When consistently applied, Seprafilm significantly decreased adhesion formation around the stoma but not operative times without any increase in the need for myotomy or enterotomy. These findings were not seen in the overall study population possibly due to the large number of surgeons using a variety of application techniques.
Summary and background data
Recent coronavirus outbreak and “stay at home” policies have accelerated the implementation of virtual healthcare. Many surgery departments are implementing telemedicine to enhance remote perioperative care. However, concern still arises regarding the safety of this modality in postoperative follow-up after gastrointestinal surgery. The aim of the present prospective study is to compare the use of telemedicine clinics to in-person follow-up for postoperative care after gastrointestinal surgery during COVID-19 outbreak.
Methods
Prospective study that included all abdominal surgery patients operated since the COVID-19 outbreak. On discharge, patients were given the option to perform their postoperative follow-up appointment by telemedicine or by in-person clinics. Demographic, perioperative, and follow-up variables were analyzed.
Results
Among 219 patients who underwent abdominal surgery, 106 (48%) had their postoperative follow-up using telemedicine. There were no differences in age, gender, ASA score, and COVID-19 positive rate between groups. Patients who preferred telemedicine over in-person follow-up were more likely to have undergone laparoscopic surgery (71% vs. 51%,
P
= 0.037) and emergency surgery (55% vs. 41%;
P
= 0.038). Morbidity rate for telemedicine and in-person group was 5.7% and 8%, (
P
= 0.50). Only 2.8% of patients needed an in-person visit following the telemedicine consult, and 1.9% visited the emergency department.
Conclusions
In the current pandemic, telemedicine follow-up can be safely and effectively performed in selected surgical patients. Patients who underwent laparoscopic and emergency procedures opted more for telemedicine than in-person follow-up.
Background
Feedback is a pivotal cornerstone and a challenge in psychomotor training. There are different teaching methodologies; however, some may be less effective.
Methods
A prospective randomized controlled trial was conducted in 130 medical students to compare the effectiveness of the video‐guided learning (VLG), peer‐feedback (PFG) and the expert feedback (EFG) for teaching suturing skills. The program lasted 4 weeks. Students were recorded making 3‐simple stitches (pre‐assessment and post‐assessment). The primary outcome was a global scale (OSATS). The secondary outcomes were performance time, specific rating scale (SRS) and the impact of the intervention (IOI), defined as the variation between the final and initial OSATS and SRS scores.
Results
No significant differences were found between PFG and EFG in post‐assessment results of OSATS, SRS scores or in the IOI for OSATS and SRS scores. Post‐assessment results of PFG and EFG were significantly superior to VLG in OSATS and SRS scores [(19.8 (18.5–21); 16.6 (15.5–17.5)) and (20.3 (19.88–21); 16.8 (16–17.5)) vs (15.7 (15–16); 13.3 (12.5–14)) (p < 0.05)], respectively. The results of PFG and EFG were significantly superior to VLG in the IOI for OSATS [7 (4.5–9) and 7.4 (4.88–10) vs 3.5 (1.5–6) (p < 0.05)] and SRS scores [5.4 (3.5–7) and 6.3 (4–8.5) vs 3.1 (1.13–4.88) (p < 0.05)], respectively.
Conclusion
The video‐guided learning methodology without any kind of feedback is not enough for teaching suturing skills compared to expert or peer feedback. The peer feedback methodology appears to be a viable alternative to handling the emerging demands in medical education.
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