Teaching elliptical excision skills to novice medical students: A randomized controlled study comparing low- and high-fidelity bench models

Denadai, Rafael; Oshiiwa, Marie; Saad-Hossne, Rogério

doi:10.4103/0019-5154.127679

Cited by 24 publications

(46 citation statements)

References 44 publications

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“…In teaching the skills of suturing and excision to postgraduate medical students, materials used to represent human skin have included vegetables, pads and foam products, chicken legs, pig feet, and other post-mortem animal parts. [1][2][3][4][5][6] The fidelity of these materials to living human tissue can vary significantly and, as shown in the literature, evaluations of model fidelity are often based on authors' opinions rather than research. [7][8][9] The criteria for selection of suture models appear to be based on cost, convenience of use, and degree of skin fidelity.…”

Section: Introductionmentioning

confidence: 99%

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Will SCOBY do? An alternative for teaching basic surgical skills of suturing and skin excision

Dreven¹,

Garner²,

MacDermott³

et al. 2018

J Surg Simul

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Background: Using pork or ethylene-vinyl acetate (EVA) pads to teach suturing and excision skills to medical students can be expensive and lack a degree of realism. This project aimed to ascertain if a symbiotic culture of bacteria and yeast (SCOBY) represented a viable alternative. Methods: Part 1 of this study was designed to identify the descriptors against which SCOBY, pork and EVA pads could be evaluated. Participants in part 1 were asked to identify elements of fidelity that best represented skin when comparing the three models. Part 2 of the study required a second cohort of participants to rank the three models against the descriptors identified. Results: The overall results indicate that, with the exception of odour, respondents rated SCOBY superior to EVA pads and equivalent to pork. There were no significant differences between pork and SCOBY for skin likeness, cutting likeness, and suturing likeness, although both were deemed superior to EVA pads. Qualitative feedback indicated that SCOBY was not as robust as pork and lacked the layers of skin that pork better represents. Cultural and religious impediments to using pork models were also highlighted. Conclusion: SCOBY offers a viable, low-cost alternative to pork to teach suturing and excision with comparable fidelity to pork and a superior fidelity to EVA pads. The smell of SCOBY is mildly vinegary due to the secondary fermentation of alcohol to acetic acid. Ten percent of the participants in part 2 of the study identified cultural or religious barriers to using pork.

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Section: Introductionmentioning

confidence: 99%

“…[7][8][9] The criteria for selection of suture models appear to be based on cost, convenience of use, and degree of skin fidelity. [1][2][3]7,8 Staff at the Grampians Clinical School -Deakin University (GCS) have used ethylene-vinyl acetate pads (EVA) and pork belly as materials to simulate human skin.…”

Section: Introductionmentioning

confidence: 99%

Will SCOBY do? An alternative for teaching basic surgical skills of suturing and skin excision

Dreven¹,

Garner²,

MacDermott³

et al. 2018

J Surg Simul

View full text Add to dashboard Cite

show abstract

“…The different inanimate bench models vary in relation to the fidelity level (realism) when compared to a live human being; there are high fidelity models, such as parts of postmortem animals (pig [37, 38, 40, 45, 46], chicken [38, 39, 44], and cattle [48] skins and ox tongue [40–42]) and others of low fidelity, such as plates of ethylene-vinyl acetate [32, 34–38, 47], organic material [33, 49], among others [40, 53]. …”

Section: Discussionmentioning

confidence: 99%

“…Therefore, since there are studies developed by our group [36–38] and by others [80–83] that demonstrate objectively that the surgical skills learned by novice undergraduate on bench models can result in improved performance in animals, corpses, and also in the operating room, regardless of the fidelity of bench model [9, 38, 39, 80–83], the choice of a specific bench model should not be based on its fidelity. Aspects such as availability, seasonal variability, and costs should be considered for this choice.…”

Section: Discussionmentioning

confidence: 99%

Basic Plastic Surgery Skills Training Program on Inanimate Bench Models during Medical Graduation

Denadai

Toledo

Souto

2012

Plastic Surgery International

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Due to ethical and medical-legal drawbacks, high costs, and difficulties of accessibility that are inherent to the practice of basic surgical skills on living patients, fresh human cadaver, and live animals, the search for alternative forms of training is needed. In this study, the teaching and learning process of basic surgical skills pertinent to plastic surgery during medical education on different inanimate bench models as a form of alternative and complementary training to the teaching programs already established is proposed.

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“…i.e., simulators that offer a high degree of realism for the training that is intended to be imparted. [41][42][43] Although human cadavers continue to be the gold standard in surgical training processes, [44][45][46] their use is linked to extensive infrastructure and logistics requirements, which make it costly and of limited availability. For this reason, experimental model cadavers constitute an interesting alternative that must certainly be used within a framework of ethical and responsible use, recognizing their true potential and analyzing their comparative anatomy.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Interlaminar Discectomy. Use of Swine Cadavers as a Training Model

Cuéllar¹,

Rugeles²

2017

Coluna/Columna

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Objective: To analyze the possibility of using cadavers of pigs for training in endoscopic interlaminar discectomy. Methods: Five young pigs were used. The necessary instruments and equipment were used, and the endoscopic transforaminal and interlaminar percutaneous approach was performed at the L7-S1 level. A specialist surgeon performed the procedure. The points of entry, needle angulation, and subjective technical difficulties indicated by the surgeon were analyzed. Results: The mean weight of pigs was 42.2 kg. The posterolateral (transforaminal) entry point was, on average, 6.28 cm from the midline at an angulation of 32.8°. The posterior (interlaminar) entry point was on average 1.82 cm. Full-endoscopic interlaminar discectomy was possible in all animals of the sample. The structures described in the literature were visible endoscopically in 100% of the models. Conclusions: The demonstrated benefits and increased indications of endoscopic lumbar surgery created the need to establish safer and more efficient training processes. The authors raise the possibility of using experimental models to develop technical skills in endoscopy via interlaminar approach. The use of teaching tools such as animal models constitutes a new learning technique and give more confidence to surgeons. The use of cadavers of pigs, obtained according to ethics, avoids the use of human cadavers, and minimizes the development of the learning curve on patients.

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Teaching elliptical excision skills to novice medical students: A randomized controlled study comparing low- and high-fidelity bench models

Cited by 24 publications

References 44 publications

Will SCOBY do? An alternative for teaching basic surgical skills of suturing and skin excision

Will SCOBY do? An alternative for teaching basic surgical skills of suturing and skin excision

Basic Plastic Surgery Skills Training Program on Inanimate Bench Models during Medical Graduation

Endoscopic Interlaminar Discectomy. Use of Swine Cadavers as a Training Model

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