Simulated Procedure Rehearsal Is More Effective Than a Preoperative Generic Warm-Up for Endovascular Procedures

Willaert, Willem; Aggarwal, Rajesh; Daruwalla, Farhad; Herzeele, Isabelle Van; Darzi, Ara; Vermassen, Frank; Cheshire, Nicholas

doi:10.1097/sla.0b013e31824f9dbf

Cited by 61 publications

(25 citation statements)

References 28 publications

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“…The authors in one RCT [25] and one case study [26] reported that preoperative simulation shortens subsequent performance time in a simulated environment. In one crossover trial [27] and one case study [33] equivocal results were reported, with preoperative simulation reducing the time of some performance metrics, but not all. Finally, in only one RCT [24] did preoperative simulation not affect the time taken to perform simulated laparoscopic surgery.…”

Section: Studies Reporting Performance Timementioning

confidence: 99%

“…Two cross-over trials [27,29] reported ambiguous findings for the effect of preoperative simulation on surgical performance; the first study [27] reported a significant effect as measured by one global rating scale, but no effect according to another also-reported scale. The second study [28] found a significant improvement in one assessed task, but not another.…”

Section: Studies Reporting Global Rating Scorementioning

confidence: 99%

“…Five of the included studies [24,25,27,31,33] reported `pureÕ performance timedefined as the time taken to perform an assessed task. Those articles that reported duration as part of a global rating scale were not included as such studies have been discussed above.…”

Section: Studies Reporting Performance Timementioning

confidence: 99%

“…The authors of one cross-over study [27] explored participantsÕ perception of how useful they found the preoperative simulation and whether they believed simulation improved their subsequent performance. This was assessed by a questionnaire utilising a five-point Likert scale.…”

Section: Subjective Evaluationmentioning

confidence: 99%

“…the assessment task) was used to prepare the participants for surgery (real-life or simulated) and thus, demanded a repetition of motor action. Two studies [27,30] had, what appears to be a more even distribution of cognitive and motor demands in their preoperative simulation and one study relied on cognitive alone (complete absence of motor action) [34].…”

Section: The Warm-up Tasksmentioning

confidence: 99%

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A systematic examination of preoperative surgery warm-up routines

et al. 2016

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Background: Recent evidence indicates that a preoperative warm-up is a potentially useful tool in facilitating performance. But what factors drive such improvements and how should a warm-up be implemented? Methods:In order to address these issues, we adopted a two-pronged approach: (i) we conducted a systematic review of the literature to identify existing studies utilizing preoperative simulation techniques; (ii) we performed task analysis to identify the constituent parts of effective warm-ups. We identified five randomised control trials, four randomised crossover trials and four case series. The majority of these studies reviewed surgical performance following preoperative simulation relative to performance without simulation.Results: Four studies reported outcome measures in real patients and the remainder reported simulated outcome measures. All but one of the studies found that preoperative simulation improves operative outcomes-but this improvement was not found across all measured parameters. Whilst the reviewed studies had a number of methodological issues, the global data indicate that preoperative simulation has substantial potential to improve surgical performance. Analysis of the task characteristics of successful interventions indicated that the majority of these studies employed warm-ups that focused on the visual motor elements of surgery. However, there was no theoretical or empirical basis to inform the design of the intervention in any of these studies. Conclusions:There is an urgent need for a more rigorous approach to the development of Ôwarm-upÕ routines if the potential value of preoperative simulation is to be understood and realised. We propose that such interventions need to be grounded in theory and empirical evidence on human motor performance.

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Section: Studies Reporting Performance Timementioning

confidence: 99%

Section: Studies Reporting Global Rating Scorementioning

confidence: 99%

Section: Studies Reporting Performance Timementioning

confidence: 99%

Section: Subjective Evaluationmentioning

confidence: 99%

Section: The Warm-up Tasksmentioning

confidence: 99%

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A systematic examination of preoperative surgery warm-up routines

et al. 2016

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Training situational awareness to reduce surgical errors in the operating room

Graafland

Schraagen

Boermeester

et al. 2015

Journal of British Surgery

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Background: Surgical errors result from faulty decision-making, misperceptions and the application of suboptimal problem-solving strategies, just as often as they result from technical failure. To date, surgical training curricula have focused mainly on the acquisition of technical skills. The aim of this review was to assess the validity of methods for improving situational awareness in the surgical theatre.Methods: A search was conducted in PubMed, Embase, the Cochrane Library and PsycINFO ® using predefined inclusion criteria, up to June 2014. All study types were considered eligible. The primary endpoint was validity for improving situational awareness in the surgical theatre at individual or team level.Results: Nine articles were considered eligible. These evaluated surgical team crisis training in simulated environments for minimally invasive surgery (4) and open surgery (3), and training courses focused at training non-technical skills (2). Two studies showed that simulation-based surgical team crisis training has construct validity for assessing situational awareness in surgical trainees in minimally invasive surgery. None of the studies showed effectiveness of surgical crisis training on situational awareness in open surgery, whereas one showed face validity of a 2-day non-technical skills training course. Conclusion:To improve safety in the operating theatre, more attention to situational awareness is needed in surgical training. Few structured curricula have been developed and validation research remains limited. Strategies to improve situational awareness can be adopted from other industries.

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SCAI/SVM expert consensus statement on Carotid Stenting: Training and credentialing for Carotid Stenting

Aronow

Collins

Gray

et al. 2015

Cathet Cardio Intervent

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Carotid artery stenting (CAS) has become an integral part of the therapeutic armamentarium offered by cardiovascular medicine programs for the prevention of stroke. The purpose of this expert consensus statement is to provide physician training and credentialing guidance to facilitate the safe and effective incorporation of CAS into clinical practice within these programs. Since publication of the 2005 Clinical Competence Statement on Carotid Stenting, there has been substantial device innovation, publication of numerous clinical trials and observational studies, accumulation of extensive real‐world clinical experience and widespread participation in robust national quality improvement initiatives [5]. Collectively, these advances have led to substantial evolution in the selection of appropriate patients, as well as in the cognitive, technical and clinical skills required to perform safe and effective CAS. Herein, we summarize published guidelines, describe training pathways, outline elements of competency, offer strategies for tracking outcomes, specify facility, equipment and personnel requirements, and propose criteria for maintenance of CAS competency. © 2015 Wiley Periodicals, Inc.

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Simulated Procedure Rehearsal Is More Effective Than a Preoperative Generic Warm-Up for Endovascular Procedures

Abstract: Patient-specific simulated rehearsal of a CAS procedure significantly improves operative performance, compared to a generic VR warm-up or no warm-up. This technology requires further investigation with respect to improved outcomes on patients in the clinical setting.

Cited by 61 publications

References 28 publications

A systematic examination of preoperative surgery warm-up routines

A systematic examination of preoperative surgery warm-up routines

Training situational awareness to reduce surgical errors in the operating room

SCAI/SVM expert consensus statement on Carotid Stenting: Training and credentialing for Carotid Stenting

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