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1.
Rev. medica electron ; 43(4): 1137-1142, 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1341543

ABSTRACT

RESUMEN Las ciencias médicas matanceras, a lo largo de su historia, han contado con personalidades reconocidas por sus conocimientos y entrega a sus respectivas especialidades. En el campo de la Cirugía contemporánea, se destaca el doctor y profesor Ramón Madrigal Lomba, quien unió a su desempeño quirúrgico y pedagógico la pasión por la historia, lo que también lo llevó a sobresalir en esa disciplina. El objetivo del presente trabajo fue contribuir al conocimiento de su vida y su obra (AU).


ABSTRACT Medical sciences in Matanzas have had, for many years, the contribution of many personalities known by their knowledge and devotion to the medical specialties they have practiced. Contemporarily, doctor and professor Ramon Madrigal Lomba stood out in the specialty of Surgery; he summed up to his surgical and pedagogical performance a passion for History, a subject where he also excelled. The objective of this work was modestly contributing to the knowledge of his life and work (AU).


Subject(s)
Humans , Male , Female , Physicians/history , History of Medicine , Physicians/ethics , Faculty/education , Faculty/history , Surgeons/education , Surgeons/history
2.
Medisan ; 25(4)2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1340208

ABSTRACT

Introducción: Una de las tareas básicas en las investigaciones es la realización de herramientas con contenidos acordes con el tema que se desea estudiar, lo cual puede solucionarse mediante los criterios de expertos, que permiten la confección de instrumentos confiables y su aplicabilidad en las ciencias biomédicas. Objetivo: Describir los resultados del proceso de selección de expertos para la validación teórica de los instrumentos utilizados en la estrategia de superación profesional de los cirujanos en el periodo preoperatorio mediato. Métodos: Se realizó un estudio cualitativo y cuantitativo en el Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, desde diciembre de 2019 hasta marzo de 2021. El universo estuvo constituido por 25 expertos, a quienes se les aplicó el test de autovaloración y el método Delphi. Resultados: Se halló que 17 (68,0 %) doctores en ciencias obtuvieron coeficiente de competencia alto y 6 (24,0 %) medio, los cuales fueron seleccionados para validar los instrumentos y el programa docente de la investigación. Los expertos consideraron que en dichos instrumentos existió suficiencia claridad, coherencia y relevancia. A pesar de que no alcanzaron la calificación máxima, todos obtuvieron entre 3 y 4 puntos, por lo que no se realizaron cambios en los ítems. Conclusiones: La validación del contenido de los instrumentos sirvió para fortalecer las herramientas utilizadas en la investigación, la experiencia en la actividad profesional y en la función científico - investigativa.


Introduction: One of the basic tasks in the investigations is the realization of tools with contents according to the topic that is wanted to study, which can be solved by means of the experts criteria that allow the making of reliable instruments and their implementation in the biomedical sciences. Objective: To describe the results of the experts selection process for the theoretical validation of the instruments used in the strategy of the surgeons professional training during the mediate preoperative period. Methods: A qualitative and quantitative study was carried out at Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, from December, 2019 to March, 2021. The universe was constituted by 25 experts to whom the self-appraisal test and Delphi method were applied. Results: It was found that 17 (68.0 %) doctors in science obtained high competence coefficient and 6 (24.0 %) mean competence coefficient, which were selected to validate the instruments and the teaching program of investigation. The experts considered that in this instruments existed sufficiency, clarity, coherence and relevance. Although they didn't reach the maximum qualification, all of them obtained between 3 and 4 points, reason why changes in the items were not carried out. Conclusion: The validation of the instruments content was good to strengthen the tools used in the investigation, the experience in the professional activity and in the scientist - investigative function.


Subject(s)
Professional Competence , Preoperative Care , Validation Study , Specialization , Surgeons/education
3.
Rev. argent. cir ; 112(4): 369-379, dic. 2020. tab, il
Article in Spanish | LILACS, BINACIS | ID: biblio-1288145

ABSTRACT

RESUMEN En la presente revisión de los últimos años de la formación de recursos humanos en cirugía, se destaca la vigencia y la visión de futuro del discurso del Prof. Dr. Mario Brea. Cuando él define el sistema de residencias, vemos que los principios son los mismos, pero adaptados al siglo XXI: ▪▪Sistema de adiestramiento progresivo. ▪▪Programa preestablecido: modernos currículos con sistemas de evaluación integrales. ▪▪Promoción y adjudicación de responsabilidades crecientes: el cumplimiento de los milestones (o en un futuro alguna otra forma de evaluación como las Entrusted Professional Activities, EPAs). ▪▪Dirección, conducción y vigilancia estrecha: tutorización con la implementación del feedback como herramienta pedagógica. ▪▪Medio y horario de trabajo apropiados: la simulación como ambiente protegido de aprendizaje de destrezas quirúrgicas y NTS; limitación horaria para disminuir el error médico. ▪▪Investigación y docencia: estimulación de la publicación de trabajos originales desde temprano en la formación y el vínculo con residentes de niveles inferiores para crear un círculo virtuoso de forma ción profesional.


