Laparoscopic training by use of a physical simulator and its application in the general surgery residency

Guerrero-Hernández, A.J.; Palacios-Zertuche, Jorge Tadeo; Reyna-Sepúlveda, Francisco; Muñoz-Maldonado, Gerardo Enrique

doi:10.1016/j.rmu.2016.10.002

Cited by 3 publications

(3 citation statements)

References 11 publications

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“…The OSCE stations were designed to test the examinees' application of cognitive knowledge to workflow and psychomotor skills through case scenarios and specific tasks in each perioperative ultrasound application. The scoring rubric consisted of a checklist of tasks for each station where the examinee was checked off as having completed (1) or not completed (0) each task on the checklist (Figure 3).…”

Section: Objectivementioning

confidence: 99%

“…Preclinical proficiency-based training has shown an impact on the learning curve for the first-year surgical residents for complex laparoscopic surgical procedures. 1 There is a steeper learning curve, lower incidence of complications, and fewer chances of faculty takeovers from residents while performing procedures on patients. 2,3 Clinical transferability of preclinical proficiency can possibly address the challenge of variable clinical exposure to develop functional autonomy and subsequent automaticity (Figure 1).…”

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confidence: 99%

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Preclinical Proficiency-Based Model of Ultrasound Training

Fatima

Mahmood

Mufarrih

et al. 2021

Anesthesia &Amp; Analgesia

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BACKGROUND: Graduate medical education is being transformed from a time-based training model to a competency-based training model. While the application of ultrasound in the perioperative arena has become an expected skill set for anesthesiologists, clinical exposure during training is intermittent and nongraduated without a structured program. We developed a formal structured perioperative ultrasound program to efficiently train first-year clinical anesthesia (CA-1) residents and evaluated its effectiveness quantitatively in the form of a proficiency index. METHODS: In this prospective study, a multimodal perioperative ultrasound training program spread over 3 months was designed by experts at an accredited anesthesiology residency program to train the CA-1 residents. The training model was based on self-learning through webbased modules and instructor-based learning by performing perioperative ultrasound techniques on simulators and live models. The effectiveness of the program was evaluated by comparing the CA-1 residents who completed the training to graduating third-year clinical anesthesia (CA-3) residents who underwent the traditional ultrasound training in the residency program using a designed index called a "proficiency index." The proficiency index was composed of scores on a cognitive knowledge test (20%) and scores on an objective structured clinical examination (OSCE) to evaluate the workflow understanding (40%) and psychomotor skills (40%). RESULTS: Sixteen CA-1 residents successfully completed the perioperative ultrasound training program and the subsequent evaluation with the proficiency index. The total duration of training was 60 hours of self-based learning and instructor-based learning. There was a significant improvement observed in the cognitive knowledge test scores for the CA-1 residents after the training program (pretest: 71% [0.141 ± 0.019]; posttest: 83% [0.165 ± 0.041]; P < .001). At the end of the program, the CA-1 residents achieved an average proficiency index that was not significantly different from the average proficiency index of graduating CA-3 residents who underwent traditional ultrasound training (CA-1: 0.803 ± 0.049; CA-3: 0.823 ± 0.063, P = .307). CONCLUSIONS: Our results suggest that the implementation of a formal, structured curriculum allows CA-1 residents to achieve a level of proficiency in perioperative ultrasound applications before clinical exposure. (Anesth Analg 2022;134:178-87) KEY POINTS• Question: Can a structured, multimodal perioperative ultrasound training program prepare ultrasound-naive trainees to gain proficiency before clinical exposure? • Findings: Ultrasound-naive trainees develop a level of proficiency measured by an objective metric, proficiency index comparable to senior graduating trainees. • Meaning: A comprehensive perioperative ultrasound training program allows ultrasound-naive trainees to develop proficiency before the clinical exposure.

