Triad of rubric assessment, constructive feedback and video recorded surgeries key assessment for competent ophthalmic surgeon

2022 ◽  
Vol 7 (4) ◽  
pp. 703-706
Author(s):  
Prachi Nilraj Bakare ◽  
Rupali Maheshgauri ◽  
Deepaswi Bhavsar ◽  
Renu Magdum
Keyword(s):  
Cataract Surgery ◽  
Formative Assessment ◽  
Surgical Training ◽  
Assessment Tool ◽  
Surgical Skills ◽  
Rater Agreement ◽  
Surgical Skill ◽  
Surgical Performance ◽  
Post Graduate ◽  
Constructive Feedback

Ophthalmic surgery involves very precise surgical skill, which is difficult to teach and even more cumbersome in assessment of resident’s surgical skill. Hence it’s a need of time to adopt newer tool for transferring as well as assessing surgical skill. With this concept in mind International Council of Ophthalmology (ICO) has developed various tools for assessing surgical skills. If we use this tool not only as learning tool but also to give constructive feedback on the surgical skills of resident doctors it will help in creating a competent ophthalmic surgeon and eventually help society in general. 1To develop more standardized surgical training; 2. To assess efficacy and feasibility of new tool in improving surgical skills of Post Graduate(PG) student; 3. To know the effect of constructive feedback on surgical performance. Small incision cataract surgery training is done by Rubric designed by ICO- OSCAR. The same tool was used to assess video recorded cataract surgery of residents by different faculties and assess their surgical skill. The assessor simply circled the observed performance description at each step of the procedure. The ICO-OSCAR score was completed. At the end of the case assessor immediately discussed operated case with student to provide timely, structured, specific performance feedback. Oscar score was recorded and analysed with inter rater agreement. OSCAR TOOL has very good inter rater agreement i.e.(0.96). Analysis of student & Observer feedback infers that OSCAR Tool is best tool for learning as well as assessment tool and is easy to use. Recorded surgeries & constructive feedback from assessor helped Post Graduate students to improve surgically. This resulted in best outcome for patient in terms of good visual acuity post operatively. The formative assessment of surgical skills becomes an integral part of our formal residency, training framework, it would be in the interest of our trainees and trainers that we should adopt the OSCAR tools to train and assess. These tools can add immense value to our residency as well fellowship surgical training and possibly help create a generation of competent trainee.Formative Assessment and constructive feedback in surgical training will improve the competency of new ophthalmic surgeons.Structured surgical training will be relatively easy to observe and perform, as trainee learns what is required to be competent.This will ultimately improve the overall quality of patient care.

A Short history of the post-graduate surgical training in Fiji - where to from here?

2018 ◽  
Vol 21 (2) ◽  
pp. 103-107 ◽  
Author(s):  
Jitoko Kelepi Cama ◽  
Sonal Singh Nagra
Keyword(s):  
Surgical Training ◽  
Training Programme ◽  
Post Graduate ◽  
School Of Medicine ◽  
Postgraduate Training Programme ◽  
The Pacific ◽  
National University ◽  
History Of ◽  
Training Of Surgeons ◽  
Pacific Island Nations

Post-graduate surgical training at the Fiji National University (FNU), previously known as the Fiji School of Medicine) has recently been updated by incorporating elements from the Royal Australasian College of Surgeons (RACS) training curriculum. The revised curriculum maintains strong contextual relevance to the needs and pathologies of the Pacific Island nations.  This paper outlines why the FNU surgical postgraduate training programme should be applauded as a successful programme in the training of surgeons for the region.