ABSTRACT The present review of the last years in the training of human resources in surgery highlights the validity and vision for the future of Prof. Dr. Mario Brea's speech. When he defines the residency system, we realize that the principles are the same, but adapted to the 21st century: ▪▪Progressive training. ▪▪Pre-established programs with modern curricula and comprehensive systems of evaluation. ▪▪Promotion and allocation of more responsibilities: compliance with Milestones (or in the future with some other type of assessment such as Entrusted Professional Activities, EPAs). ▪▪Direction, guidance and close supervision with the implementation of feedback as a pedagogical tool.Appropriate work environment and schedule: simulation as a protected environment for learning surgical and NTS skills; restrictive working hours to reduce medical error. ▪▪Research and teaching: the publication of original papers should be encouraged since the early years of training as well as the relationship with junior residents to create a virtuous circle of professional training.


Subject(s)
Internship and Residency , Medical Staff, Hospital/education , General Surgery/education , United States , Professional Training , Fellowships and Scholarships , Surgeons/education
6.
Rev. cir. (Impr.) ; 72(4): 369-374, ago. 2020.
Article in Spanish | LILACS | ID: biblio-1138725

ABSTRACT

Resumen La docencia innovadora en cirugía la asociamos habitualmente al uso de tecnología moderna para mejorar la educación que realizamos en nuestra especialidad. Sin embargo, en educación, la innovación está relacionada con la incorporación de aspectos más teóricos que tecnológicos. Esto está respaldado por una creciente cantidad de evidencia conducida principalmente por educadores, quienes utilizan la mirada de las ciencias sociales, que difieren ampliamente de cómo validamos la evidencia los cirujanos. Pese a esto, en los últimos 40 años, hemos visto globalmente como ha habido un importante cambio paradigmático en el modelo educativo con el que educamos en cirugía. Este ha sido impulsado básicamente por la introducción de técnicas mínimamente invasivas, cambios sociales y el progreso de las ciencias de la educación. Como sociedad científica tenemos aun el desafío de impulsar la formación de educadores quirúrgicos, establecer estándares nacionales según la experiencia de países líderes en la materia y regular los currículos de pre y postgrado introduciendo conceptos educacionales modernos como el profesionalismo y la educación basada en competencias. Nuestra meta debería ser una sola: profesionalizar la educación quirúrgica en nuestro país poniendo el foco en el residente o en el estudiante. Esto implica entre otras cosas, que se cambie el objetivo de formar profesionales que dominen una batería rígida de procedimientos a prepararlos para enfrentar competentemente un mundo profesional que se encuentra en constante cambio y evolución. Sólo así estaremos realmente realizando innovación en docencia quirúrgica y podremos enfocarnos entonces en la tecnología.


Innovative education in surgery is frequently associated with incorporating modern technology to facilitate learning in our specialty. Nevertheless, innovation in education is more dependent on restructuring the educational processes than introducing technology alone. This is underpinned by a consistent amount of evidence generated by education professionals, that usually conduct research under the paradigm of social sciences, which differ widely from the ways in which surgeons understand the world. However, during the last 40 years, there has been a well-recognized shift in the way we surgeons educate. It has been claimed that the determinants of such changes have been the introduction of minimal invasive procedures, sociocultural changes and the development of modern education theories. Our surgical scientific society still have the challenge of promoting the training of surgical educators, stablishing national standards according to the experience of the developed world and regulating undergraduate and graduate curricula by introducing modern educational concepts like competency-based education and professionalism. Our major goal is to professionalize medical education in our country, focusing in the learning process of the residents or students. This imply among other aspects, to change the focus from educating on a rigid set of technical procedures to train professionals that are capable of responding competently to a world that is in a rapid and constant change. I believe that this is the only way to innovate in surgical education. Once we have reach this, then we will be able to focus on the modern technology that can help us achieve such goals.


