scholarly journals Task-specific bench model training versus basic laparoscopic skills training for laparoscopic radical prostatectomy: a randomized controlled study

2013 ◽  
Vol 3 (1) ◽  
pp. 22 ◽  
Author(s):  
Robert Sabbagh ◽  
Suman Chatterjee ◽  
Arun Chawla ◽  
Anil Kapoor ◽  
Edward D. Matsumoto
Keyword(s):  
Radical Prostatectomy ◽  
Rating Scale ◽  
Skills Training ◽  
Global Rating Scale ◽  
Controlled Study ◽  
Control Group ◽  
Global Rating ◽  
Laparoscopic Suturing ◽  
Model Training ◽  
Bench Model

Background: Performing a laparoscopic urethrovesical anastomosis(LUA) after a radical prostatectomy is technically challengingfor the novice laparoscopic surgeon. We developed a low-fidelityurethrovesical model (UVM) to allow a urologist to practise thiscritical step. The aim of our study was to compare the effect oftask-specific bench model training (anastomotic suturing on theUVM) with that of basic laparoscopic suturing on intracorporealurethrovesical anastomosis performance.Methods: We recruited 28 senior surgical residents, fellows or staffsurgeons for this prospective, single-blinded, randomized controlledstudy. We randomly assigned participants to an interventiongroup practising LUA on the UVM or to a control group practisingbasic laparoscopic suturing and knot-tying on a foam pad.After practising, we videotaped participants performing 5 intracorporealinterrupted sutures on a foam pad and a LUA on theUVM. A blinded expert scored the videotaped performance usinga laparoscopic suturing checklist (CL) and a global rating scale(GRS), and timed the performance.Results: On the foam pad suturing task, the group that trainedon the UVM had significantly higher CL scores (10.9 v. 8.1,p = 0.017). On the LUA task, the group that trained on the UVMhad significantly higher CL scores (10.9 v. 8.1, p = 0.017), GRS(29.6 v. 22.8, p = 0.005) and shorter times (27.6 v. 38.3 min,p = 0.004) than the control group.Conclusion: Our task-specific bench model was shown to be superiorto basic laparoscopic suturing drills on a foam pad.Généralités : L’anastomose urétrovésicale par voie laparoscopique(AUL) suivant une prostatectomie radicale pose certaines difficultéstechniques au chirurgien peu expérimenté avec la laparoscopie.Nous avons créé un modèle urétrovésical basse-fidélité(MUB) permettant aux urologues de pratiquer cette étape crucialede l’intervention. Le but de l’étude était de comparer l’impactd’exercices avec un modèle spécifique à la tâche (sutures anasto-motiques sur le modèle urétrovésical) et d’exercices de sutureslaparoscopiques sur l’aptitude à effectuer des anastomoses urétrovésicalesintracorporelles.Méthodologie : Vingt-huit résidents séniors en chirurgie, chercheursboursierset chirurgiens ont été recrutés pour cette étude prospectiveet contrôlée, menée à simple insu avec répartition aléatoire.Les participants ont été répartis au hasard en 2 groupes, soit ungroupe qui a pratiqué l’anastomose urétrovésicale sur le MUB etun groupe témoin qui a pratiqué les sutures laparoscopiques etla formation de noeuds sur un coussinet de mousse. Après la pratique,les participants ont été filmés pendant qu’ils effectuaient5 suturations intracorporelles interrompues sur un coussinet demousse et une anastomose urétrovésicale par laparoscopie à l’aidedu modèle urétrovésical. Un expert ne connaissant pas le typed’exercices utilisé a ensuite évalué les chirurgiens à l’aide d’uneliste de vérification des éléments clés d’une suturation laparoscopique(LV), d’un score global et du temps requis pour les suturations.Résultats : Lors de la tâche de suturation avec coussinet de mousse,le groupe qui avait pratiqué à l’aide du modèle urétrovésical aobtenu des scores LV significativement plus élevés (10,9 contre8,1; p = 0,017). Quant à la tâche d’anastomose urétrovésicalepar laparoscopie, le groupe qui avait pratiqué sur le modèle urétrovésicala également obtenu des scores LV significativement plusélevés (10,9 contre 8,1; p = 0.017), mais aussi un score globalplus élevé (29,6 contre 22,8, p = 0,005), et il a effectué la tâcheen moins de temps (27,6 minutes contre 38,3 minutes, p = 0,004)par rapport au groupe témoin.Conclusion : Nous avons élaboré un modèle spécifique à la tâchequi s’est révélé supérieur aux exercices de suturation laparoscopiquesur coussinet de mousse.