Evaluation of the Modified Naranjo Criteria for Assessing Causal Attribution of Clinical Outcome to Homeopathic Intervention as Presented in Case Reports

Homeopathy ◽  
2020 ◽  
Vol 109 (04) ◽  
pp. 191-197
Author(s):  
Chetna Deep Lamba ◽  
Vishwa Kumar Gupta ◽  
Robbert van Haselen ◽  
Lex Rutten ◽  
Nidhi Mahajan ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Causal Relationship ◽  
Clinical Case ◽  
Assessment Tool ◽  
Causal Attribution ◽  
Case Reports ◽  
Face Validity ◽  
Rater Agreement ◽  
The Face ◽  
Selection Of

Abstract Objectives The objective of this study was to establish the reliability and content validity of the “Modified Naranjo Criteria for Homeopathy—Causal Attribution Inventory” as a tool for attributing a causal relationship between the homeopathic intervention and outcome in clinical case reports. Methods Purposive sampling was adopted for the selection of information-rich case reports using pre-defined criteria. Eligible case reports had to fulfil a minimum of nine items of the CARE Clinical Case Reporting Guideline checklist and a minimum of three of the homeopathic HOM-CASE CARE extension items. The Modified Naranjo Criteria for Homeopathy Inventory consists of 10 domains. Inter-rater agreement in the scoring of these domains was determined by calculating the percentage agreement and kappa (κ) values. A κ greater than 0.4, indicating fair agreement between raters, in conjunction with the absence of concerns regarding the face validity, was taken to indicate the validity of a given domain. Each domain was assessed by four raters for the selected case reports. Results Sixty case reports met the inclusion criteria. Inter-rater agreement/concordance per domain was “perfect” for domains 1 (100%, κ = 1.00) and 2 (100%, κ = 1.00); “almost perfect” for domain 8 (97.5%, κ = 0.86); “substantial” for domains 3 (96.7%, κ = 0.80) and 5 (91.1%, κ = 0.70); “moderate” for domains 4 (83.3%, κ = 0.60), 7 (67.8%, κ = 0.46) and 9 (99.2%, κ = 0.50); and “fair” for domain 10 (56.1%, κ = 0.38). For domains 6A (46.7%, κ = 0.03) and 6B (50.3%, κ = 0.18), there was “slight agreement” only. Thus, the validity of the Modified Naranjo Criteria for Homeopathy tool was established for each of its domains, except for the two that pertain to direction of cure (domains 6A and 6B). Conclusion The Modified Naranjo Criteria for Homeopathy—Causal Attribution Inventory was identified as a valid tool for assessing the likelihood of a causal relationship between a homeopathic intervention and clinical outcome. Improved wordings for several criteria have been proposed for the assessment tool, under the new acronym “MONARCH”. Further assessment of two MONARCH domains is required.

scholarly journals The Efficacy of Transcranial Direct Current Stimulation in Enhancing Surgical Skill Acquisition: A Preliminary Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 11 (6) ◽  
pp. 707
Author(s):  
Chao-Ming Hung ◽  
Bing-Yan Zeng ◽  
Bing-Syuan Zeng ◽  
Cheuk-Kwan Sun ◽  
Yu-Shian Cheng ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Skill Acquisition ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Surgical Skill ◽  
Sham Control ◽  
Surgical Performance ◽  
Randomized Controlled

The application of transcranial direct current stimulation (tDCS) to targeted cortices has been found to improve in skill acquisition; however, these beneficial effects remained unclear in fine and complicated skill. The aim of the current meta-analysis was to investigate the association between tDCS application and the efficacy of surgical performance during surgical skill training. We included randomized controlled trials (RCTs) investigating the efficacy of tDCS in enhancing surgical skill acquisition. This meta-analysis was conducted under a random-effect model. Six RCTs with 198 participants were included. The main result revealed that tDCS was associated with significantly better improvement in surgical performance than the sham control (Hedges’ g = 0.659, 95% confidence intervals (95%CIs) = 0.383 to 0.935, p < 0.001). The subgroups of tDCS over the bilateral prefrontal cortex (Hedges’ g = 0.900, 95%CIs = 0.419 to 1.382, p < 0.001) and the primary motor cortex (Hedges’ g = 0.599, 95%CIs = 0.245 to 0.953, p = 0.001) were both associated with significantly better improvements in surgical performance. The tDCS application was not associated with significant differences in error scores or rates of local discomfort compared with a sham control. This meta-analysis supported the rationale for the tDCS application in surgical training programs to improve surgical skill acquisition.

