Abstract:
OBJECTIVE:In single-incision laparoscopic surgery (SILS), operating through 1 incision presents ergonomic challenges. No consensus exists on whether articulating instruments (ARTs) may help. This study evaluated their effect on simulated SILS, hypothesizing that they would affect performance and workload. DESIGN:Surgeons were randomized to 2 straight instruments (STRs), 1 ART and 1 STR, or 2 ARTs. After baseline testing, 25 repetitions of the Fundamentals of Laparoscopic Surgery (FLS) peg-transfer (PEG) task and 5 repetitions of the short-hand for the FLS pattern-cutting task (CIRCLE) were performed. Primary outcomes were maximum FLS PEG scores, CIRCLE times and errors, and Imperial College Surgical Assessment Device hand motion analysis. National Aeronautics and Space Administration (NASA) Raw Task Load Index (RTLX) questionnaires evaluated a secondary outcome--workload. SETTING:The trial took place in a simulated operating theater within the Academic Surgical Unit at St Mary's Hospital, London, UK. PARTICIPANTS:Eligible surgeons had completed at least 5 laparoscopic cases as a primary operator. Surgeons were stratified by laparoscopic experience into intermediate (less than 25 previous procedures as primary operator) or advanced (25 procedures or more). A total of 21 surgeons were recruited and randomized; 7 of them to each instrument combination group. All surgeons completed PEG, and 5 from each group completed CIRCLE. RESULTS:Groups' baseline PEG scores were similar (p = 0.625). STR-ART achieved higher maximum PEG scores than STR or ART did (median = 236 vs 198 vs 193, respectively, p = 0.002). Fastest CIRCLE times were similar (median = 190s vs 130s vs 186s, p = 0.129) as were minimum errors (median = 1 vs 2 vs 3, p = 0.101). For PEG, Imperial College Surgical Assessment Device demonstrated similar total path lengths (median = 12.3m vs 12.3m vs 16.0m, p = 0.545) and total numbers of movements (median = 89.6 vs 86.4 vs 171, p = 0.080). Groups' NASA Raw Task Load Index scores were similar (p = 0.708). CONCLUSIONS:Combining 1 STR and 1 ART improved SILS performance in the PEG task. Therefore, this may be the optimum instrument configuration for use within some clinical SILS applications.
journal_name
J Surg Educjournal_title
Journal of surgical educationauthors
Corker HP,Singh P,Sodergren MH,Balaji S,Kwasnicki RM,Darzi AW,Paraskeva Pdoi
10.1016/j.jsurg.2014.08.004subject
Has Abstractpub_date
2015-01-01 00:00:00pages
1-7issue
1eissn
1931-7204issn
1878-7452pii
S1931-7204(14)00230-Xjournal_volume
72pub_type
杂志文章,随机对照试验abstract:BACKGROUND:The purpose of this study was to develop a surgical skills program for first-year surgical residents by integrating the Canadian Medical Education Direction for Specialists (CanMEDS) roles. METHODS:A 9-week course combining basic surgical skills and CanMEDS roles was developed and provided to 24 residents f...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2013.09.006
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVE:A fundamental aspect of surgical planning in liver resections is the identification of key vessel tributaries to preserve healthy liver tissue while fully resecting the tumor(s). Current surgical planning relies primarily on the surgeon's ability to mentally reconstruct 2D computed tomography/magnetic resonan...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2017.07.031
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Human factors are important causes of error, but little is known about their possible effect during objective structured clinical examinations (OSCE). We have previously identified stress and pressure in OSCE examiners in the postgraduate intercollegiate Membership of the Royal College of Surgeons (MRCS) exa...