Do we need a confederate in full-scale medical simulation? A randomized controlled trial.

2021 ◽  
Author(s):  
Jeremie Traoré ◽  
Frédéric Balen ◽  
Thomas Geeraerts ◽  
Sandrine Charpentier ◽  
Xavier Dubucs ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Rating Scale ◽  
Controlled Trial ◽  
Full Scale ◽  
Global Rating Scale ◽  
Controlled Study ◽  
Control Group ◽  
Global Rating ◽  
Performance Score ◽  
Overall Performance

Abstract Background: During simulation training, the confederate is a member of the pedagogical team. Its role is to facilitate the interaction between participants and the environment, and is thought to increase realism and immersion. Its influence on participants' performance in full-scale simulation remains however unknown. The purpose of this study was to explore the effect of the presence of a confederate on the participants’ performance during full-scale simulation of crisis medical situations. Methods: This was a prospective, randomized study comparing 2 parallel groups. Participants were emergency medicine residents engaging in a simulation session, with or without confederates. Participants were then evaluated on their Crisis Resource Management performance (CRM). The overall performance score on the Ottawa Global Rating Scale was assessed as primary outcome and the 5 non-technical CRM skills as secondary outcomes.Results: A total of 63 simulation sessions, including 63 residents, were included for statistical analysis (n= 32 for Control group and 31 for Confederate group). The mean Overall Performance score was 3.9± 0.8 in the Control group and 4.0± 1.1 in the Confederate group, 95% confidence interval of the difference [-0.6; 0.4], p=0.60. No significant differences between the two groups were observed on each CRM items (leadership, situational awareness, communication, problem solving, resource utilization)Conclusion: In this randomized and controlled study, the presence of confederates during full-scale simulated practice of crisis medical situations does not seem to improve the CRM skills performance of Emergency medicine residents. Trial registration: this study does not need to be registered on Clintrial as it doesn’t report a health care intervention on human participants.

1005 Acquisition of Surgical Skills in Medical Students Via Telementoring: A Randomised Control Trial

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Feeley ◽  
I Feeley ◽  
D Hehir
Keyword(s):  
Medical Students ◽  
Rating Scale ◽  
Significant Degree ◽  
Randomised Control Trial ◽  
Global Rating Scale ◽  
Control Group ◽  
Live Streaming ◽  
Global Rating ◽  
Post Test ◽  
Suturing Skills

Abstract Aim To evaluate the use of telementoring in acquisition of basic suturing skills in medical students. Method This was a single blinded two- armed randomised control trial. Medical students undergoing clinical rotations in their penultimate and final years were invited to participate in this study. Informed consent was obtained. The control group underwent conventional suturing training, with the interventional group undergoing the tutorial in a remote learning setting via live streaming. Pre- and post-test assessment was carried out using validated Global Rating Scale tool. Results Eleven students were enrolled in this study. Participants were comparable at baseline (p=.18) and following the tutorial (p=.29). Participants improved to a statistically significant degree in both the virtual group (p=.02) and the in-person group (p=.001). Conclusions Telementoring is an effective tool in the provision of teaching basic suturing skills in medical students. Research on its use in more complex practical skills is warranted.

scholarly journals Aprendizagem Assistida por Pares: Uma Alternativa Pedagógica no Ensino de Competências a Estudantes de Medicina

2020 ◽  
Vol 33 (11) ◽  
pp. 742
Author(s):  
Joana Fernandes Ribeiro ◽  
Manuel Rosete ◽  
Andreia Teixeira ◽  
Hugo Conceição ◽  
Lèlita Santos
Keyword(s):  
Medical Students ◽  
Rating Scale ◽  
Technical Skills ◽  
Surgical Skills ◽  
Global Rating Scale ◽  
Control Group ◽  
P Value ◽  
Global Rating ◽  
Learning Program ◽  
Peer Assisted Learning