scholarly journals 934 Remote one-to-one virtual surgical skills training: Evolving the delivery of operative skills training in the UK

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
Christian Asher ◽  
Ibrahim Ibrahim ◽  
Eyfrossini Katsarma
Keyword(s):  
Surgical Training ◽  
Wound Closure ◽  
Cost Effective ◽  
Skills Training ◽  
Training Programme ◽  
Surgical Skills ◽  
Wound Closure Techniques ◽  
Surgical Skills Training ◽  
Speciality Training ◽  
One To One

Abstract Introduction COVID-19 has had an unprecedented effect on surgical training, including prerequisite entry-level courses to speciality training. We describe the implementation of a virtual, one-to-one training programme aimed at the acquisition and retention of operative skills. Methods Enrolment commenced 8th May 2020 for wound closure techniques or an extended programme including tendon repairs, delivered by Specialist Registrars in Plastic Surgery using Zoom® (v. 5.0.5) via mobile device. Participant feedback was collected retrospectively using a 5-point scale following course completion. Results 5 participants completed the wound closure programme, and 3 the extended programme, over an average of 5 weeks, with 2 sessions per week. 5 participants were male, 3 female and were of the following grades: 2 CT2, 4 FY2, 1 FY1 and 1 medical student. A total of 103.5 hours of training was recorded to 7 September 2020. Participants reported that all virtual skills taught were readily transferable to the theatre environment. Following the course, all participants felt confident to complete the skills learnt independently, rating the course as excellent. Conclusions The COVID-19 crisis has placed insurmountable obstacles in the face of surgical training. With further validation, we aim to develop surgical skills training with virtual, easily reproducible, cost-effective, trainee centred programmes.

scholarly journals Automation of surgical skill assessment using a three-stage machine learning algorithm

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Joël L. Lavanchy ◽  
Joel Zindel ◽  
Kadir Kirtac ◽  
Isabell Twick ◽  
Enes Hosgor ◽  
...  
Keyword(s):  
Machine Learning ◽  
Learning Algorithm ◽  
Surgical Skills ◽  
Adverse Outcomes ◽  
Machine Learning Algorithms ◽  
Surgical Instruments ◽  
Skill Assessment ◽  
Surgical Skill ◽  
Surgical Skill Assessment ◽  
Motion Features

AbstractSurgical skills are associated with clinical outcomes. To improve surgical skills and thereby reduce adverse outcomes, continuous surgical training and feedback is required. Currently, assessment of surgical skills is a manual and time-consuming process which is prone to subjective interpretation. This study aims to automate surgical skill assessment in laparoscopic cholecystectomy videos using machine learning algorithms. To address this, a three-stage machine learning method is proposed: first, a Convolutional Neural Network was trained to identify and localize surgical instruments. Second, motion features were extracted from the detected instrument localizations throughout time. Third, a linear regression model was trained based on the extracted motion features to predict surgical skills. This three-stage modeling approach achieved an accuracy of 87 ± 0.2% in distinguishing good versus poor surgical skill. While the technique cannot reliably quantify the degree of surgical skill yet it represents an important advance towards automation of surgical skill assessment.

