Plaster cast removal simulation model for resident training.

Measuring surgical competency is essential for surgical residents to ensure patient safety. Traditional assessment tools rely on subjective evaluation. This study evaluated whether artificial intelligence (AI)-based hand tracking can more objectively distinguish between levels of surgical competency and predict surgical years of experience versus traditional assessments. A total of 44 participants, including medical students, surgical residents, and surgical consultants, performed transcutaneous suturing, intracutaneous suturing, and surgical knot tying. Videos of intracutaneous suturing were scored using the objective structured assessment of technical skills (OSATS). Hand movements were analysed using AI tracking software to extract coordinates to measure velocity, pathlength, and jerk. Linear regression models predicted experience years using procedural time and OSATS in combination with hand tracking metrics. Hand tracking metrics varied mainly between medical students and more experienced groups. Traditional assessment tools (procedural time, OSATS) could predict experience years during training, with an adjusted coefficient of determination (R2) ranging from 0.537 to 0.638, dependent on procedure type. Hand tracking variables identified multiple significant predictors for years of experience, with an adjusted R2 of 0.540-0.712, which outperformed the traditional tools in each procedure. Combining all assessment tools (time, OSATS, and hand tracking) gave the best predictive value, with an adjusted R2 ranging from 0.540 to 0.809, with velocity, pathlength, jerk, and acceleration as significant predictors. AI-based hand tracking provides a new method for objective, reproducible measures of surgical skills. Incorporating hand tracking metrics enhances prediction of surgical experience, and supports standardized as well as objective evaluation of skills assessment in surgical training.

BackgroundTechnical proficiency of the operating surgeons is one of the most important factors in the safe performance of pancreaticoduodenectomy. The objective of the present study was to investigate whether surgical simulation of pancreatico-jejunostomy (PJ) using an inanimate biotissue model could improve the technical proficiency of hepato-biliary pancreatic (HBP) surgical fellows.MethodsThe biotissue drill consisted of sewing biotissues to simulate PJ. The drill was repeated a total of five times by each of the participant surgical fellows. The improvement of the surgical fellows’ technical proficiency was evaluated by the supervisor surgeons using the Objective Structured Assessment of Technical Skills (OSATS) scale.ResultsEight HBP surgical fellows completed all the 5 drills. Both the OSATS 25 score and OSATS summary score, assessed by the two supervisor surgeons, improved steadily with repeated execution of the PJ drill. The average OSATS score, as assessed by both the supervisor surgeons, improved significantly from the first to the final drill, with a P value of 0.003 and 0.014 for the assessment by the two surgeons, respectively. On the other hand, no chronological alteration was observed in time of procedure (P = 0.788).ConclusionRepeated execution of a biotissue PJ drill improved the HBP surgical fellows’ technical proficiency, as evaluated by OSATS. The present study lends support to the evidence that simulation training can contribute to shortening of the time required to negotiate the learning curve for the technique of PJ in the actual operating room.

Objective: Evaluate the acquired surgical suture skills in veterinary medicine students after one-day training using new designed interactive surgical suture training (ISST) model. Methodology: 150 students were subjected to one-day surgical suture training. An objective structured assessment of technical skills (OSATS) task-specific checklist of 20 tasks was performed by three faculty members. A questionnaire was completed by each student. Results: tasks like square knot using hand tie, appropriate tension of knotting, correct edge distance, and equal spacing between sutures were well performed by final year students significantly. For other tasks, the final year student got better scores without distinct differences (P > 0.05). More than 90% of students confirmed the easy use of the ISST model and it simulated the real training. They strongly recommended the ISST training model. Conclusions: one-day surgical suture training was very suitable for undergraduate students; also the ISST model was convenient and easy to use during training. The OSATS’s checklist and the questionnaire were a reasonable way of objective assessment of surgical suture training. We suggest training surgical sutures on the ISST model and using the OSATS checklist with a questionnaire for training evaluation to all medical students and trainees.

To develop a model of gastroenterostomy and to analyze the acquisition of skills after training by simulation. Experimental longitudinal study and of a quantitative character. The sample consisted of twelve general surgery residents from four hospitals. The training consisted of making ten anastomoses divided equally into five sessions and it took place over a period of six weeks. The evaluation of the anastomoses considered the time and the analysis of the operative technique through the global evaluation scale Objective Structured Assessment of Technical Skills (OSATS). Residents showed a reduction in operative time and evolution in the surgical technique statistically significant (p<0.01). The correlation index of 0.545 and 0.497 showed a high linear correlation between time variables and OSATS. The preparation of ten gastroenterostomies is an exercise capable of transferring basic and advanced skills in laparoscopy through a standardized training using synthetic organs and a simulator.

