate the progression of competence, learning curve and degree of satisfaction with the training model of medical students undergoing training to perform laparoscopic knots in a simulator. Methods: This was a prospective, longitudinal, interventional study, carried out from April 2016 to July 2017, with the participation of 52 students from the Centro Universitário Christus, Fortaleza, Brazil, from the first to the third year of medical school, undergoing theoretical practical, systematic, and methodized training, with progression of skills to perform laparoscopic knots in a simulation environment in four stages, with a total duration of 16 hours. It was established the task of performing laparoscopic stitches, with five simple knots, in the beginning and in the end, in a suture mold, in an abdominal cavity simulator, in 18 minutes. The main outcomes were time and quality of performance. The students were evaluated before the first and after all stages of the training regarding the quantity and quality of the knots or the subject of the stage and satisfaction with the training model. ANOVA and Student’s t tests were performed for the independent samples and the chi-square test for the categorical variables. For variables with serial measurements, general linear models were used. Univariate binomial models were used in the evaluation variables of the training model. P values <0.05 were considered significant. Results: The values of the medians were analyzed between the first and last stages of the training; of the number of simple knots (0.0 and 15.0) and laparoscopic knots (0.0 and 3.0), the adequacy of the sizes of the suture tail ends (0.0 and 11.0), the number of adjusted initial simple knots ( 0.0 and 3.0) and adjusted sequential ones (0.0 and 24.0). There was statistical significance in all evaluated parameters (p< 0.001). The learning curve showed that 99.1% of the students attained competence. The degree of satisfactory evaluation of the training model was considered good or great in 97% or more, with statistical relevance in 8 of the 10 evaluated statements. Conclusions: The study demonstrated that the students showed competence progression and learning curve evolution. The degree of student satisfaction in relation to the training model stages was very significant.

Implications of Activity Classification Aggregation in Urban Freight Trip Generation Linear Models

2019 ◽  
pp. 22-37 ◽  
Author(s):  
Ivan D. Sanchez-Diaz ◽  
Jesus Gonzalez-Feliu
Keyword(s):  
Data Collection ◽  
Linear Models ◽  
Statistical Significance ◽  
Detailed Data ◽  
Trip Generation ◽  
Commercial Activity ◽  
Urban Freight ◽  
Levels Of Detail ◽  
High Level

This chapter studies the implication of aggregating establishments by categories with different levels of detail for modeling FTG. To this effect, the chapter conducts an assessment of freight trip generation (FTG) patterns homogeneity inside activity-based grouping. The method implemented is econometric in nature, which allows the assessment of the statistical significance of variables representing commercial activity sectors and sub-sectors. The results show that for some sectors the traditional high-level aggregation includes sub-sectors with homogenous FTG patterns and thus produces appropriate models; in some other cases (e.g., retail, manufacturing), the sub-sectors have different FTG patterns and thus more detailed data is needed to calibrate accurate models. This research can be used to enhance the efficiency of data collection, as it identifies some sub-sectors that need larger efforts for data collection, and some other categories where FTG homogeneity allows for less detailed data collection without hampering the quality of the models.

Palliative care training: A national survey of U.S. hematology/oncology fellows.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 28-28
Author(s):  
Brendan F. Curley ◽  
Roby Antony Thomas ◽  
Sijin Wen ◽  
Jianjun Zhang ◽  
Jame Abraham ◽  
...  
Keyword(s):  
Palliative Care ◽  
Pearson Correlation ◽  
Statistical Significance ◽  
Fellowship Training ◽  
Categorical Variables ◽  
Exact Test ◽  
Dying Patients ◽  
Oncology Practice ◽  
Eol Care

