Simulation for team training and assessment: case studies of online training with virtual worlds.


:Individuals in clinical training programs concerned with critical medical care must learn to manage clinical cases effectively as a member of a team. However, practice on live patients is often unpredictable and frequently repetitive. The widely substituted alternative for real patients-high-fidelity, manikin-based simulators (human patient simulator)-are expensive and require trainees to be in the same place at the same time, whereas online computer-based simulations, or virtual worlds, allow simultaneous participation from different locations. Here we present three virtual world studies for team training and assessment in acute-care medicine: (1) training emergency department (ED) teams to manage individual trauma cases; (2) prehospital and in-hospital disaster preparedness training; (3) training ED and hospital staff to manage mass casualties after chemical, biological, radiological, nuclear, or explosive incidents. The research team created realistic virtual victims of trauma (6 cases), nerve toxin exposure (10 cases), and blast trauma (10 cases); the latter two groups were supported by rules-based, pathophysiologic models of asphyxia and hypovolemia. Evaluation of these virtual world simulation exercises shows that trainees find them to be adequately realistic to "suspend disbelief," and they quickly learn to use Internet voice communication and user interface to navigate their online character/avatar to work effectively in a critical care team. Our findings demonstrate that these virtual ED environments fulfill their promise of providing repeated practice opportunities in dispersed locations with uncommon, life-threatening trauma cases in a safe, reproducible, flexible setting.


World J Surg


World journal of surgery


LeRoy Heinrichs W,Youngblood P,Harter PM,Dev P




Has Abstract


2008-02-01 00:00:00












  • Trauma evaluation of patients with chest injury in the 2008 earthquake of Wenchuan, Sechuan, China.

    abstract:BACKGROUND:The purpose of the present study was twofold: to summarize the characteristics of trauma patients with thoracic injury in the 2008 earthquake of Wenchuan, Sichuan, China, and to validate the accuracy of the Injury Severity Score (ISS), the New Injury Severity Score (NISS), and the Chest Injury Index (CII) in...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Hu Y,Tang Y,Yuan Y,Xie TP,Zhao YF

    更新日期:2010-04-01 00:00:00

  • Alternative surgical strategies and favorable outcomes in patients with medullary thyroid carcinoma in Japan: experience of a single institution.

    abstract:BACKGROUND:Medullary thyroid carcinoma (MTC) accounts only for 1.4% of all thyroid malignancies in Japan. Since 1996, we have performed hemithyroidectomy, instead of total thyroidectomy, for sporadic nonhereditary MTC when the primary lesion is located in only one lobe. Regarding lymph node dissection, modified radical...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Ito Y,Miyauchi A,Yabuta T,Fukushima M,Inoue H,Tomoda C,Uruno T,Kihara M,Higashiyama T,Takamura Y,Miya A,Kobayashi K,Matsuzuka F

    更新日期:2009-01-01 00:00:00

  • Long-term survival after resection of proximal bile duct carcinoma (Klatskin tumors).

    abstract::This retrospective study in 79 surgically treated patients with a proximal bile duct carcinoma revealed 12 patients with a median age of 59.5 years (range 21-73 years) who survived more than 5 years. These 12 patients were analyzed to identify specific patient characteristics for long-term survival. Fifteen patients d...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Gerhards MF,van Gulik TM,Bosma A,ten Hoopen-Neumann H,Verbeek PC,Gonzalez Gonzalez D,de Wit LT,Gouma DJ

    更新日期:1999-01-01 00:00:00

  • Postoperative complications affect long-term survival outcomes following hepatic resection for colorectal liver metastasis.

    abstract:BACKGROUND:The impact of postoperative complications (POCs) on long-term survival outcomes following hepatic resection for colorectal liver metastasis (CRLM) is in controversy. The aim of the present meta-analysis was to systematically evaluate the POC effect on overall survival (OS) and disease-free survival (DFS) in ...

    journal_title:World journal of surgery

    pub_type: 杂志文章,meta分析,评审


    authors: Yin Z,Huang X,Ma T,Jin H,Lin Y,Yu M,Jian Z

    更新日期:2015-07-01 00:00:00

  • Fluorodeoxyglucose-positron emission tomography in adenocarcinomas of the distal esophagus and cardia.