journal_title:Journal of surgical education
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jsurg.2016.12.013
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:This study used a virtual patient simulation (VPS) to quantifiably and objectively assess undergraduate (UG) to postgraduate (PG) medical learners' acquisition of the entrustable professional activity (EPA) "handover," focusing particularly on the transition to residency. This EPA is critical because it is pa...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2019.03.008
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Quality improvement (QI) activities are an integral part of residency training. We started the process to implement team-based, multilevel QI project streams within our academic surgical residency by studying resident perceptions. OBJECTIVE:Our residency carried out 6 QI projects in line with the American C...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2018.10.006
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Despite the importance of preclerkship experiences, surgical education has essentially remained confined to the third-year operating room experience. According to experience-based learning theory, the acquisition of new clinical knowledge is a dynamic process of social enculturation and professional identity...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2008.04.002
更新日期:2008-07-01 00:00:00
abstract:PURPOSE:The amount of financial debt incurred by Texas medical students and residents during training was examined as well as the impact of this debt on these trainees' career choices. METHOD:An invitation to participate was sent in a Web-based survey to medical students and residents at 6 university programs in Texas...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2008.09.003
更新日期:2009-01-01 00:00:00
abstract::Congenital agenesis of the gallbladder and cystic duct represents a rare anomaly of the biliary system. It likely results from an embryologic mishap in the development of the hepatobiliary bud and can occur with other associated malformations. We report the case of congenital absence of the gallbladder and cystic duct...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2012.07.001
更新日期:2013-01-01 00:00:00
abstract:INTRODUCTION:The Association of Program Directors in Surgery convened a panel during Surgical Education Week 2016 to discuss the current state of the general surgery residency application process and to review alternative ways to evaluate the suitability of each applicant to a residency program. METHODS/RESULTS:Over 4...
journal_title:Journal of surgical education
pub_type: 杂志文章,评审
doi:10.1016/j.jsurg.2016.09.005
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:Using a laparoscopic box trainer fitted with motion analysis trackers and software, we aim to identify differences between junior and senior residents performing the peg transfer task, and the impact of a distracting secondary task on performance. DESIGN:General surgery residents were asked to perform the la...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.07.012
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:To evaluate tension at the failure of 3 commonly used sutures when suture ends were cut to 3 lengths. STUDY DESIGN:Knots were tied using U.S. Pharmacopeia Size 0-0 polyglactin 910, silk, or polydioxanone sutures. The knots were tied randomly on a jig by the same surgeon. End lengths were then cut to random l...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2009.10.003
更新日期:2009-09-01 00:00:00
abstract:OBJECTIVES:Food deprivation is a common condition for visceral surgeons and especially laparoscopic approaches require high levels of concentration. The current literature does not provide adequate answers whether intraoperative breaks, especially food intake, might influence the quality of the surgical skills. Thus, t...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.03.029
更新日期:2020-01-01 00:00:00
abstract:INTRO:This project expanded upon previous exploration of emotional intelligence during the habituation for military second year medical students undergoing high-stress simulation with trauma and surgical skill training. The objective was to interpret emotional intelligence data before and after hyper-realistic immersio...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.04.020
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVES:To validate the use of a novel physical model, the "Clinical Male Pelvic Trainer (CMPT) Mk 2-Advanced," for scrotal examination simulation and evaluate its use for surgical education. MATERIALS AND METHODS:A total of 7 CMPT Mk 2-Advanced scrotal models were used for teaching: normal, varicocele, testicular ...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2016.10.008
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:To determine the effect of the 80-hour work week restrictions on general surgery resident operative volume in a large, community-based, university-affiliated, general surgery residency program. METHODS:We performed a retrospective review of Accreditation Council for Graduate Medical Education (ACGME) operati...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2010.05.007
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:Describe the early impact of the COVID-19 pandemic on general surgery residency training nationwide. DESIGN:A 31-question electronic survey was distributed to general surgery program directors. Qualitative data underwent iterative coding analysis. Quantitative data were evaluated with summary statistics and ...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.07.036
更新日期:2020-07-25 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine whether students' performance evaluations by faculty were influenced by the clinical service on which the student was evaluated. METHODS:Third-year medical students spent 8 weeks rotating on 3 (or 2) surgical services. Typically, students rotate on one 4-week genera...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2010.03.003
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:Few medical school programs in Canada address challenges related to the significant increase in responsibility for patient care between medical school and residency. This is particularly important in surgery and anesthesia due to the high-acuity care required during the perioperative period. The purpose of th...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2017.08.022
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:Compare characteristics of U.S. medical school graduates with U.S.-born and foreign-born international medical school (IMG) graduates. DESIGN:Retrospective analysis. SETTING:East Carolina University, a tertiary care teaching hospital. PARTICIPANTS:Demographic data, United States Medical Licensing Examinati...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2008.05.002
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVES:The American Board of Surgery Certifying Examination (ABSCE) is an oral examination designed to evaluate a resident׳s ability to apply their cognitive knowledge to manage a broad range of clinical problems. In this study, we analyze our 5-year experience with a Philadelphia-wide mock oral examination (PMOE)....