28 Background: The American Society of Clinical Oncology (ASCO) has recommended integration of palliative care into oncology practice at the time of diagnosis of advanced cancer. The attitudes, knowledge, and skills of Hematology/Oncology fellows in palliative medicine to implement this recommendation have not been assessed. Methods: In 2013 we surveyed current US Hematology/Oncology fellows to assess their attitudes and the quality of teaching in palliative care received during fellowship and their perceived preparedness to care for patients at End of Life (EOL). Trainees at all US programs were surveyed via Research Electronic Data Capture. The survey was IRB approved, anonymous and voluntary. Results: 176 surveys were collected. Statistical analysis was performed with t-test for numeric and Fisher’s exact test for categorical variables. 98% of respondents felt that providing care for dying patients was important. 99% indicated that physicians have a responsibility to help patients at EOL. Fellows felt their overall training in fellowship was superior to their quality of training (p<0.0001) or teaching (p <0.0001) on EOL. Pearson correlation showed that those with training in palliative care felt more prepared caring for patients at EOL (p <0.0001). Fellows who had training in palliative care during fellowship (45.4% of those surveyed) felt they had better teaching on managing a patient at EOL than those who did not (p<0.0001). There was no statistical significance noted with self-identified roles of spirituality or religion in attitudes, knowledge, or skills. 64% reported having conducted over ten family meetings regarding EOL. Only 18.9% were supervised (p<0.0001) and only 13.1% were given feedback more than ten times (p<0.0001). 89.7% of fellows surveyed stated they have disagreed with treatment without palliative care on at least one occasion. 40% of respondents did not know how to respond to a request to stop chemotherapy. Conclusions: Hematology/Oncology fellows believe that EOL care is important. Education about EOL is not at the same level of their overall fellowship training despite the recognition of the benefit of palliative care in Oncology. Educational initiatives need to be introduced to improve training on EOL care.

P1203DEGREE OF FUNCTIONAL DEPENDENCE IN PATIENT IN SUBSTITUTE RENAL TREATMENT IN HGUCR

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
MARIA PAZ CASTRO FERNÁNDEZ ◽  
LUIS GUILLERMO PICCONE SAPONARA ◽  
Agustin Carreno ◽  
Diego Siedel ◽  
NANCY GIOVANNA URIBE HEREDIA ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Barthel Index ◽  
Protective Factor ◽  
Functional Dependence ◽  
Statistical Significance ◽  
Categorical Variables ◽  
Total Dependence

Abstract Background and Aims Elderly patients and comorbidity present more frequently deterioration of their cognitive and / or functional capacity, and consequently worse quality of life related to health and the need for help to perform their basic activities. It has been described in the literature that peritoneal dialysis (PD) is a protective factor in the patient's survival against hemodialysis (HD). Quality of life is an important parameter in patients undergoing renal replacement therapy, which influences the choice of dialysis modality. We analyzed and compared the degree of functional dependence of patients on PD versus HD. Method Descriptive and cross-sectional study. A total of 84 patients belonging to the General University Hospital of Ciudad Real were included. Demographic variables (age, sex), associated comorbidity, etiology of CKD, among others, were collected. To assess the degree of dependence, the Barthel index and Lawton and Brody were performed. Statistical analysis with SPSS 25.0. Categorical variables are expressed as percentages and have been compared using the Chi2 test. Quantitative variables are expressed as mean +/- standard deviation, and the T-student was used to compare them. Statistical significance for a value of p &lt;0.05. Results Of the 84 patients, 40.5% received PD and 59.5% HD. 60.7% were male and 39.3% female, with an average age of 60.90 years. 75% were hypertensive, 38.1% diabetic, 61.9% dyslipidemic, 27.4% obese and 61.9% had peripheral vasculopathy. The most frequent causes of CKD were diabetic nephropathy (22.6%), glomerular etiology (21.4%), unfiltered (20.2%) and nephroangiosclerosis (14.3%), among others. The degree of functional dependence according to the Barthel index was 63.1.9% for total independence, 29.8% mild dependence, 4.8% moderate dependence and 1.2% total dependence; and for the Lawton and Brody index, 42.9% total independence, 14.3% mild dependence, 27.4% moderate dependence, 11.9% severe dependence and 3.6% total dependence. When comparing the degree of functional dependence between both dialysis techniques, we observed that patients in PD had a lower degree of functional dependence compared to patients in HD, these differences being statistically significant (Lawton and Brody 73.5% in PD vs. 22% in HD, p &lt;0.001 and Barthel index 85.3% in PD vs 48% in HD, p = 00.4). Conclusion In our experience, the degree of functional dependence in patients in PD is lower compared to patients in HD with less comorbidity, being able to condition the choice of the technique of renal replacement therapy.

