Abstract:
OBJECTIVE:The purpose of this study was to investigate whether individualized deliberate practice on a virtual reality (VR) simulator results in improved technical performance in the operating room. BACKGROUND:Training on VR simulators has been shown to improve technical performance in the operating room (OR). Currently described VR curricula consist of trainees practicing the same tasks until expert proficiency is reached. It has yet to be investigated whether the individualized deliberate practice, where curricula tasks vary depending on prior levels of technical proficiency, would translate into the OR. METHODS:This single-blinded prospective trial randomized 16 novice surgical residents to a deliberate practice (DP) group and a conventional residency training group. Both groups performed a laparoscopic cholecystectomy in the OR that was video-recorded. Technical performance of DP group residents in the OR was assessed using 3 validated assessment tools. A score of less than 60% on any component of the assessment tool resulted in the trainee practicing a specific task on the VR simulator. The DP group practiced on the simulator as per their individualized schedule. Both groups then performed another laparoscopic cholecystectomy. A blinded expert assessed the OR recordings using a validated global rating scale. RESULTS:Although both groups had similar technical abilities preintervention [DP: median score, 13.5 (9.3-15.0); control: median score, 14.5 (9.3-17.8); P = 0.45], the DP residents had a superior technical performance postintervention [DP: median score, 17.0 (15.3-18.5); control: median score, 12.5 (7.5-14.0); P = 0.03]. Of 8 DP residents, 6 practiced 5 basic VR tasks (median 1 trial to pass), and 7 of 8 practiced 2 advanced tasks (median 4 trials to pass). CONCLUSIONS:A curriculum of deliberate individualized practice on a VR simulator improves technical performance in the OR. This has implications to greatly improve the feasibility of implementing simulation-based curricula in residency training programs, rather then having them being limited to research protocols.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Palter VN,Grantcharov TPdoi
10.1097/SLA.0000000000000254subject
Has Abstractpub_date
2014-03-01 00:00:00pages
443-8issue
3eissn
0003-4932issn
1528-1140pii
00000658-201403000-00006journal_volume
259pub_type
杂志文章,随机对照试验abstract:OBJECTIVE:This article outlines the formation of the Australian and New Zealand Audit of Surgical Mortality (ANZASM) and describes its objectives, governance, functioning and challenges. BACKGROUND:A nationwide audit of surgical mortality provides an overview of the leading causes of death in patients who require surg...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000581
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine the results of liver resection for patients with bilateral hepatic metastases from colorectal cancer. We aimed to assess the evolution of the technical approach over time and correlations with morbidity, mortality, and oncologic outcome. SUMMARY BACKGROUND DATA:Although...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181557e47
更新日期:2008-01-01 00:00:00
abstract::The peripheral nitrogen wasting and loss of functional capacity caused by the malnutrition of disease and the immobilization of hospitalization may not be readily reversed by refeeding alone. In order to examine submaximal exercise as an adjunctive anabolic stimulus to intravenous refeeding (IVF) in depleted subjects,...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-198803000-00012
更新日期:1988-03-01 00:00:00
abstract:OBJECTIVE:The goal of this study was to examine a multi-institutional experience with adrenal metastases to describe survival outcomes and identify subpopulations who benefit from adrenal metastasectomy. BACKGROUND:Adrenalectomy for metastatic disease is well-described, although indications and outcomes are incomplete...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003876
更新日期:2020-05-18 00:00:00
abstract:OBJECTIVE AND BACKGROUND:Ventricular assist devices (VADs) have been used for temporary circulatory support pending transplantation or recovery of the native heart. Outcome in 38 patients treated at the authors' institution with VADs pending transplantation was analyzed to provide information relevant to the future use...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199706000-00007
更新日期:1997-06-01 00:00:00
abstract::Seventy-five consecutive patients who sustained injuries to the duodenum were admitted to our hospital over a nine-year period. Nineteen blunt injuries and 56 penetrating injuries were encountered. Blunt injuries were usually the result of motor vehicle accidents and steering wheel impact was frequently implicated. Pe...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198006000-00006
更新日期:1980-06-01 00:00:00
abstract::Seven patients with a mean burn size of 69.6% total body-surface area underwent skin grafting with autologous cultured epidermis. They were compared with a historical group of 18 controls, with a mean burn size of 60%, who underwent grafting with conventional meshed split-thickness autograft. There were no statistical...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199006000-00005
更新日期:1990-06-01 00:00:00