Subject(s)
Humans , Education, Medical/methods , Surgeons/education , Chile , Competency-Based Education/methods , Education, Medical/trends , High Fidelity Simulation Training/methods
8.
Rev. cir. (Impr.) ; 72(3): 209-216, jun. 2020. tab, graf, ilus
Article in Spanish | LILACS | ID: biblio-1115544

ABSTRACT

Resumen Introducción: Si bien la anastomosis intracorpórea (AI) ha demostrado beneficios clínicos sobre la anastomosis extracorpórea (AE) en la hemicolectomía derecha laparoscópica (HDL), su aplicación ha sido limitada por su dificultad técnica y curva de aprendizaje más larga. El presente estudio busca desarrollar y evaluar un modelo simulado para entrenar este procedimiento. Materiales y Método: Se desarrolló un modelo en base a tejido ex vivo, con colon porcino e intestino bovino, montados en un simulador de laparoscopía. Este se modificó sucesivamente en base a entrevistas semiestructuradas a cirujanos hasta lograr el modelo final. Para evaluar apariencia y reacción al modelo, coloproctólogos, cirujanos y residentes previamente expuestos a entrenamiento simulado, realizaron una ileotransverso anastomosis mecánica en el modelo y luego contestaron una encuesta. Resultados: Doce sujetos participaron. Cuatro coloproctólogos, 4 residentes de coloproctología, 2 residentes de cirugía general, 1 cirujano general y 1 cirujano digestivo. El 91,6% valoró positivamente la ergonomía lograda, mientras que el 83,3% y 75% valoraron positivamente el uso del instrumental y la relación anatómica entre estructuras, respectivamente. Todos los participantes consideraron el modelo útil para entrenar sutura manual laparoscópica, el 91,6% para entrenar enterotomías y 83,3% para entrenar el uso de endograpadora. Todos declararon que el módulo permite entender y reflexionar sobre la técnica propuesta. Conclusión: Este modelo desarrollado sería útil para entrenar habilidades críticas para realizar una AI en HDL. Su incorporación a un programa de entrenamiento en laparoscopía avanzada podría contribuir a acortar la curva de aprendizaje de este procedimiento.


Introduction: Although intracorporeal anastomosis has demonstrated clinical benefits over extracorporeal anastomosis in laparoscopic right hemicolectomy, its application has been limited due to its technical difficulty and longer learning curve. The present study aims to develop and evaluate a simulated model to train this procedure. Materials and Method: An ex vivo tissue model was developed with porcine colon and bovine small bowel mounted in a laparoscopic simulator. This was subsequently modified based on semi-structured interviews to experts until the final model was achieved. To evaluate appearance and reaction to the model, the participants performed an ileocolic mechanical anastomosis in the model and answered a survey. Results: Twelve subjects participated. Four colorectal surgeons, 4 colorectal surgery fellows, 2 residents of general surgery, 1 general surgeon and 1 upper digestive surgeon. Of all subjects, 91.6%, 83.3% and 75% deemed ergonomics achieved, the use of instruments, and the anatomical relationship between structures as similar to reality, respectively. All participants deemed the model useful to train laparoscopic manual suturing, while 91.6% and 83.3% of them considered it useful to train enterotomies and the use of an endostapler, respectively. All declared that the model allows to understand the proposed technique. Conclusion: This model would be useful to train critical skills to perform an intracorporeal anastomosis in laparoscopic right hemicolectomy. Its incorporation into an advanced simulated laparoscopy training program could help shorten the learning curve of this procedure.


Subject(s)
Anastomosis, Surgical/methods , Surgeons/education , Simulation Training/methods , Surveys and Questionnaires , Laparoscopy/methods , Colectomy/methods
9.
Rev. argent. cir ; 112(3): 274-292, jun. 2020. graf
Article in Spanish | LILACS | ID: biblio-1279741

