Simulation for Skills-based Education in Pulmonary and Critical Care Medicine

Michaud, Gaëtane; Gordan, Patrick L.; Channick, Colleen; Wahidi, Momen M.; Yarmus, Lonny; Feller‐Kopman, David; Makani, Samir; Koenig, Seth; Mayo, Paul H.; Kovitz, Kevin L.; Thomson, Carey C.

doi:10.1513/annalsats.201410-461ar

Cited by 46 publications

(28 citation statements)

References 52 publications

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“…Therefore, even if trainees' performance improved over time, we are unable to address whether the benefit shown by the practice on the mannequin will translate into improved skills in vivo. Although previous studies reported a good correlation between skills gained in vitro and performance in vivo [4], the relationship between the use of our model and clinical performance will need to be evaluated in the future.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of a low-cost, 3D-printed model for bronchoscopy training

Parotto¹,

Jiansen²,

Abotaiban³

et al. 2017

Anaesthesiol Intensive Ther

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Background: Flexible bronchoscopy is a fundamental procedure in anaesthesia and critical care medicine. Although learning this procedure is a complex task, the use of simulation-based training provides significant advantages, such as enhanced patient safety. Access to bronchoscopy simulators may be limited in low-resource settings. We have developed a low-cost 3D-printed bronchoscopy training model. Methods: A parametric airway model was obtained from an online medical model repository and fabricated using a low-cost 3D printer. The participating physicians had no prior bronchoscopy experience. Participants received a 30-minute lecture on flexible bronchoscopy and were administered a 15-item pre-test questionnaire on bronchoscopy. Afterwards, participants were instructed to perform a series of predetermined bronchoscopy tasks on the 3D printed simulator on 4 consecutive occasions. The time needed to perform the tasks and the quality of task performance (identification of bronchial anatomy, technique, dexterity, lack of trauma) were recorded. Upon completion of the simulator tests, participants were administered the 15-item questionnaire (post-test) once again. Participant satisfaction data on the perceived usefulness and accuracy of the 3D model were collected. A statistical analysis was performed using the t-test. Data are reported as mean values (± standard deviation). Results: The time needed to complete all tasks was 152.9 ± 71.5 sec on the 1st attempt vs. 98.7 ± 40.3 sec on the 4th attempt (P = 0.03). Likewise, the quality of performance score improved from 8.3 ± 6.7 to 18.2 ± 2.5 (P < 0.0001). The average number of correct answers in the questionnaire was 6.8 ± 1.9 pre-test and 13.3 ± 3.1 post-test (P < 0.0001). Participants reported a high level of satisfaction with the perceived usefulness and accuracy of the model. Conclusions:We developed a 3D-printed model for bronchoscopy training. This model improved trainee performance and may represent a valid, low-cost bronchoscopy training tool.

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Section: Discussionmentioning

confidence: 99%

“…Furthermore, even low-fidelity simulators have proved to be effective, and in certain areas, such as basic bronchoscopy tasks, they may indeed be superior to high-fidelity computerized simulators [4].…”

mentioning

confidence: 99%

Evaluation of a low-cost, 3D-printed model for bronchoscopy training

Parotto¹,

Jiansen²,

Abotaiban³

et al. 2017

Anaesthesiol Intensive Ther

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“…Supervised simulator-based training allows hospitalists to master basic components of a procedure 64 (including orientation to equipment, sequence of operations, dexterity, ultrasound anatomy, and real-time guidance technique) while improving both cognitive and manual skills. 42,43,[65][66][67][68][69][70][71] In addition to their role in basic training (which is outside the scope of this position statement), simulators can be useful for remedial training. To be sufficient for hospitalists who do not pass their patient-based assessments, however, remedial training that begins with simulation must also include patient-based training and assessment.…”

Section: If Remedial Training Is Needed Simulator-based Training Canmentioning

confidence: 99%

Credentialing of Hospitalists in Ultrasound‐Guided Bedside Procedures: A Position Statement of the Society of Hospital Medicine

Lucas

Tierney

Jensen

et al. 2018

Journal of Hospital Medicine

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Ultrasound guidance is used increasingly to perform the following 6 bedside procedures that are core competencies of hospitalists: abdominal paracentesis, arterial catheter placement, arthrocentesis, central venous catheter placement, lumbar puncture, and thoracentesis. Yet most hospitalists have not been certified to perform these procedures, whether using ultrasound guidance or not, by specialty boards or other institutions extramural to their own hospitals. Instead, hospital privileging committees often ask hospitalist group leaders to make ad hoc intramural certification assessments as part of credentialing. Given variation in training and experience, such assessments are not straightforward "sign offs." We thus convened a panel of experts to conduct a systematic review to provide recommendations for credentialing hospitalist physicians in ultrasound guidance of these 6 bedside procedures. Pathways for initial and ongoing credentialing are proposed. A guiding principle of both is that certification assessments for basic competence are best made through direct observation of performance on actual patients.

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“…Flexible catheter (4) is used to connect 50 mL syringe with three-way stop-cock (5) and three-way stop-cock is used to change the channel of the withdrawn fluid e.g. to the 50-mL syringe and to the drainage bag (6). The drainage bag is used to collect the pleuritic fluid for further diagnostic examination.…”

Section: Image Processing Levelmentioning

confidence: 99%

“…The quality was also further enhanced with the recent advancements in surgical training regimes e.g. by employing surgical simulators [5] [6] in advanced surgeries, e.g. thoracic surgeries.…”

Section: Introductionmentioning

confidence: 99%

Development of an intelligent surgical training system for Thoracentesis

Nakawala

Ferrigno

Momi

2018

Artificial Intelligence in Medicine

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Surgical training improves patient care, helps to reduce surgical risks, increases surgeon's confidence, and thus enhances overall patient safety. Current surgical training systems are more focused on developing technical skills, e.g. dexterity, of the surgeons while lacking the aspects of context-awareness and intra-operative real-time guidance. Context-aware intelligent training systems interpret the current surgical situation and help surgeons to train on surgical tasks. As a prototypical scenario, we chose Thoracentesis procedure in this work. We designed the context-aware software framework using the surgical process model encompassing ontology and production rules, based on the procedure descriptions obtained through textbooks and interviews, and ontology-based and marker-based object recognition, where the system tracked and recognised surgical instruments and materials in surgeon's hands and recognised surgical instruments on the surgical stand. The ontology was validated using annotated surgical videos, where the system identified "Anaesthesia" and "Aspiration" phase with 100% relative frequency and "Penetration" phase with 65% relative frequency. The system tracked surgical swab and 50mL syringe with approximately 88.23% and 100% accuracy in surgeon's hands and recognised surgical instruments with approximately 90% accuracy on the surgical stand. Surgical workflow training with the proposed system showed equivalent results as the traditional mentor-based training regime, thus this work is a step forward a new tool for context awareness and decision-making during surgical training.

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Simulation for Skills-based Education in Pulmonary and Critical Care Medicine

Cited by 46 publications

References 52 publications

Evaluation of a low-cost, 3D-printed model for bronchoscopy training

Evaluation of a low-cost, 3D-printed model for bronchoscopy training

Credentialing of Hospitalists in Ultrasound‐Guided Bedside Procedures: A Position Statement of the Society of Hospital Medicine

Development of an intelligent surgical training system for Thoracentesis

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