abstract:OBJECTIVE:To determine whether the acute anti-inflammatory influence of epinephrine (EPI) extends to changes in heart rate variability (HRV) induced by the prototypical inflammatory stimulus, endotoxin (lipopolysaccharide [LPS]). SUMMARY BACKGROUND DATA:HRV reflects fluctuating cardiac autonomic inputs and is acutely ...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e3181a40193
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:The efficacy of irrigating the peritoneal cavity during appendectomy for perforated appendicitis has been debated extensively. To date, prospective comparative data are lacking. Therefore, we conducted a prospective, randomized trial comparing peritoneal irrigation to suction alone during laparoscopic append...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e31826a91e5
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVE:This study determined whether there are any laboratory or other features that will enable prediction of spontaneous closure in patients with gastrointestinal cutaneous fistulas. SUMMARY BACKGROUND DATA:Although the anatomic criteria for spontaneous closure of gastrointestinal cutaneous fistulas have been pre...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199306000-00003
更新日期:1993-06-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to analyze the health care costs and savings associated with quality improvement (QI) interventions initiated and implemented utilizing NSQIP. BACKGROUND:Five acute care facilities of Alberta Health Services (AHS) adopted NSQIP in 2015 for a pilot project. METHODS:The cost-savings ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002708
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:This study was designed to examine the differential effects of tumor necrosis factor (TNF) and nitric oxide on the acute cardiovascular changes that occur in response to endotoxemia. SUMMARY BACKGROUND DATA:Recent studies have suggested that some, if not all, of the cardiovascular effects of TNF are mediated...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199601000-00009
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Liver resection is performed for many types of malignancies. Few reports document actual long-term survival. METHODS:Long-term follow-up of a series of 548 liver resections performed between 1970 and 1992 was performed and is presented. RESULTS:All patients were followed for at least 15 years after surgery...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181b59491
更新日期:2009-12-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of growth hormone (GH) treatment on skeletal muscle protein catabolism in patients with multiple organ failure in the intensive care unit (ICU). SUMMARY BACKGROUND DATA:Skeletal muscle depletion affects the incidence of complications and the length of hospital stay. A protein-sparin...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-200004000-00018
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVE:To explore the impact of short-term surgical missions (STMs) on medical practice in Guatemala as perceived by Guatemalan and foreign physicians. SUMMARY BACKGROUND DATA:STMs send physicians from high-income countries to low and middle-income countries to address unmet surgical needs. Although participation a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003292
更新日期:2019-04-18 00:00:00
abstract:INTRODUCTION:Thymic neuroendocrine tumors (NETs) are uncommon but malignant tumors of the thymus gland that are usually associated with systemic symptoms due to hypersecretion of biogenic amines from metastatic lesions. Due to the limited number of studies in the literature, very little is known about progress or trend...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181dd4ec4
更新日期:2010-06-01 00:00:00
abstract::The myocardial effects of protamine, with and without heparin, were documented in this investigation. Isolated rabbit hearts (n = 30) were retrograde perfused with Krebs-Ringers bicarbonate solution aerated with 95% O2/5% CO2 through the aortic root (37 C, 80 mmHg). Developed left ventricular blood pressure, heart rat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199010000-00001
更新日期:1990-10-01 00:00:00
abstract:OBJECTIVE:To assess our outcomes after minimally invasive esophagectomy (MIE). SUMMARY BACKGROUND DATA:Esophagectomy has traditionally been performed by open methods. Results from most series include mortality rates in excess of 5% and hospital stays frequently greater than 10 days. MIE has the potential to improve th...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000089858.40725.68
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:To identify independent predictors of 30-day venous thromboembolism (VTE) events requiring treatment after outpatient surgery. BACKGROUND:An increasing proportion of surgical procedures are performed in the outpatient setting. The incidence of VTE requiring treatment after outpatient surgery is unknown. MET...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182519ccf
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:To determine the DNA replication error (RER) status in young patients with colorectal cancer (CRC), and to compare the clinical and pathologic characteristics of RER-positive and RER-negative cases. SUMMARY BACKGROUND DATA:Recent studies suggest that patients with RER-positive CRC have an improved prognosis....