scholarly journals From Introduction to Integration: Providing Community-Engaged Structure for Interprofessional Education

2016 ◽  
Vol 3 ◽  
pp. JMECD.S30368 ◽  
Author(s):  
Daniel P. Griffin ◽  
Marie C. Matte ◽  
John M. Clements ◽  
Elizabeth A. Palmer ◽  
Laurie A. Bahlke ◽  
...  
Keyword(s):  
Student Satisfaction ◽  
Athletic Training ◽  
Interprofessional Education ◽  
Statistical Significance ◽  
P Value ◽  
Speech Language Pathology ◽  
Healthcare Profession ◽  
Clinical Scenarios ◽  
Language Pathology

Background Training future healthcare profession students using interprofessional education (IPE) is critical to improve quality of health care and patient safety. Objective The objective of this study was to implement an IPE program and determine student satisfaction with each session, including a clinical case requiring teams with members from each profession addressing clinical scenarios. Subjects The subjects of this study were students from Athletic Training, Medicine, Nursing, Pharmacy, Physical Therapy, Physician Assistant, Social Work, and Speech-Language Pathology. Methods Evaluations, administered to all participating students, consisted of Likert-style responses, rating agreement with a series of questions, and space for descriptive comments. Score differences for each question were compared using independent group t-tests with a P-value of 0.05 to determine statistical significance. Results There were statistically higher satisfaction ratings for the problem-based learning case when compared to less interactive sessions ( P < 0.0001). Conclusion Students perceived benefits of the IPE program. Perceptions improved when various students had the opportunity to work together on clinically relevant problems.

scholarly journals Validation of a high-fidelity training model for fetoscopic spina bifida surgery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Luc Joyeux ◽  
Allan Javaux ◽  
Mary P. Eastwood ◽  
Felix R. De Bie ◽  
Gert Van den Bergh ◽  
...  
Keyword(s):  
Spina Bifida ◽  
Learning Curve ◽  
Abdominal Cavity ◽  
Splitting Method ◽  
Fetal Surgery ◽  
Operation Time ◽  
Training Model ◽  
High Fidelity ◽  
Technical Performance ◽  
Repair Operation

AbstractOpen fetal surgery for spina bifida (SB) is safe and effective yet invasive. The growing interest in fetoscopic SB repair (fSB-repair) prompts the need for appropriate training. We aimed to develop and validate a high-fidelity training model for fSB-repair. fSB-repair was simulated in the abdominal cavity and on the stomach of adult rabbits. Laparoscopic fetal surgeons served either as novices (n = 2) or experts (n = 3) based on their experience. Technical performance was evaluated using competency Cumulative Sum (CUSUM) analysis and the group splitting method. Main outcome measure for CUSUM competency was a composite binary outcome for surgical success, i.e. watertight repair, operation time ≤ 180 min and Objective-Structured-Assessment-of-Technical-Skills (OSATS) score ≥ 18/25. Construct validity was first confirmed since competency levels of novices and experts during their six first cases using both methods were significantly different. Criterion validity was also established as 33 consecutive procedures were needed for novices to reach competency using learning curve CUSUM, which is a number comparable to that of clinical fSB-repair. Finally, we surveyed expert fetal surgeons worldwide to assess face and content validity. Respondents (26/49; 53%) confirmed it with ≥ 71% of scores for overall realism ≥ 4/7 and usefulness ≥ 3/5. We propose to use our high-fidelity model to determine and shorten the learning curve of laparoscopic fetal surgeons and retain operative skills.