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2014.06.019
更新日期:2014-11-01 00:00:00
abstract:PURPOSE:The purpose of the study was to develop a model that predicts an individual applicant's probability of successful placement into a surgical subspecialty fellowship program. METHODS:Candidates who applied to surgical fellowships during a 3-year period were identified in a set of databases that included the elec...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2011.11.006
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Suturing is a skill expected to be attained by all medical students on graduation, according to the General Medical Council's (GMC) Tomorrow's Doctors. There are no GMC recommendations for the amount of suture training required at medical school nor the level of competence to be achieved. This study examines...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2015.09.017
更新日期:2016-03-01 00:00:00
abstract::The COVID-19 pandemic has forced an unprecedented worldwide change in our daily lives, particularly in healthcare. In response to the lockdown measure it has brought on, some deaneries cancelled planned teaching days, while others had delivered remote smaller scale teaching sessions electronically. Due to significant ...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2020.10.013
更新日期:2020-10-19 00:00:00
abstract:OBJECTIVE:To conduct a needs assessment to identify gaps in communication skills training in ophthalmology residency programs and to use these results to pilot a communication workshop that prepares residents for difficult conversations. DESIGN:A mixed-methods design was used to perform the needs assessment. A pre-and...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2017.08.011
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Feedback plays an important role in the learning process. However, often this may be delivered in an unstructured fashion that can detract from its potential benefit. Further, students may have different preferences in how feedback should be delivered, which may be influenced by which method they feel will l...
journal_title:Journal of surgical education
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jsurg.2015.04.017
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVE:Interest in international surgery among general surgery residents in the United States has been shown in several publications. Several general surgery residency programs have reported their experiences with international surgery rotations (ISRs). Learning to use limited resources more efficiently is often cit...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2011.10.009
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVE:In North America, the number of craniofacial surgery fellowship graduates is increasing, yet an analysis of practice settings upon graduation is lacking. We characterize the practice types of recent graduates of craniofacial fellowship programs in the United States and Canada. DESIGN:A 6-year cohort of crani...
journal_title:Journal of surgical education
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jsurg.2016.08.014
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Clinician-scientist numbers have been stagnant over the past few decades despite awareness of this trend. Interventions attempting to change this problem have been seemingly ineffective, but research residency positions have shown potential benefit. OBJECTIVE:We sought to evaluate the effectiveness of a cli...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2017.10.003
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:To investigate the degree of variability in perception as related to the service versus education issue in general surgery residency education. STUDY DESIGN:A survey questionnaire was designed with 15 scenarios constructed by the author to represent an array of resident experiences with differing educational...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2011.11.007
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVES:To compare career choices of residency graduates from Independent Academic Medical Center (IAMC) and University Academic Medical Center (UAMC) programs and evaluate program directors' perceptions of residents' motivations for pursuing general surgery or fellowships. DESIGN:From May to August 2011, an electr...
journal_title:Journal of surgical education
pub_type: 杂志文章
doi:10.1016/j.jsurg.2012.05.006
更新日期:2012-11-01 00:00:00