To evaluate a previously validated low-cost sinus surgery task trainer as a means of acquiring basic endoscopic sinus surgery skills and as an objective structured assessment of technical skills (OSATS) to determine procedural competency. Prospective blinded study. Medical students (N = 52) with no sinus surgery experience learned to perform nasal endoscopy and five specific sinus surgery tasks using the validated task trainer. Training included regimented expert instruction, peer instruction/observation, and experienced-based learning. Pre- and post-training video recordings of nasal endoscopy and five sinus surgery skills were obtained. Two blinded expert otolaryngologists compared pre- and post-training performance using a checklist and global rating scale. Medical student post-training performance was significantly better than pre-training performance for each checklist item and global rating scale as calculated by paired t test (P < .001). Interrater reliability and internal consistency were confirmed by Kendall's coefficient of concordance and Cronbach's α calculations, respectively. The sinus surgery task trainer provides an effective means of teaching and evaluating nasal endoscopy and basic sinus surgery skills for novice surgeons. With repeated practice, there was significant improvement in performance. An OSATS using the sinus surgery task trainer suggests that we can effectively measure endoscopic sinus surgery ability with the potential to reliably determine competency outside the operating room.

APPLICATION OF HIGH FIDELITY SIMULATION IN TEACHING MITRAL VALVE ANNULOPLASTY TO CARDIAC SURGERY RESIDENTS

Hernia repairs are one of the most common general surgery procedures and an essential part of training for general surgery residents. The widespread incorporation of robotic hernia repairs warrants the development of a procedure-specific robotic curriculum to assist novice surgeons in improving technical skills. To evaluate a robotic hernia simulation-based curriculum for general surgery residents using video review. Retrospective cohort study of PGY-3 general surgery residents from the University of Chicago from 2019 to 2021. The residents completed inguinal hernia repair (IHR) and ventral hernia repair (VHR) drills as part of a robotic simulation curriculum. The drills were recorded and graded according to the modified objective structured assessment of technical skills (OSATS) and time to completion. The drills were completed by 3 attending surgeons to establish gold-standard benchmarks. In total, 20 residents started the curriculum, 19 completed all IHR drills and 17 completed all VHR drills. Attending surgeon total OSATS scores and time to completion were significantly better than the trainees on the first attempt (P < 0.05). When comparing 1st to 4th attempt, resident OSATS scores improved significantly for IHR (15.5 vs 23.3; P < 0.001) and VHR (16.8 vs 23.3; P < 0.001). Time also improved over 4 attempts (IHR: 28.5 vs 20.5 minutes; P < 0.001 and VHR: 29.6 vs 21.2 minutes; P < 0.001). Residents achieved attending-level OSATS scores by their fourth attempt for VHR, but not for IHR. Residents did not achieve attending-level times for either hernia drills. The robotic hernia curriculum improved resident performance on hernia repair drills and was well-received by the residents.

Validity Argument for a Simulation-Based Objective Structured Clinical Examination Scenario for Evaluation of Surgical Skills in Trauma

Design and validation of a low-cost, high-fidelity model for robotic pyeloplasty simulation training

Home-Based Life Saving Skills in Ethiopia: An Update on the Second Phase of Field Testing

OBJECTIVE To develop and evaluate a high-fidelity simulated laparoscopic ovariectomy (SLO) model for surgical training and testing. DESIGN Evaluation study. SAMPLE 15 veterinary students (novice group), 5 veterinary surgical interns or residents (intermediate group), and 6 veterinary surgeons (experienced group). PROCEDURES Laparoscopic surgery experience was assessed by questionnaire and visual analog scales. Basic laparoscopic skills were assessed with a commercial training model. A commercial canine abdomen model was customized with a high-fidelity simulated canine female genital tract. Each subject's SLO performance (laparoscopic entry, dissection along marked planes, and left ovariectomy) was evaluated by measurement of surgical time and errors (splenic puncture and deviation from dissection marks) and with global and operative component rating scales. Construct and concurrent validity were assessed by correlation of SLO results with self-estimated measures of experience level and with basic laparoscopic skills test results, respectively. Face validity was assessed with a questionnaire completed by intermediate and experienced group participants. RESULTS 13 participants (3/15, 5/5, and 5/6 in the novice, intermediate, and experienced groups, respectively) completed SLO within the preset time. No difference in errors was found among groups. Completion time was significantly correlated with self-estimated experience level (r = -0.626), confirming construct validity, and with basic laparoscopic skills scores (r = -0.552) and global (r = -0.624) and operative component (r = -0.624) rating scale scores, confirming concurrent validity. Overall mean face validity score was low (64.2/100); usefulness of the model for surgical training received the highest score (8/10). CONCLUSIONS AND CLINICAL RELEVANCE Results suggested the SLO model may be a useful surgical training tool. Further studies are needed to confirm usefulness of the model in veterinary laparoscopy training.