Introduction: Technical skills training is fundamental for clinical practice although poorly emphasised in undergraduate medical curricula. In these circumstances, Peer Assisted Learning methodology has emerged as a valid alternative to overcome this insufficiency. The purpose of this study is to evaluate the impact on students of a Peer Assisted Learning program in basic surgical skills, regarding technical competences and knowledge improvement.Material and Methods: A total of 104 randomly selected third year medical students participated in a workshop delivered by fifth year students. From that total, 34 students were assessed before and after the workshop, using the Objective Structured Assessment of Technical Skills instrument, that consists of a global rating scale and a procedure-specific checklist. Sixth year students (control group) were also assessed in their performance without participating in the workshop. Before workshop versus after workshop Objective Structured Assessment of Technical Skills results were compared using Wilcoxon and McNemar tests. After workshop versus control group Objective Structured Assessment of Technical Skills results were compared using Mann-Whitney, qui-squared test and Fisher’s exact test.Results: For the global rating scale, students obtained an after the workshop score (29.5) that was significantly higher than the before the workshop score (15.5; p-value < 0.001), but no significant differences were found between after the workshop and control group scores (p-value = 0.167). For the procedure-specific checklist, 3rd year students had a substantial positive evolution in all parameters and obtained higher rates of correct achievements compared to the control group.Discussion: The final outcomes demonstrated a significant qualitative and quantitative improvement of knowledge and technical skills, which is in accordance with other literature.Conclusion: This Peer Assisted Learning program revealed promising results concerning improvement of surgical skills in medical students, with little staff faculty contribution and extension to a much broader number of students.

scholarly journals Training on synthetic ethylene-vinyl acetate bench model allows novice medical students to acquire suture skills

2012 ◽  
Vol 27 (3) ◽  
pp. 271-278 ◽  
Author(s):  
Rafael Denadai ◽  
Rogério Saad-Hossne ◽  
Marie Oshiiwa ◽  
Érika Malheiros Bastos
Keyword(s):  
Medical Students ◽  
Vinyl Acetate ◽  
Rating Scale ◽  
Ethylene Vinyl Acetate ◽  
Global Rating Scale ◽  
Global Rating ◽  
Post Test ◽  
Group A ◽  
Group B ◽  
Bench Model

PURPOSE: To assess the acquisition of suture skills by training on ethylene-vinyl acetate bench model in novice medical students. METHODS: Sixteen medical students without previous surgery experience (novices) were randomly divided into two groups. During one hour group A trained sutures on ethylene-vinyl acetate (EVA) bench model with feedback of instructors, while group B (control) received a faculty-directed training based on books and instructional videos. All students underwent a both pre-and post-tests to perform two-and three-dimensional sutures on ox tongue. All recorded performances were evaluated by two blinded evaluators, using the Global Rating Scale. RESULTS: Although both groups have had a better performance (p<0.05) in the post-test when compared with the pre-test, the analysis of post-test showed that group A (EVA) had a better performance (p<0.05) when compared with group B (control). CONCLUSION: The ethylene vinyl acetate bench model allowed the novice students to acquire suture skills faster when compared to the traditional model of teaching.

scholarly journals Assessing communication skills during OSCE: need for integrated psychometric approaches

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Giovanni Piumatti ◽  
Bernard Cerutti ◽  
Noëlle Junod Perron
Keyword(s):  
Factor Analysis ◽  
Medical Students ◽  
Measurement Invariance ◽  
Communication Skills ◽  
Rating Scale ◽  
Skills Training ◽  
Global Rating Scale ◽  
Global Rating ◽  
Measurement Instruments ◽  
Current Form

Abstract Background Physicians’ communication skills (CS) are known to significantly affect the quality of health care. Communication skills training programs are part of most undergraduate medical curricula and are usually assessed in Objective Structured Clinical Examinations (OSCE) throughout the curriculum. The adoption of reliable measurement instruments is thus essential to evaluate such skills. Methods Using Exploratory Factor Analysis (EFA), Multi-Group Confirmatory Factor Analysis (MGCFA) and Item Response Theory analysis (IRT) the current retrospective study tested the factorial validity and reliability of a four-item global rating scale developed by Hodges and McIlroy to measure CS among 296 third- and fourth-year medical students at the Faculty of Medicine in Geneva, Switzerland, during OSCEs. Results EFA results at each station showed good reliability scores. However, measurement invariance assessments through MGCFA across different stations (i.e., same students undergoing six or three stations) and across different groups of stations (i.e., different students undergoing groups of six or three stations) were not satisfactory, failing to meet the minimum requirements to establish measurement invariance and thus possibly affecting reliable comparisons between students’ communication scores across stations. IRT revealed that the four communication items provided overlapping information focusing especially on high levels of the communication spectrum. Conclusions Using this four-item set in its current form it may be difficult to adequately differentiate between students who are poor in CS from those who perform better. Future directions in best-practices to assess CS among medical students in the context of OSCE may thus focus on (1) training examiners so to obtain scores that are more coherent across stations; and (2) evaluating items in terms of their ability to cover a wider spectrum of medical students’ CS. In this respect, IRT can prove to be very useful for the continuous evaluation of CS measurement instruments in performance-based assessments.