144: A Prospective Longitudinal Study of Quality of Life Following Radical Perineal Prostatectomy

2004 ◽  
Vol 171 (4S) ◽  
pp. 38-38
Author(s):  
Benjamin K. Yang ◽  
Matthew D. Young ◽  
Brian Calingaert ◽  
Johannes Vieweg ◽  
Brian C. Murphy ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Longitudinal Study ◽  
Prospective Longitudinal Study ◽  
Perineal Prostatectomy ◽  
Prospective Longitudinal

PENERAPAN iLEARNING SURVEY (iSur) DALAM MENINGKATKAN KUALITAS SISTEM INFORMASI SELAMA PROSES PEMBELAJARAN DI PERGURUAN TINGGI RAHARJA

CCIT Journal ◽  
2014 ◽  
Vol 7 (3) ◽  
pp. 335-354
Author(s):  
Untung Rahardja ◽  
Muhamad Yusup ◽  
Ana Nurmaliana
Keyword(s):  
Higher Education ◽  
Student Satisfaction ◽  
Teaching And Learning ◽  
Online Survey ◽  
The Other ◽  
Learning Activities ◽  
Faculty Performance ◽  
Satisfaction Measurement ◽  
Valid Information

The accuracy and reliability is the quality of the information. The more accurate and reliable, the more information it’s good quality. Similarly, a survey, the better the survey, the more accurate the information provided. Implementation of student satisfaction measurement to the process of teaching and learning activities on the quality of the implementation of important lectures in order to get feedback on the assessed variables and for future repair. Likewise in Higher Education Prog has undertaken the process of measuring student satisfaction through a distributed questioner finally disemester each class lecture. However, the deployment process questioner is identified there are 7 (seven) problems. However, the problem can be resolved by the 3 (three) ways of solving problems one of which is a system of iLearning Survey (Isur), that is by providing an online survey to students that can be accessed anywhere and anytime. In the implementation shown a prototype of Isur itself. It can be concluded that the contribution Isur system can maximize the decision taken by the Higher Education Prog. By using this Isur system with questions and evaluation forms are submitted and given to the students and the other colleges. To assess the extent to which the campus has grown and how faculty performance in teaching students class, and can be used as a media Isur valid information for an assessment of activities throughout college.

ASSECSSING MOCA TEST IN SUBACUTE STROKE PATIENTS AND COMPARE MOCA VERSUS MMSE

2016 ◽  
pp. 120-127
Author(s):  
Dinh Toan Nguyen
Keyword(s):  
Human Life ◽  
Statistical Significance ◽  
High Sensitivity ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Female Age ◽  
Subacute Stroke ◽  
Duration Of Illness ◽  
Dsm Iv

Background: Dementia after stroke, particularly subacute period is often overlooked. Today the quality of human life is increasingly high, finding scales that have high value for detection of dementia in patients with stroke is increasingly interested. MoCA test is high sensitivity with mild dementia and identify more abnormalities of awareness caused by vascular, but MoCA have not been studied much in Vietnam. Objective: Assessing MoCA test in subacute stroke patients and compare MoCA versus MMSE in these patients. Subjects: 90 patients with subacute stroke period, these people are being treated at Department of cardiovascular internal medicine at Hue Central Hospital, from 7/2014 - 7/2015. Methods: cross-sectional description and analysis. Results: The mean age is 65.57 ± 13.38, accounting for 54.4% male and 45.6% female. Age, duration of illness has weak correlation with MoCA. The risk factors: hypertension, stroke ischemic transient, alcoholism, smoking, heart disease, diabetes, dyslipidemia related no statistical significance with MoCA. The proportion of dementia in subacute stroke according MoCA is 82.2%. The concordance between MoCA and MMSE was good (kappa = 0.684). Using DSM-IV criteria as the gold standard we found MoCA more valuable in the dementia diagnosis than MMSE (AUC 0.864 versus 0.774, p <0.05). Conclusion: The rate of dementia in stroke subacute period according MoCA is quite high. MoCA is valuable than MMSE in detecting dementia in patients with stroke subacute period, this scale is short, easy to implement so should put into using widely in clinical practice. Key words: MoCA test, subacute stroke, dementia

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