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199801000-00008
更新日期:1998-01-01 00:00:00
abstract::Emergency portacaval shunt for variceal bleeding is associated with a high operative mortality, particularly if used as a last resort. Because of this, a strong case has been made against emergency shunt. This report describes an experience with emergency portacaval shunt for the treatment of variceal bleeding when us...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198707000-00007
更新日期:1987-07-01 00:00:00
abstract:OBJECTIVE:This case control study is a detailed analysis of the causes of death and the risk factors of short-term mortality after appendectomy. SUMMARY BACKGROUND DATA:Although death is a rare event after appendectomy, we found a 7-fold excess mortality after appendectomy overall and a 9-fold excess mortality after n...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31821ad9c4
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Length of postoperative stay (LOS) has gained increasing attention as a potential indicator of surgical efficiency. Our objective was to examine the feasibility of assessing LOS at 182 hospitals to identify institutions with outlying performance. METHODS:Patients were identified who underwent colorectal sur...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/sla.0b013e3181b2a948
更新日期:2009-12-01 00:00:00
abstract::Percutaneous transhepatic bile drainage was performed in 13 patients with obstructive jaundice, using a combination of the PTC technique and a Seldinger angiography catheter. In 11 cases, the outflow of bile through the catheter was satisfactory and complications were few. Since the risk of the procedure is low and it...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197701000-00018
更新日期:1977-01-01 00:00:00
abstract:BACKGROUND:The role of adjuvant chemoradiation in esophageal cancer has been underestimated in the literature. This study was undertaken to determine whether adjuvant chemoradiation improves survival compared with surgery alone. METHODS:Data of 1095 esophageal squamous cell carcinoma (ESCC) patients, including 679 in ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001410
更新日期:2016-07-01 00:00:00
abstract::Between June 1977 and November 1981, 26 children and adults with ulcerative colitis have undergone a total colectomy, an endorectal dissection of the rectal mucosa, and an ileoanostomy. A combined abdominoperineal approach was used to perform the operation, and the mucosal-submucosal rectal tube was dissected out inta...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract::The costs for elective cholecystectomies were measured 1955, 1965 and 1975. The average length of stay decreased by 25% between 1955 and 1965 and with the same amount between 1965 and 1975. In spite of these marked reductions in the average length of stay there was only a significant decrease in costs between 1955 and...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:
更新日期:1979-04-01 00:00:00
abstract:OBJECTIVE:To assess the relevance of resection margin status for survival outcome after resection and adjuvant therapy for pancreatic cancer. BACKGROUND:The definitions for R0 and R1 margin status after resection for pancreatic cancer are controversial. The strict definition of R0 requiring a 1 mm tumor-free margin is...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001731
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the influence of the response to preoperative chemotherapy, especially tumor progression, on the outcome following resection of multiple colorectal liver metastases (CRM). SUMMARY BACKGROUND DATA:Hepatic resection is the only treatment that currently offers a chance of long-term survival, althoug...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000145964.08365.01
更新日期:2004-12-01 00:00:00
abstract::Low mortality rates for elective surgical treatment of abdominal aortic aneurysms justify an aggressive approach in most patients. However, in high-risk patients with small aneurysms and no symptoms, the decision to operate remains a delicate balance of risk and benefit. Our observations include 99 high-risk patients ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198409000-00003
更新日期:1984-09-01 00:00:00