scholarly journals P33 Effectiveness of OSCEs in training German pharmacy students in consultation on self-medication – a randomised controlled investigation

2019 ◽  
Vol 104 (6) ◽  
pp. e30.2-e31
Author(s):  
I Farahani ◽  
A Laven ◽  
S Farahani ◽  
MA Deters ◽  
M Feickert ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Communication Skills ◽  
Rating Scale ◽  
Intervention Group ◽  
Pharmacy Students ◽  
Global Rating Scale ◽  
Control Group ◽  
Global Rating ◽  
Self Medication ◽  
Consultation Skills

BackgroundIn Germany 37.1% of dispensed medicinal products were intended to use in self-medication in 2017.1 An investigation showed that 25.2% of children and adolescents used self-medication in Germany.2 Hence, pharmacists’ education needs to include training for competence in consultation.3A modern method to train this competence is the use of OSCEs (Objective Structured Clinical Examinations). The aim of this study was to assess whether the use of OSCEs in pharmacy students to train the consultation performance on self-medication is more effective than a conservative teaching method.MethodsThis randomised controlled investigation was conducted in a pre-post-design with pre-OSCEs before training and post-OSCEs after training in each group. Clinical skills at baseline and after the training were measured. Forty students in their last year of pharmacy studies were randomised into a control and an intervention group. The control group attended a lecture on self-medication and the intervention group had additionally to the lecture one hour of OSCEs for training purpose. An analytical checklist was used for measuring consultation skills and a global rating scale for assessing communication skills.ResultsComplete data was received from 30 students (n=16 intervention group, n=14 control group). Consultation skills improved significantly (analytical checklist: 19.88% ± 10.95% intervention group vs. 9.29% ± 10.89% control group, p< 0.05). However, the communication skills (global rating scale: 20.83% ± 24.33% in the intervention group vs. 11.90% ± 17.12% in the control group, p= 0.380) did not improve significantly during the one-hour training period.ConclusionOSCEs for training purpose are an effective method to convey pharmacy students consultation skills in self-medication. However, communication skills need more training. Based on these results OSCEs on self-medication for the paediatric population should be investigated. This is relevant due to the frequency of self-medication in the paediatric population.ReferencesAbda.de. [Internet]. Berlin: Federal union of German associations of pharmacists. Numbers, data, facts 2016. [Cited January 30, 2019]. Available from: https://www.abda.de/fileadmin/assets/ZDF/ZDF_2018/ABDA_ZDF_2018_Brosch.pdf Du Y, Knopf H. Self-medication among children and adolescents in Germany: results of the National Health Survey for children and adolescents (KiGGS). Br J Clin Pharmacol 2009;68:599–608.Joint Statement by the International Pharmaceutical Federation (FIP) and the World Self Medication Industry (WSMI). [Internet]. Responsible Self-medication. 1998. [Cited January 30, 2019]. Available from: https://www.fip.org/www/uploads/database_file.php?id=241&table_id=.Disclosure(s)Imaneh Farahani, Anna Laven, Samieh Farahani, Maira A. Deters, Martin Feickert, Fabian K. Suessenbach, Holger Schwender and Stephanie Laeer declare that they have no conflict of interest.

scholarly journals The effect of microsurgical training on novice medical students’ basic surgical skills—a randomized controlled trial

2019 ◽  
Vol 43 (4) ◽  
pp. 459-466
Author(s):  
Stian Kreken Almeland ◽  
Andrew Lindford ◽  
Henriette Pisani Sundhagen ◽  
Karl Ove Hufthammer ◽  
Eivind Strandenes ◽  
...  
Keyword(s):  
Medical Students ◽  
Plastic Surgery ◽  
Rating Scale ◽  
Assessment Tool ◽  
Intervention Group ◽  
Global Rating Scale ◽  
Control Group ◽  
Diagnostic Study ◽  
Global Rating ◽  
Suturing Skills