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Section: Objectivementioning

confidence: 99%

mentioning

confidence: 99%

Preclinical Proficiency-Based Model of Ultrasound Training

Fatima

Mahmood

Mufarrih

et al. 2021

Anesthesia &Amp; Analgesia

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“…Guerrero-Hernández et al conducted a prospective, random, and double-blind comparative study of Narcotrend index or BIS with traditional monitoring methods in desflurane-combined remifentanil anesthesia and confirmed that the Narcotrend group and BIS group have the same effect, and the dosage of desflurane is significantly reduced compared with the traditional group. During the recovery stage of desflurane combined with remifentanil, the Narcotrend grade is correlated with the desflurane end-expiratory concentration, and with the typical change of the trend from C/D/E to A/B/C, the desflurane end-expiratory concentration gradually decreases [ 9 ]. Nakazato et al confirmed that under desflurane anesthesia in different age groups, EC50 in children was significantly higher than that in young people and adults.…”

Section: Introductionmentioning

confidence: 99%

Application of Intelligent Detection of Neural Signal in Depth Evaluation of Obstetrics and Gynecology Anesthesia

Zhang

et al. 2022

Contrast Media & Molecular Imaging

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In order to evaluate the application of EEG intelligent detection in gynecological anesthesia depth, the application of ANGEL-6000 EEG depth monitor in laparoscopic gynecological anesthesia was proposed. This method was applied to 60 patients who underwent elective laparoscopic gynecological surgery in our hospital from February to August 2016. Inclusion criteria were ASA i ∼ ii; the average age was (37.8 ± 6.6) years from 20 to 50 years old; the average body weight was (51.53 ± 3.87) kg; conscious and no communication barriers; and patients without instrument ventilation. The patients were divided into observation group and control group according to the random number table method, with 30 patients in each group. The two groups were anesthetized with the same anesthetic drugs, and their consciousness index was monitored. IoC values were recorded before induction of anesthesia (T0), 5 min after intubation (T1), 5 min after operation (T2), intraoperative exploration (T3), at the end of operation (T4), 1 min before extubation (T5), and 5 min after extubation (T6). The dosage of anesthetic drugs, operation time, extubation time, and operation time of the two groups were statistically analyzed. Compared with the operation time of patients in the two groups, the extubation time, awake time, and time out of the operating room of patients in the control group were longer than the observation group. The IoC values of patients in the control group at T0 and T6 time points were lower than those in the observation group at each time point from T1 to T5. Comparison of perioperative dose of remifentanil and atracurium between the two groups was performed. The control group used more propofol dose in perioperative period. The application of neuroelectric signal in laparoscopic gynecological surgery to detect changes in perioperative IoC value can well reflect the level of consciousness of patients and reflect the effect of perioperative stimulation at different time points on the EEG of patients in real time.

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Preliminary Validation of an Editable Virtual Reality Simulator for Minimally Invasive Surgical Training

et al. 2019

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MIS-SIM is a virtual reality (VR) environment designed and developed for the creation of virtual scenarios that can be used to train and acquire basic and advance laparoscopic skills. The environment is composed by a task editor where a content creator design and develop tasks for the simulator to play. Once they are completed, objective metrics are automatically stored and examined in MIS-SIM's server so they can be displayed by an online platform. The project was validated in Semmelweis University in Budapest, Hungary where an experienced professor designed tasks for 16 young surgeons (PGY 3-4-5) from different surgical fields (gynaecology, general-, plastic-, vascular-, thoracic-, neurosurgery, etc.) with different experiences in laparoscopy. Each participant fulfilled each task as if they were completing them on physical simulator.

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Laparoscopic training by use of a physical simulator and its application in the general surgery residency

Cited by 3 publications

References 11 publications

Preclinical Proficiency-Based Model of Ultrasound Training

Preclinical Proficiency-Based Model of Ultrasound Training

Application of Intelligent Detection of Neural Signal in Depth Evaluation of Obstetrics and Gynecology Anesthesia

Preliminary Validation of an Editable Virtual Reality Simulator for Minimally Invasive Surgical Training

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