    abstract::Adenocarcinomas of the esophagogastric junction (AEG) are now recognized as a separate tumor entity with increasing incidence. The aim of the present study was to evaluate whether positron emission tomography (PET) using the glucose analog F-18-fluorodeoxyglucose (FDG) can be used for metabolic characterization of thi...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Ott K,Weber WA,Fink U,Helmberger H,Becker K,Stein HJ,Müller J,Schwaiger M,Siewert JR

    更新日期:2003-09-01 00:00:00

  • Long-term results of side-to-side pancreaticojejunostomy.

    abstract::Chronic alcoholism is the etiologic factor initiating most instances of chronic pancreatitis and its complications in the United States of America. The goal of operative intervention is to relieve incapacitating abdominal and back pain, while preserving as much endocrine and exocrine function as possible. Ultrasound a...

    journal_title:World journal of surgery

    pub_type: 杂志文章,评审


    authors: Greenlee HB,Prinz RA,Aranha GV

    更新日期:1990-01-01 00:00:00

  • Thoracoscopic sympathectomy for primary palmar hyperhidrosis: resection versus transection -- a prospective trial.

    abstract::Upper dorsal sympathectomy is the only successful therapeutic method for idiopathic palmar hyperhidrosis (IPHH). However, the techniques for sympathetic ablation are still debated. The aim of this study was to compare prospectively two accepted methods for endoscopic sympathetic ablation: resection of T2-T3 ganglia ve...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Assalia A,Bahouth H,Ilivitzki A,Assi Z,Hashmonai M,Krausz MM

    更新日期:2007-10-01 00:00:00

  • Mirizzi syndrome: ten years experience from a teaching hospital in Riyadh.

    abstract:OBJECTIVE:Mirizzi syndrome (MS) is an uncommon presentation of cholelithiasis. This study aims to find the incidence and analyze the outcome of management of this condition at Riyadh Medical Complex (RMC) with particular reference to diagnostic methods and outcome of surgical treatment. METHODS:Retrospective study on ...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Al-Akeely MH,Alam MK,Bismar HA,Khalid K,Al-Teimi I,Al-Dossary NF

    更新日期:2005-12-01 00:00:00

  • Radiological evaluation of benign breast disorders.

    abstract::The radiological features of common benign conditions of the breast and the radiological procedures used in the investigation of benign breast disorders are presented. ...

    journal_title:World journal of surgery

    pub_type: 杂志文章,评审


    authors: Gravelle IH,Lyons K

    更新日期:1989-11-01 00:00:00

  • Cervical pharyngoesophageal and laryngotracheal injuries.

    abstract::Aerodigestive tract injuries in the neck are found in about 7% of penetrating neck injuries and are very rare in blunt trauma. A combination of a good physical examination with endoscopy and esophagography can reliably diagnose all significant injuries. Airway control in laryngotracheal trauma is the most urgent prior...

    journal_title:World journal of surgery

    pub_type: 杂志文章,评审


    authors: Demetriades D,Velmahos GG,Asensio JA

    更新日期:2001-08-01 00:00:00

  • Head injury in the United Kingdom.

    abstract::This paper reviews aspects of head injury management and research in the United Kingdom (UK). We discuss evidence about the scale and etiology of head injury in Britain and how this information has supported a triage-based approach, incorporating risk analysis. A Cohesive organization based upon nationally accepted, y...

    journal_title:World journal of surgery

    pub_type: 杂志文章,评审


    authors: Kay A,Teasdale G

    更新日期:2001-09-01 00:00:00

  • Study on the use of T-tube for patients with persistent duodenal fistula: is it useful?

    abstract:BACKGROUND:The commonest surgical treatment used for peptic ulcer perforation is omental patching. If, however, the perforation leaks, it rarely heals by itself due to persistence of duodenal fistula (DF). We present our experience with a T-tube placed into the DF for better outcome of the patients. METHODS:All patien...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Gupta V,Singh SP,Pandey A,Verma R

    更新日期:2013-11-01 00:00:00

  • Expression of pepsinogen C in gynecomastias and male breast carcinomas.

    abstract::Pepsinogen C is a proteolytic enzyme involved in the digestion of proteins in the stomach; it is also synthesized by a significant percentage of female breast carcinomas. In addition, it has been demonstrated that pepsinogen C is one of the few proteins induced by androgens in breast carcinoma cells. Here we evaluate ...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Serra Díaz C,Vizoso F,Rodríguez JC,Merino AM,González LO,Baltasar A,Pérez-Vázquez MT,Medrano J

    更新日期:1999-05-01 00:00:00

  • Serum hyaluronate level for predicting subclinical liver dysfunction after hepatectomy.

