Proficiency-Based Training Using Simulator-Based Tools Could be Validated for Certification of Surgical Procedural Proficiency

Hohmann, Erik; Brand, Jefferson C.; Rossi, Michael J.; Lubowitz, James H.

doi:10.1016/j.arthro.2019.09.020

Cited by 7 publications

(3 citation statements)

References 27 publications

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“…Há relatos de uso de simuladores nas mais diversas áreas do conhecimento humano, como nas forças armadas, na aviação civil, no trânsito, assim como na saúde (AEBERSOLD, 2016;ALLEN et al, 2019;KOVÁCSOVÁ, 2020). Na área da saúde, os resultados são animadores na melhoria de performance dos usuários, a ponto de programas de treinamento com simuladores certificarem o bom desempenho de seus alunos, quando presente (HOHMANN et al, 2019).…”

Section: Resultsunclassified

Avanços Tecnológicos no Ensino de Odontologia: mapeamento de patentes sobre o uso de simuladores

Reis

Martinez

Gondim

et al. 2021

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Este artigo realizou um mapeamento patentário sobre a educação em odontologia, que se utiliza principalmente de simuladores, uma vez que se sabe que a excelência do aprendizado depende do desenvolvimento de habilidades técnicas e motoras de modo prático e que uma das utilidades do mapeamento patentário tecnológico da atividade é obter a evolução tecnológica de um determinado assunto, neste caso: o uso de simuladores em odontologia. A evolução temporal dos documentos patentários apresentou três picos (em 1997; de 2001 a 2003; e de 2007 a 2011). No entanto, foi possível destacar o modelo de simulador de articuladores com 45 documentos patentários, representando 38% dos documentos relevantes. Destes, 10 documentos encontram-se no pico entre 2007 e 2011. Acredita-se que a partir desse mapeamento, é possível subsidiar estratégias de inovação tecnológica e auxiliar na promoção de pesquisas e de desenvolvimentos focados na melhoria da qualidade da educação em odontologia.

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Section: Resultsunclassified

Avanços Tecnológicos no Ensino de Odontologia: mapeamento de patentes sobre o uso de simuladores

Reis

Martinez

Gondim

et al. 2021

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“…Technological advances and higher standards of patient care have led to the apprenticeship model for clinical training being questioned. Surgical training in particular has fundamentally shifted towards becoming a proficiency-based training model with high utilisation of simulated training [ 1 , 2 ]. The need to balance trainee development whilst ensuring patient safety has led to a revolution in a range of simulation-based training tools including skills courses, virtual reality, and wet laboratory models across many surgical specialties [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Determining the learning curve for a novel microsurgical procedure using histopathology

et al. 2022

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Purpose Wet laboratories are becoming an increasingly important training tool as part of a push to a proficiency-based training model. We created a microsurgical wet laboratory to investigate the utility of histopathology use in assessing surgical outcomes and determine the learning curve of a novel microsurgical procedure. Methods A microsurgical wet laboratory was established using pig eyes to simulate the human cornea. Three novice surgeons and an experienced surgeon performed an anterior cornea lamellar dissection and the duration of the procedure was recorded. With the aid of histological analysis, the thickness and characteristics of the dissected graft was recorded. The number of attempts to complete the experiment, defined as three successful dissections with mean thickness below 100 μm, was documented. Results The use of histopathology was highly successful allowing in-depth analysis of the dissected graft for each attempt. Trainees reached the endpoint of the study in 21, 26 and 36 attempts (mean: 28 attempts) whilst the corneal surgeon completed the experiment in 12 attempts (p = 0.07). Mean dissection thickness decreased over time for all participants. The mean dissection time for trainees was 10.6 ± 4.2 min compared to the corneal surgeon with a mean of 8.2 ± 3.1 min (p = 0.03). Conclusion We propose a corneal wet laboratory model that allows for simple, efficient, and flexible microsurgical training. The use of histopathological analysis allows for careful graft analysis, providing objective feedback throughout the training exercise. Trainees demonstrated improvements in the three key aspects of the procedure: accuracy as evidenced by decreasing histological thickness, confidence by self-report and fluidity by decreasing duration of the procedure.

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“…Training is important; however, it often lacks quality measures of evaluation. Knowledge can be tested easily through oral or written examinations, but it is more difficult to assess surgical skills [2, 12, 22]. In most countries, surgical skills are evaluated based on the number of operations performed.…”

Section: Introductionmentioning

confidence: 99%

The Diagnostic Arthroscopy Skill Score (DASS): a reliable and suitable assessment tool for arthroscopic skill training

Anetzberger

Becker

Eickhoff³

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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Purpose To develop and validate a novel score to more objectively assess the performance of diagnostic knee arthroscopy using a simulator. Methods A Diagnostic Arthroscopy Skill Score (DASS) was developed by ten AGA (AGA-Society for Arthroscopy and Joint-Surgery) instructors for the assessment of arthroscopic skills. DASS consists of two parts: the evaluation of standardized diagnostic knee arthroscopy (DASS part1 ) and the evaluation of manual dexterity, including ambidexterity and triangulation, using objective measurement parameters (DASS part2 ). Content validity was determined by the Delphi method. One hundred and eleven videos of diagnostic knee arthroscopies were recorded during simulator training courses and evaluated by six specially trained instructors using DASS. Construct validity, measurement error calculated by the minimum detectable change (MDC), internal consistency using Cronbach's alpha and interrater and intrarater reliability were assessed. The Bland-Altman method was used to calculate the intrarater agreement. Results Six skill domains were identiied and evaluated for each knee compartment. DASS, DASS part1, and DASS part2 showed construct validity, with experts achieving signiicantly higher scores than competents and novices. MDC was 4.5 ± 1.7 points for DASS part1 . There was high internal consistency for all domains in each compartment from 0.78 to 0.86. The interrater reliability showed high agreement between the six raters (ICC = 0.94). The evaluation of intrarater reliability demonstrated good and excellent agreement for ive raters (ICC > 0.80) and moderate agreement for one rater (ICC = 0.68). The Bland-Altman comparison showed no diference between the irst and second evaluations in ive out of six raters. Precision, estimated by the regression analysis and comparison with the method of Bland and Altman, was excellent for four raters and moderate for two raters. Conclusions The results of this study indicate good validity and reliability of DASS for the assessment of the surgical performance of diagnostic knee arthroscopy during simulator training. Standardized training is recommended before arthroscopy surgery is considered in patients. Level of evidence II.

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Proficiency-Based Training Using Simulator-Based Tools Could be Validated for Certification of Surgical Procedural Proficiency

Cited by 7 publications

References 27 publications

Avanços Tecnológicos no Ensino de Odontologia: mapeamento de patentes sobre o uso de simuladores

Avanços Tecnológicos no Ensino de Odontologia: mapeamento de patentes sobre o uso de simuladores

Determining the learning curve for a novel microsurgical procedure using histopathology

The Diagnostic Arthroscopy Skill Score (DASS): a reliable and suitable assessment tool for arthroscopic skill training

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