ABSTRACT

RESUMEN Introducción: la seguridad de la colonoscopia realizada por cirujanos y el tratamiento de sus complica ciones han sido analizados aisladamente y en escasas publicaciones nacionales. Objetivos: el objetivo principal del estudio fue analizar las colonoscopias realizadas por cirujanos co lorrectales, sus complicaciones y resolución. El objetivo secundario fue comparar los resultados entre un hospital universitario y distintos centros del país dotados de cirujanos colorrectales que habían recibido entrenamiento en una residencia posbásica. Material y métodos: estudio multicéntrico, prospectivo a nivel nacional. Se incluyeron las colonosco pias realizadas entre 2011 y 2016 . Se analizaron como variables las complicaciones, edad, sexo, tipo de endoscopia, diagnóstico, tratamiento, sitio de realización y de entrenamiento del cirujano. Se ex presaron en promedios, porcentajes y rangos. El análisis estadístico consistió en el test exacto ordinal, relaciones y proporciones y exacto de Fisher. Se consideró significancia a p < 0,05. Resultados: de 24 907 procedimientos, 17 283 fueron diagnósticos y 17 202 provenían de centros del interior. Hubo 43 complicaciones (0,17%); 35 específicas: perforaciones (19), hemorragias (8), sín drome pospolipectomía (5) y técnicas (3), diagnosticadas y resueltas por el mismo equipo sin mor bimortalidad. No hubo diferencias en las complicaciones según el centro ni tipo de colonoscopia en incidencia o tratamiento. Todos los cirujanos se entrenaron en residencias de posgrado con programas de entrenamiento en colonoscopia. Conclusiones: existen similares resultados entre cirujanos provenientes de instituciones con residen cia posbásica y centros del interior al realizar colonoscopias. La colonoscopia realizada por cirujanos es un procedimiento seguro y posible de ser adquirido como competencia luego de un entrenamiento formal realizado en una residencia posbásica.


ABSTRACT Introduction: The safety of colonoscopies performed by surgeons and the management of their com plications has not been analyzed in depth in the low number of national publications. Objective: The primary endpoint of this study was to analyze the outcomes of colonoscopies perfor med by colorectal surgeons, in terms of complications. and their resolution. The secondary endpoint was to compare the results between a university hospital and different centers nationwide staffed with colorectal surgeons who had received formal training during a residency program in the surgical subspecialty. Material and methods: We conducted a multicenter, prospective and consecutive national study. The colonscopies performed between 2011 and 2016 were included. The variables analyzed included complications, age, sex, type of endoscopy, diagnosis, treatment, location were the procedure was performed and surgeon's training. The results were expressed as mean, percentage and range. The statistical analysis was performed using Fisher's exact test. A p value < 0.05 was considered statistically significant. Results: A total of 24,907 procedures were performed, 17,283 corresponded to diagnostic colonosco pies and 17,202 were made in provincial centers. Forty-four complications were recorded (0.17%), of which 35 were procedure-related complications: 19 perforations, 8 bleeding events, 5 post-polypec tomy syndromes and three related with the technique; all were diagnosed and solved by the same team without morbidity and mortality. There were no differences in the incidence of complications and how they were treated according to the center or type of colonoscopy. All the surgeons received colonoscopy training during a residency program in the surgical subspecialty. Conclusions: The results obtained in colonoscopies performed by surgeons trained in institutions with residency programs in surgical subspecialties are similar t Safe colonoscopies can be performed by surgeons who have been trained in institutions with a residency program in a surgical subspecialty and with a formal training program in colonoscopy.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Colonoscopy/adverse effects , Colorectal Surgery/adverse effects , Prospective Studies , Surgeons/education , Hemorrhage , Hospitals, University , Internship and Residency
11.
Rev. cir. (Impr.) ; 72(1): 22-29, feb. 2020. tab
Article in Spanish | LILACS | ID: biblio-1092886

ABSTRACT

Resumen Introducción Los cambios en la práctica profesional han transformado la intención de los estudiantes de medicina de optar por una carrera en cirugía. Objetivo Evaluar los factores asociados con esta intención en un contexto de acelerada dinámica educativa y sanitaria. Materiales y Método Evaluamos la intención de los estudiantes de diez facultades de medicina en Colombia, y los factores asociados, mediante un cuestionario (escala de Likert) desarrollado a partir de la revisión de la literatura. Identificamos la asociación entre los factores y la intención mediante un análisis de regresión lineal. Los resultados de la regresión se presentan mediante coeficientes β (p < 0,05). Resultados Un total de 252 estudiantes (65,87% mujeres) fueron incluidos en el análisis. El promedio de la intención fue 3,15 ± 1,34 (1-5). Los factores significativamente asociados fueron: identificación con el estilo de vida quirúrgico (β = 0,25); identificación con modelos (β = 0,18); atributos personales (β = 0,25) e identificación con la práctica profesional del cirujano (β = 0,16). No encontramos asociación significativa con el género (mujeres en la especialidad), prestigio, dinámica del posgrado ni recompensa futura. Conclusión Existe una intención moderada de elegir una carrera de cirugía entre estudiantes de medicina colombianos. Optar por esta carrera requiere atributos personales, modelos e identificación con el estilo de vida y práctica profesional del cirujano. Se requieren estudios cualitativos que exploren en profundidad estos resultados e intervenciones focalizadas a estimular esta intención entre los estudiantes.