    abstract::The serum hyaluronate (HA) level reflects sinusoidal endothelial cell function correlated with liver function. We have reviewed multiple liver function indicators from 37 patients who underwent hepatectomy for various liver diseases. The serum HA level was well correlated with the indocyanine green retention rate at 1...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Mizuguchi T,Katsuramaki T,Nobuoka T,Kawamoto M,Oshima H,Kawasaki H,Kikuchi H,Shibata C,Hirata K

    更新日期:2004-10-01 00:00:00

  • Penetrating chest wounds: 24 years experience.

    abstract::Thoracic and thoracoabdominal penetrating wounds are frequently encountered in urban medical centers in the United States. This study was undertaken to determine the clinical characteristics and in hospital outcome of these injuries. This was a longitudinal, nonblinded study using the established standard of care of p...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Mandal AK,Sanusi M

    更新日期:2001-09-01 00:00:00

  • Time to Readmission and Mortality Among Patients Undergoing Liver and Pancreatic Surgery.

    abstract:BACKGROUND:The impact of time to readmission (TTR) on post-discharge mortality has not been well examined. We sought to define the impact of TTR on postoperative mortality after liver or pancreas surgery. METHODS:A retrospective cohort analysis of liver and pancreas surgical patients was conducted using 2013-2015 Medi...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Chen Q,Bagante F,Olsen G,Merath K,Idrees JJ,Beal EW,Akgul O,Cloyd J,Dillhoff M,Schmidt C,White S,Pawlik TM

    更新日期:2019-01-01 00:00:00

  • An algorithm informed by the parathyroid hormone level reduces hypocalcemic complications of thyroidectomy.

    abstract:BACKGROUND:Measurement of the parathyroid hormone (PTH) level following total thyroidectomy (TTx) may allow prediction of postoperative hypocalcemia. We present an algorithmic method of managing hypocalcemia pre-emptively, based on the PTH level 1 h after operation. MATERIALS AND METHODS:We examined 423 consecutive pa...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Wiseman JE,Mossanen M,Ituarte PH,Bath JM,Yeh MW

    更新日期:2010-03-01 00:00:00

  • Cost-benefit analysis for the treatment of severe obesity.

    abstract::Cost-benefit and cost-effectiveness analyses (CEAs) are only now beginning to be used by business, government, and policymakers to evaluate various medical treatments. The evolution of why CEAs are being demanded is reviewed. To date, a formal CEA of obesity treatments has not been published. This article outlines how...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Martin LF,White S,Lindstrom W Jr

    更新日期:1998-09-01 00:00:00

  • Differentiated thyroid cancer presenting with distant metastases: a population analysis over two decades.

    abstract:BACKGROUND:Differentiated thyroid cancer (DTC) with distant metastases at presentation is uncommon; the prognosis of patients with this condition is more favorable than for other cancers. Demographic, clinical, and pathologic characteristics are described at a population level; factors associated with long-term disease...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Goffredo P,Sosa JA,Roman SA

    更新日期:2013-07-01 00:00:00

  • Surgical management of malignant islet cell tumors.

    abstract::The surgical management of pancreatic islet cell carcinomas poses a complicated set of questions resulting from their rare occurrence and the difficulty in establishing a diagnosis in early cases or, conversely, the problems inherent in dealing with metastatic disease. However, because their biologic behavior is rathe...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Grant CS

    更新日期:1993-07-01 00:00:00

  • Bloodless liver resection using the monopolar floating ball plus ligasure diathermy: preliminary results of 16 liver resections.

    abstract::Blood loss during liver transection and ischemia-reperfusion injury associated with hepatic inflow occlusion are significant drawbacks during liver surgery. Sixteen patients underwent liver resection using the Monopolar Floating Ball (FB) plus LigaSure (LS) diathermy without occlusion of the hepatoduodenal ligament (g...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Sakamoto Y,Yamamoto J,Kokudo N,Seki M,Kosuge T,Yamaguchi T,Muto T,Makuuchi M

    更新日期:2004-02-01 00:00:00

  • Long-term results of hemostatic gastric suture in the treatment of esophagogastric varices.

    abstract::Portal azygos disconnection, using vein ligatures and a circumferential hemostatic suture of the gastric wall at the level of the upper pole, is a simple and a rapid technique that effectively controls bleeding from esophagogastric varices. Its low mortality rate in emergency cases or poor-risk patients can be of grea...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Romero-Torres R