Structured Long Interview and Clinical Examination (SLICE) as Formative Assessment Tool in Clinical Clerkship: Medical Students Perspective

2021 ◽  
pp. 1-16
Author(s):  
Wajiha Shadab ◽  
Amna Ahmed Noor ◽  
Saira Waqqar ◽  
Gul Muhammad Shaikh
Keyword(s):  
Medical Students ◽  
Formative Assessment ◽  
Thematic Analysis ◽  
Assessment Tool ◽  
Clinical Skills ◽  
General Medicine ◽  
Sampling Technique ◽  
Clinical Clerkship ◽  
Primary Investigator ◽  
Skills Learning

Abstract Objective: This study aimed to assess the medical students’ opinions and views on undertaking SLICE as a formative assessment. Methods: This was a qualitative, exploratory study. Purposive sampling technique was used to select final year medical students who have undertaken a formative assessment through SLICE in their clerkship rotation. Total 32 students participated in this study .Four sets of focus group discussions (FGD) were conducted from medical students who had recently gone through their clinical clerkship modules for Pediatrics, General Medicine, General Surgery and Gynecology& Obstetrics. Each recorded FGD was transcribed verbatim. Thematic analysis was conducted manually. Themes were identified from the transcribed data, coded and analyzed. In order to achieve adequate coding and researcher reliability, investigator triangulation was performed. The initial thematic analysis was performed by the primary investigator. Thereafter, two more investigators independently analyzed the data. Before the data was finalized, all the three investigators reached a final consensus upon the themes that had emerged, ensuring triangulation of the analyzed data. Results: A four staged thematic analysis was conducted, in which five major themes and five sub-themes emerged. The main themes being: Purpose, Learning, Timing, Relevancy and Fairness of SLICE. Conclusion: The students generally thought that SLICE was effective in enhancing their clinical skills learning and should be conducted more frequently with minor adjustments. Continuous...

Implementing Cognitive Training Into a Surgical Skill Course: A Pilot Study on Laparoscopic Suturing and Knot Tying

2018 ◽  
Vol 25 (6) ◽  
pp. 625-635 ◽  
Author(s):  
Benjamin De Witte ◽  
Franck Di Rienzo ◽  
Xavier Martin ◽  
Ye Haixia ◽  
Christian Collet ◽  
...  
Keyword(s):  
Cognitive Training ◽  
Spatial Orientation ◽  
Mental Workload ◽  
Surgical Skills ◽  
Training Period ◽  
Control Group ◽  
Surgical Skill ◽  
Knot Tying ◽  
Laparoscopic Suturing ◽  
Skill Group

Mini-invasive surgery—for example, laparoscopy—has challenged surgeons’ skills by extending their usual haptic space and displaying indirect visual feedback through a screen. This may require new mental abilities, including spatial orientation and mental representation. This study aimed to test the effect of cognitive training based on motor imagery (MI) and action observation (AO) on surgical skills. A total of 28 postgraduate residents in surgery took part in our study and were randomly distributed into 1 of the 3 following groups: (1) the basic surgical skill, which is a short 2-day laparoscopic course + MI + AO group; (2) the basic surgical skill group; and (3) the control group. The MI + AO group underwent additional cognitive training, whereas the basic surgical skill group performed neutral activity during the same time. The laparoscopic suturing and knot tying performance as well as spatial ability and mental workload were assessed before and after the training period. We did not observe an effect of cognitive training on the laparoscopic performance. However, the basic surgical skill group significantly improved spatial orientation performance and rated lower mental workload, whereas the 2 others exhibited lower performance in a mental rotation test. Thus, actual and cognitive training pooled together during a short training period elicited too high a strain, thus limiting potential improvements. Because MI and AO already showed positive outcomes on surgical skills, this issue may, thus, be mitigated according to our specific learning conditions. Distributed learning may possibly better divide and share the strain associated with new surgical skills learning.

scholarly journals A Values Affirmation Intervention to Improve Female Residents' Surgical Performance

2016 ◽  
Vol 8 (3) ◽  
pp. 378-383 ◽  
Author(s):  
Arghavan Salles ◽  
Claudia M. Mueller ◽  
Geoffrey L. Cohen
Keyword(s):  
Stereotype Threat ◽  
Surgical Training ◽  
Psychological Intervention ◽  
Controlled Trial ◽  
Negative Effects ◽  
Surgical Performance ◽  
Negative Stereotypes ◽  
Clinical Evaluations ◽  
Values Affirmation ◽  
Condition B

