ABSTRACT
Urological surgical skill teaching is an important part of urology resident training. As urological surgery has entered the age of minimally invasive surgery, the training model of surgical skills needs to be optimized and improved. Based on the current clinical features of urological surgical procedures, a three-stage training system has been established for urological surgical skills by Department of Urology, Peking Union Medical College Hospital. This training system provides more feasible and effective surgical skills training for urology residents by using multimedia, simulation training and other training methods. The system can be applied to the standardized training of urology residents and helps them grow up to be urological specialists with the ability to complete specialized surgery and deal with clinical problems independently.
ABSTRACT
Cholecystectomy preferably laparoscopy is gold standard treatment for symptomatic cholelithiasis. However for some anatomical and/or pathological reasons the procedure is converted to open. Conversion rates at high volume centres is <5%. We present a case report of 48 aged lady, previously operated multiple times for hydatid liver and lung with symptomatic cholelithiasis. She was planned for laparoscopic cholecystectomy. During the procedure, inadvertent anatomy of “the wandering gallbladder” was noted. Here we describe the management approach selected for this type of unusual presentation. We recommend noting down detailed past history (preferably surgical) and preoperative consideration of deviant anatomical location and findings of gallbladder. We should maintain a low threshold for conversion to open.
ABSTRACT
Objective To assess the face and construct validity of a full procedural transurethral prostate resection simulator (TURPSimTM) in the training of transurethral resection of the prostate. Methods Ten experienced and thirteen inexperienced urologists (TURP experience ≥ 30 and ≤ 3 respectively) were included for TURP training on TURPSimTM. Each participant filled out a questionnaire regarding their previous experience and opinion of the usefulness of the simulator before and after performing six full procedures at level-2 difficulty. Performance was evaluated between the two groups and pre- /post-training, including GRS and objective parameters recorded on the simulator. Results The experienced group had higher GRS scores (16.3±2.6 vs 12.9±4.0, P=0.024) and prostate resection rate [(94.6±2.8)% vs (89.8±4.4)%, P=0.006]. Less blood loss [(78 ml vs 115 ml, P=0.208) and less capsule resection rate [(27.6±5.4)% vs (29.1±6.2)%, P=0.558] were detected in the experienced group than in the inexperienced group with no significant differences. After training, GRS and coagulation precision increased (14.4±3.8 vs 20.0±3.4, P<0.001; 93% vs 100%, P=0.001) ,while capsule resection rate [(28.4±5.8)% vs (20.8±3.9)%, P<0.001), blood loss (86 ml vs 76 ml, P=0.039) and injury of sphincter (5.5±2.2 vs 3.2±1.7, P<0.001) decreased in both groups. Conclusions Proof of face and construct validity is shown for this full procedural simulator to simulate the skills necessary to perform TURP. The surgical skills of urologists may be enhanced after training on the simulator.
ABSTRACT
In the traditional cadaver dissection course, it is hard to demonstrate dissection skills to all the medical students because of limitations such as the high ratio of students to instructors and the lack of facilities. To overcome these limitations, we developed a digital anatomy dissection course. Through this system, it was possible to perform effective instruction of anatomic dissection. This method could provide the appropriate teaching in a short period of time. Furthermore, students can review the dissection course on digital files saved on a CD-ROM. Clinical cadaveric workshops can be provided by this method not only for students but also for continuing medical education for clinicians.
Subject(s)
Humans , Cadaver , CD-ROM , Education, Medical, Continuing , Students, MedicalABSTRACT
OBJECTIVE: Our goal was to develop a system using virtual reality (VR) technology to test the haptic skills of medical students. Currently, surgical skills are learned on live patients in a clinical environment in which the student practices under the close supervision of an experienced surgeon. We are interested in using haptic feedback devices to enhance surgical skills, because simulated touch in a virtual world improves the performance of trainee surgeons. In this study, we evaluated the efficacy of a test that evaluates the surgical skill of medical students by using a VR simulator.<BR>METHODS: We used a microsurgical simulator with a force-feedback system. Its effectiveness in helping 36 medical students to acquire the tactile skills used in microscopic surgery was evaluated experimentally. Operating time and the number of sites of hemorrhage were measured to evaluate surgical aptitude. We also evaluated system performance with respect to reality, immersiveness, and operability as secondary measures. Data were analyzed using descriptive methods.<BR>RESULTS: The operating time and number of hemorrhagic sites were positively correlated. Subject students were clustered into three groups: dexterous, awkward, or clumsy. The relation between the number of hemorrhages in the retina and immersion and operability differed between the group of would-be surgeons and those of would-be internists and pediatricians. All the students commented that the simulator was a useful tool for medical education.<BR>CONCLUSIONS: The VR simulator can be used not only to teach and evaluate subtle tactile and surgical skills relevant to the surgical profession, but also to test the aptitude of medical students. The training transfer from a haptic simulator to actual practice methodology should be quantifiable in the near future. This work has steered medical informatics research into a new type of medical education.