Grantsmanship Refined: Evaluation and Training of Efficacy in Residents (Greater Study).

AimTo measure the utility of the Simulation training model for training purposes over and above conventional methods of training for vaginal assessment during labour.MethodsThe study group included undergraduate trainees, and the control group included postgraduate trainees and qualified personnel, i.e. senior registrars and consultants. Participants from the study group were trained for vaginal assessment on the simulation training model. Then both the groups were tested on the model for accuracy in estimating each value of cervical dilatation and fetal station. Mean cervical dilatation and station accuracy scores were noted, and comparative analysis was done between the study and control groups.ResultsA total of 150 participants were included. The overall mean dilatation and station accuracy scores of a model trained study group participants were better than subjectively trained control group participants. Study group participants showed greater accuracy for smaller dilatations, i.e. 1, 2, 3, 4cm and middle dilatation, i.e. 5cm and 6cm (p value=<0.05). In contrast, comparing the two groups for higher dilatations from 6 to 10 cm did not show any statistical significance. Study group participants also showed greater accuracy for all the fetal stations except stations 0 and +1.ConclusionsThe simulation training model can be considered an in vitro training device to improve the trainees' understanding of cervical dilatation and fetal station and can be made a part of a routine obstetric teaching program.

Despite the progress in the development of simulation games and models for training in many areas, the post harvest produce sector seldom has been a subject of instructional tools. The game developed with produce sector in mind accounted for the complexity of the sector combining the systems dynamics and the systems thinking to model and simulate the essential elements responsible for meeting consumer demand. The game provides a participatory, hands-on experience to understand the concepts and develop skills desired in the post harvest fresh produce industry. A computer-mediated simulation game for this objective was developed in Windows environment. It uses the Stella software (a systems thinking software) to model the system and to develop the simulation equations. The game combines systems thinking and system dynamics to simulate essential relationships between links in the produce delivery. It models the critical elements of the post harvest system of fresh produce retailing faced by the manager of the produce department in a large retail outlet. The simulation emphasis the importance of correct ordering based upon deterministic and stochastic consumer demand, the delays in produce delivery by the system, perishability and a measure of financial assessment of the retailer performance. It can be used as a teaching tool by marketing, postharvest engineering and biology students and as a training tool by the produce department personnel in retail outlets to understand the dynamics of the post harvest marketing system.

PurposeTo evaluate the performance of a novel robot for CT-guided needle positioning procedures and compare it to the freehand technique in an abdominal phantom. MethodsOne interventional radiology fellow and one experienced interventional radiologist (IR) performed twelve robot-assisted and twelve freehand needle positionings in a phantom over predetermined trajectories. The robot automatically aimed a needle-guide according to the planned trajectories, after which the clinician manually inserted the needle. Using repeated CT scans, the needle position was assessed and adjusted if the clinician deemed it necessary. Technical success, accuracy, number of position adjustments, and procedure time were measured. All outcomes were analyzed using descriptive statistics and were compared between the robot-assisted and freehand procedures using the paired t-test and Wilcoxon signed rank test. ResultsCompared with the freehand technique, the robot system improved the number of technically successfully needle targeting (20/24 vs 14/24), with higher accuracy (mean Euclidean deviation from target center: 3.5 ± 1.8 mm vs 4.6 ± 2.1 mm, p = 0.02) and required fewer needle position adjustments (0.0 ± 0.2 steps vs 1.7 ± 0.9 steps, p < 0.001), respectively. The robot improved the needle positioning for both, the fellow and the expert IR, compared to their freehand performances, with more improvement for the fellow than for the expert IR. The procedure time was similar for the robot-assisted and freehand procedures (19.5 ± 9.2 min. vs 21.0 ± 6.9 min., p = 0.777). ConclusionsCT-guided needle positioning with the robot was more successful and accurate than freehand needle positioning and required fewer needle position adjustments without prolonging the procedure.