Original Homebuilt Off-the-Job Training System for Vascular Surgeons: System Analysis and Assessment

Abstract

Objective: We assessed the effectiveness and appropriateness of our original off-the-job training (Off JT) system using data acquired from recruited medical students and doctors.Materials and Methods: We presented our original homebuilt Off JT system, which is simple and inexpensive. In our unique system, we performed anastomosis at the bottom of a plastic pot, which mimics the actual open surgical procedure at a deep site. There were four evaluation points: (A) operating time, (B) performance of anastomosis by semi-automatically analyzing the image with the coefficient of variation (standard deviation/length) of the “bite” and the “pitch,” (C) scoring of the total surgical skill evaluated by the trainers according to the Operative Performance Rating System (OPRS), and (D) the relationship of these three factors (A, B, and C).Results: The procedural time and coefficient of variation of the bite and pitch decreased and the OPRS score increased after training. There was a strong correlation between procedural time, anastomotic performance, and OPRS score.Conclusion: The effectiveness of our original homebuilt system was shown by reduced procedural time, improved anastomotic quality, and increased OPRS score.

Ten-Hour Simulation Training Improved the Suturing Performance of Medical Students

“…Anastomosis of grafts or blood vessels is one of the most basic and familiar procedures for vascular and cardiovascular surgeons; therefore, to assess the effectiveness of our suture training, we focused on the thread arrangement in anastomoses. We had previously determined that bite, pitch, and skewness were associated with suturing symmetry and confirmed that bite, pitch, procedural time, and OPRS were strongly correlated [8].…”

Development of a Web Application That Evaluates Suture Performance in Off-the-Job Training

“…Moreover, we studied anastomotic performance under the system and revealed that procedure time, objective score for the skills, and anastomotic quality were considerably correlated. 10) The system was practically used in the Distal Bypass Workshop (http://www.jsvs.org/ja/event/distal_bypass_ workshop/) carried out by the Japanese Society for Vascular Surgery from 2017 to 2019. Our purpose for developing this application of segmentation was derived from the responses to questionnaires administered in the past workshops.…”

“…For evaluating suture performance (balance of the suture), we used two factors adopted in our previous study: the bite (the length of a stitch across the graft/tube) and pitch (the interval between stitches). 10) The balance was evaluated with the coefficient of variation (CV) as shown previously. 10) In addition, we adopted another factor-skewness-to evaluate the balance of the angle among stitches, especially in curved suture lines of side-to-end anastomoses.…”

“…10) The balance was evaluated with the coefficient of variation (CV) as shown previously. 10) In addition, we adopted another factor-skewness-to evaluate the balance of the angle among stitches, especially in curved suture lines of side-to-end anastomoses. The skewness was calculated by using the circular statistics as defined by Pewsey.…”

“…In our previous report which demonstrated the original homebuilt off-the-job training (Off JT) system, we used the operative time and operative performance rating system (OPRS) to calculate the procedural performance. 10) In addition, we also evaluated the anastomosed graft with balance of sutured thread: bite and pitch. These objective factors were derived from the segmentation process, which clarify the thread line from the pictures of the anastomoses.…”