    更新日期:1989-05-01 00:00:00

  • Indications for early postoperative intraperitoneal chemotherapy of advanced gastric cancer: results of a prospective randomized trial.

    abstract::Previous analysis of this prospective randomized trial and meta-analysis of published randomized trials of adjuvant intraperitoneal chemotherapy demonstrated improved survival in patients with advanced gastric cancer. Simple criteria applicable at the time of surgery for patient selection were sought in this analysis....

    journal_title:World journal of surgery

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Yu W,Whang I,Chung HY,Averbach A,Sugarbaker PH

    更新日期:2001-08-01 00:00:00

  • Long-term result of total versus partial fundoplication after esophagomyotomy for primary esophageal motor disorders.

    abstract:BACKGROUND:The selection of the type of fundoplication or the necessity for an added fundoplication after esophagomyotomy (Heller's operation) for the treatment of achalasia remains controversial. The present retrospective study was designed to compare the long-term results of total and partial fundoplication on the my...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Zhu ZJ,Chen LQ,Duranceau A

    更新日期:2008-03-01 00:00:00

  • Evidence for the role of perioperative PTH measurement after total thyroidectomy as a predictor of hypocalcemia.

    abstract:BACKGROUND:Total thyroidectomy is now accepted worldwide as the standard surgical procedure for the management of benign bilateral nodular thyroid disease. Hypocalcemia is the most common complication of that procedure and a variety of strategies for diagnosing and managing post-thyroidectomy hypocalcemia have been adv...

    journal_title:World journal of surgery

    pub_type: 杂志文章,评审


    authors: Grodski S,Serpell J

    更新日期:2008-07-01 00:00:00

  • Evaluation of operative notes concerning laparoscopic cholecystectomy: are standards being met?

    abstract:BACKGROUND:Laparoscopic cholecystectomy (LC) is the most performed minimal invasive surgical procedure and has a relatively high complication rate. As complications are often revealed postoperatively, clear, accurate, and timely written operative notes are important in order to recall the procedure and start follow-up ...

    journal_title:World journal of surgery

    pub_type: 杂志文章,多中心研究


    authors: Wauben LS,Goossens RH,Lange JF

    更新日期:2010-05-01 00:00:00

  • Laparoscopic cholecystectomy for gallbladder disease in patients with severe cardiovascular disease.

    abstract:BACKGROUND:Cardiovascular disease (CVD) and gallstones are reported to be strongly associated because both diseases are frequently part of a metabolic syndrome. Laparoscopic cholecystectomy (LC) has become the standard treatment for gallbladder disease around the world. Cardiovascular disease is considered as an absolu...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Liu YY,Yeh CN,Lee HL,Chu PH,Jan YY,Chen MF

    更新日期:2009-08-01 00:00:00

  • A Double-Blinded Randomized Clinical Study on the Therapeutic Effect of Gastrografin in Prolonged Postoperative Ileus After Elective Colorectal Surgery.

    abstract:BACKGROUND:Postoperative ileus is a common problem with significant clinical and economic consequences. We hypothesized that Gastrografin may have therapeutic utility by accelerating the recovery of postoperative ileus after colorectal surgery. The aim of this trial was to study the impact of oral Gastrografin administ...

    journal_title:World journal of surgery

    pub_type: 杂志文章,随机对照试验


    authors: Biondo S,Miquel J,Espin-Basany E,Sanchez JL,Golda T,Ferrer-Artola AM,Codina-Cazador A,Frago R,Kreisler E

    更新日期:2016-01-01 00:00:00

  • Implementation Analysis of a Perioperative Patient Safety Program in Guatemala.

    abstract:BACKGROUND:The implementation of programs to improve patient safety remains challenging in low- and middle-income countries. The goal of our study was to define the barriers and facilitators to implementation of a perioperative patient safety program in Guatemala. MATERIAL AND METHODS:We conducted semi-structured inte...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Sico IP,Hall BJ,Aguilar-González A,Orozco M,Ramirez C,Baumgartner JN,Boyd D,Bolaños J,Calgua E,Lou-Meda R,Rice HE

    更新日期:2020-07-01 00:00:00

  • Nonoperative management of intraabdominal hypertension and abdominal compartment syndrome.

    abstract::Intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have detrimental effects on all organ systems and are associated with significant morbidity and mortality. In recent years, the diagnosis and management of these syndromes has evolved tremendously, and the importance of comprehensive strategies...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Cheatham ML

    更新日期:2009-06-01 00:00:00