Introduction The changes in the professional practice have transformed the intention of medical students to choose a surgical career. Aim Evaluate the factors associated with this intention in a context of accelerated educational and health dynamics. Materials and Method We evaluated the intention of the students of ten medical schools in Colombia, and the associated factors, through a questionnaire (Likert scale) settled from a literature review. We identify the association between the factors and the intention by using linear regression analysis. The results of the regression are presented by β coefficients (p < 0.05). Results A total of 252 students (65.87% women) were included in the analysis. The average of the intention was 3.15 ± 1.34 (1-5). The factors significantly associated were: identification with the surgical lifestyle (β = 0.25); identification with models (β = 0.18); personal attributes (β = 0.25) and identification with the professional practice of the surgeon (β = 0.16). We did not find significant associations with gender (women in the specialty), prestige, postgraduate dynamics and future rewards. Conclusion There is a moderate intention to choose a career in surgery among Colombian medical undergraduates. Choosing this career requires personal attributes, models and identification with the lifestyle and professional practice of the surgeon. Further qualitative studies are necessary to explore these results in depth, as well as interventions to stimulate this intention among students.


Subject(s)
Humans , Students, Medical/psychology , Surgeons/psychology , Surveys and Questionnaires , Colombia , Surgeons/education
13.
Rev. cir. (Impr.) ; 71(6): 545-551, dic. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1058316

ABSTRACT

Resumen Objetivo: Nuestro objetivo es comparar la efectividad de la tutoría impartida por pares de 6° versus 14° semestre en la adquisición de habilidades procedimentales básicas en estudiantes de medicina. Materiales y Método: Estudio cuasi-experimental, antes y después. La intervención consta inicialmente de un curso de formación de monitores de sutura (MS) para dos estudiantes de 6° y dos de 14° semestre de medicina. Posteriormente se implementó un taller de sutura tutorizado por MS a 23 estudiantes de 8° semestre de medicina. Se evaluó sutura continua y discontinua mediante el instrumento: "The Objective Structured Assessment Of Technical Skills" (OSATS) y satisfacción mediante encuesta tipo Likert validada por expertos. Se describen y comparan los resultados pre y postintervención y satisfacción de los estudiantes, de acuerdo al semestre cursado del MS. Se aplicó consentimiento informado. Se utilizó SPSS24® para análisis estadístico mediante prueba de Mann Whitney. Se consideró significativo p < 0,05. Resultados: Ambos grupos progresaron significativamente en la escala OSATS, grupo tutorizado por MS de 6° semestre: 18,1 vs 28,1 (p < 0,001) y grupo tutorizado por MS de 14° semestre: 15,5 vs 27,8 (p < 0,001). Los puntajes finales no presentan diferencias significativas. La intervención fue evaluada con 66 de 68 puntos, sin diferencias significativas según el semestre cursado del MS. Conclusión: Nuestra experiencia muestra que es posible utilizar la tutoría por pares entrenados para la enseñanza de habilidades quirúrgicas, independientemente si la tutoría es impartida por pares de cursos inferiores o superiores, logrando un progreso significativo y un desempeño procedimental equivalente, además de una alta satisfacción entre los estudiantes.


Aim: Our objective is to compare the effectiveness of tutoring taught by 6th versus 14th semester peer students in the acquisition of basic procedural skills in medical students. Materials and Method: Quasi experimental study, before and after. The intervention initially consists of a training workshop for suture monitors (SM) for two students of 6th and two students of 14th semester of medicine. Subsequently, a suture workshop taught by SM to 23 fourth-year medical students was implemented. Continuous and discontinuous suture was evaluated using the instrument: "Objective structured evaluation of technical skills" (OSATS) and satisfaction through a survey validated by experts. The results of pre and post intervention and student satisfaction are described and compared, according to the semester attended by the SM. Informed consent was applied. Excel® and SPSS24® were used for statistical analysis by Mann Whitney test. It was considered significant p < 0.05. Results: Both groups progressed significantly on the OSATS scale, group tutored by 6° semester SM: 18.1 vs 28,1 (p < 0.001) and group tutored by 14° semester SM: 15.5 vs 27,8 and (p < 0.001). The final scores did not they present significant differences. The intervention was well evaluated with 66 out of 68 points, without significant differences according to the semester coursed of the SM. Conclusion: Our experience shows that it is possible to use peer tutoring by trained tutors to teach surgical skills, regardless of whether the teaching is given by pairs of lower or higher courses, achieving significant progress and equivalent procedural performance, in addition to high satisfaction among students.