Abstract Background It has been demonstrated that medical students are capable of learning microsurgical techniques. We hypothesize that microsurgical training might give insight into the importance of delicate tissue handling and correct knot tying that could have a positive influence on macrosurgical skills. The primary aim of this study was to evaluate the effect of microsurgical training on macrosurgical suturing skills in novice medical students. Subjects and methods In 2018, 46 novice medical students were enrolled and randomized into two groups. The intervention group received both macro- and microsurgical training and the control group received only microsurgical training. Both groups underwent an assessment test that consisted of macrosurgical tasks of three simple interrupted sutures with a square knot and continuous three-stitch long over-and-over sutures. These tests were individually filmed and assessed using the University of Bergen suturing skills assessment tool (UBAT) and the Objective Structured Assessment of Technical Skill global rating scale (OSATS). Questionnaires regarding future career ambitions and attitudes towards plastic surgery were also completed both prior to and following the tests. Results The intervention group needed a longer time to complete the tasks than the control group (12.2 min vs. 9.6 min, p > 0.001), and scored lower on both the UBAT (5.6 vs. 9.0, p > 0.001) and the OSATS (11.1 vs. 13.1, p > 0.001) assessments. The microsurgery course tended to positively influence the students’ attitudes towards a career in plastic surgery (p = 0.002). This study demonstrates poorer macrosurgical skills in the medical students group exposed to microsurgical training. The true effect of microsurgical training warrants further investigation. Level of evidence: Level I, diagnostic study.

scholarly journals Otoskills training during covid-19 pandemic: a before-after study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maxime Fieux ◽  
Antoine Gavoille ◽  
Fabien Subtil ◽  
Sophie Bartier ◽  
Stéphane Tringali
Keyword(s):  
Surgical Training ◽  
Rating Scale ◽  
Surgical Simulation ◽  
Global Rating Scale ◽  
Middle Ear Surgery ◽  
Global Rating ◽  
Training Requirements ◽  
Significant Difference ◽  
Before And After ◽  
Total Performance

Abstract Background The ongoing COVID-19 pandemic has disrupted the surgical training of residents. There is a real concern that trainees will not be able to meet their training requirements. Low-fidelity surgical simulation appears to be an alternative for surgical training. The educational benefits of repeating ossiculoplasty simulations under a microscope have never been evaluated. With this study we aimed to evaluate the differences in performance scores and on a global rating scale before and after training on an ossiculoplasty simulator. Methods In this quasi-experimental, prospective, single-centre, before-after study with blinded rater evaluation, residents performed five microscopic ossiculoplasty tasks with a difficulty gradient (sliding beads onto rods, the insertion of a partial prosthesis, the insertion of a total prosthesis, and the insertion of a stapedotomy piston under microscopic or endoscopic surgery) before and after training on the same simulator. Performance scores were defined for each task, and total performance scores (score/min) were calculated. All data were collected prospectively. Results Six out of seven intermediate residents and 8/9 novices strongly agreed that the simulator was an effective training device and should be included in the ENT residency program. The mean effect of training was a significant increase in the total performance score (+ 0.52 points/min, [95 % CI, 0.40–0.64], p < 0.001), without a significant difference between novice and intermediate residents. Conclusions This preliminary study shows that techniques for middle-ear surgery can be acquired using a simulator, avoiding any risk for patients, even under lockdown measures.

Objective structured assessment of technical skill in temporal bone dissection: validation of a novel tool

2021 ◽  
pp. 1-11
Author(s):  
M Stavrakas ◽  
G Menexes ◽  
S Triaridis ◽  
P Bamidis ◽  
J Constantinidis ◽  
...  
Keyword(s):  
Temporal Bone ◽  
Rating Scale ◽  
Assessment Tool ◽  
Three Dimensional ◽  
Technical Skills ◽  
Technical Skill ◽  
Global Rating Scale ◽  
Global Rating ◽  
Validity And Reliability ◽  
Cortical Mastoidectomy

Abstract Objective This study developed an assessment tool that was based on the objective structured assessment for technical skills principles, to be used for evaluation of surgical skills in cortical mastoidectomy. The objective structured assessment of technical skill is a well-established tool for evaluation of surgical ability. This study also aimed to identify the best material and printing method to make a three-dimensional printed temporal bone model. Methods Twenty-four otolaryngologists in training were asked to perform a cortical mastoidectomy on a three-dimensional printed temporal bone (selective laser sintering resin). They were scored according to the objective structured assessment of technical skill in temporal bone dissection tool developed in this study and an already validated global rating scale. Results Two external assessors scored the candidates, and it was concluded that the objective structured assessment of technical skill in temporal bone dissection tool demonstrated some main aspects of validity and reliability that can be used in training and performance evaluation of technical skills in mastoid surgery. Conclusion Apart from validating the new tool for temporal bone dissection training, the study showed that evolving three-dimensional printing technologies is of high value in simulation training with several advantages over traditional teaching methods.

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