ABSTRACT  Female residents in surgical training may face stereotype threat. The awareness of negative stereotypes about surgical ability based on gender may heighten stress and thus reduce performance.Background  The main objective of this study was to assess the effectiveness of a brief stress-reducing writing exercise, known as a values affirmation, to mitigate the negative effects of stereotype threat on the performance of female surgical residents.Objective  This is a randomized, controlled trial in which 167 residents were invited to participate. A total of 45 resident volunteers, including 18 women, were randomized to the affirmation condition or the no-affirmation condition. We administered a values affirmation intervention and measured clinical evaluations data both prior to and 6 months after the intervention.Methods  Women benefited from the affirmation. Women who had participated in the affirmation exercise earned higher clinical evaluation scores than those in the control condition (B = 0.34, P &lt; .05). For men, performance did not differ by affirmation condition (B = –0.20, P = .35).Results  Our findings suggest a benefit of values affirmation for women in surgical training, as measured by performance on clinical evaluations. This suggests that a brief psychological intervention may improve on-the-job performance for women in surgery, an underrepresented group.Conclusions

scholarly journals Establishing a surgical skills laboratory and dissection curriculum for neurosurgical residency training

2015 ◽  
Vol 123 (5) ◽  
pp. 1331-1338 ◽  
Author(s):  
James K. C. Liu ◽  
Varun R. Kshettry ◽  
Pablo F. Recinos ◽  
Kambiz Kamian ◽  
Richard P. Schlenk ◽  
...  
Keyword(s):  
Surgical Training ◽  
Training Programs ◽  
Core Competencies ◽  
Technical Skills ◽  
Surgical Skills ◽  
Training Experience ◽  
Surgical Trainees ◽  
Modern Health Care ◽  
External Pressures ◽  
Skills Laboratory

Surgical education has been forced to evolve from the principles of its initial inception, in part due to external pressures brought about through changes in modern health care. Despite these pressures that can limit the surgical training experience, training programs are being held to higher standards of education to demonstrate and document trainee competency through core competencies and milestones. One of the methods used to augment the surgical training experience and to demonstrate trainee proficiency in technical skills is through a surgical skills laboratory. The authors have established a surgical skills laboratory by acquiring equipment and funding from nondepartmental resources, through institutional and private educational grants, along with product donations from industry. A separate educational curriculum for junior- and senior-level residents was devised and incorporated into the neurosurgical residency curriculum. The initial dissection curriculum focused on cranial approaches, with spine and peripheral nerve approaches added in subsequent years. The dissections were scheduled to maximize the use of cadaveric specimens, experimenting with techniques to best preserve the tissue for repeated uses. A survey of residents who participated in at least 1 year of the curriculum indicated that participation in the surgical skills laboratory translated into improved understanding of anatomical relationships and the development of technical skills that can be applied in the operating room. In addition to supplementing the technical training of surgical residents, a surgical skills laboratory with a dissection curriculum may be able to help provide uniformity of education across different neurosurgical training programs, as well as provide a tool to assess the progression of skills in surgical trainees.

Piloting the ISCP Surgical Skills Assessment: The Wales Deanery Experience

2013 ◽  
Vol 95 (1) ◽  
pp. 1-4
Author(s):  
G Shingler ◽  
J Ansell ◽  
S Goddard ◽  
N Warren ◽  
J Torkington
Keyword(s):  
Systematic Review ◽  
Surgical Training ◽  
Surgical Skills ◽  
Operating Theatre ◽  
Skills Assessment ◽  
Surgical Simulators ◽  
Simulation Based

The evidence for using surgical simulators in training and assessment is growing rapidly. A systematic review has demonstrated the validity of different simulators for a range of procedures. Research suggests that skills developed on simulators can be transferred to the operating theatre. The increased interest in simulation comes as a result of the need to streamline surgical training. This is reflected by the numerous simulation-based courses that have become an essential part of modern surgical training.

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