Subject(s)
Humans , Surgical Procedures, Operative/education , Education, Medical/methods , Surgeons/education , Students, Medical , Mentoring/methods
14.
Rev. cir. (Impr.) ; 71(5): 405-411, oct. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1058294

ABSTRACT

Resumen Introducción: El entrenamiento estandarizado mediante simulación ha demostrado mejorar habilidades de residentes y cirujanos. Sin embargo, los centros de simulación que imparten programas validados son escasos y centralizados. Favorecer el acceso de la comunidad quirúrgica a estos programas constituye el desafío actual. Objetivo: Describir el primer "Learning Center" (LC) realizado durante el 90° Congreso Chileno de Cirugía, evaluar su impacto y percepción de los asistentes sobre simulación en cirugía mínimamente invasiva (CMI) en los programas de formación actual. Materiales y Método: Estudio de corte transversal. Se describieron las características del LC. Se aplicó una encuesta tipo Likert para evaluar impacto y percepción de los asistentes. Criterios de inclusión: completar ≥ 1 sesión de entrenamiento, exclusión: encuesta incompleta. Se aplicó estadística descriptiva y analítica no paramétrica. Resultados: LC se compuso de 10 estaciones de entrenamiento con distintos niveles de dificultad. Un equipo de 9 instructores monitorizaron y entregaron feedback efectivo a los asistentes. 84 asistentes contestaron la encuesta completa, 39% mujeres. La muestra se conformó por 41,6% residentes de cirugía general, 35,7% cirujanos, 17,9% internos de medicina, y 4,8% médicos generales. 85% manifestó acuerdo con el impacto positivo del LC como recurso educacional continuo durante el congreso, y la utilidad de la práctica simulada para el desarrollo de habilidades en CMI. No hubo diferencias significativas según sexo o nivel de formación. Conclusión: El primer LC se desarrolló con una amplia aceptación entre sus participantes, constituyendo un posible recurso permanente. El entrenamiento simulado en CMI parece ser un recurso aceptado y percibido como una necesidad por la comunidad quirúrgica nacional.


Background: Standardized Simulated Training (SST) has shown to improve both resident and surgeon skills. However, Simulation Centers with validated training programs are scarce and centralized. The current challenge is to provide the surgical community access to these programs. Aim: To describe the first Learning Center (LC), launched during the 90th Chilean Surgical Congress, and to assess its impact and attendees' perception on simulation in Minimally Invasive Surgery (MIS) in current surgery residency programs. Materials and Method: Cross-sectional study. LC characteristics are described. A Likert survey was applied to assess its impact and attendees' perception. Inclusion criteria: to have performed ≥ 1 training sessions. Exclusion criteria: incomplete surveys. Descriptive and non-parametric analytical statistics were applied. Results: The LC was composed of 10 training stations with different difficulty levels. Nine instructors monitored and gave attendees effective feedback. 84 attendees answered the survey adequately. 39% were women. The sample was composed of 41.6% General Surgery Residents, 35.7% Surgeons, 17.9% Medicine Clerks and 4.8% General Practitioners. 85% of participants agreed regarding both the positive impact of the LC as a continuous educational resource during the congress and SST usefulness in development of MIS skills. There were no significant differences according to sex or medical degree. Conclusion: The first LC was widely accepted amongst its participants, constituting a possible permanent resource in the Chilean Surgical Congress. SST in MIS seems to be an accepted resource and perceived as a necessity by the national surgical community.


Subject(s)
Humans , Male , Female , Surgeons/education , Simulation Training , High Fidelity Simulation Training/trends , Chile , Surveys and Questionnaires , Education, Medical/trends
17.
Rev. bras. cir. plást ; 34(2): 250-259, apr.-jun. 2019. ilus, tab
Article in English, Portuguese | LILACS | ID: biblio-1015983

ABSTRACT

Introdução: Muito se discute sobre a formação do cirurgião plástico na especialização médica nacional e internacionalmente. Há necessidade da busca por melhoras e padronização na formação visando o futuro da especialidade. Métodos: Foi avaliado protocolo preenchido no Congresso Brasileiro de Cirurgia Plástica (Belo Horizonte) por especializandos do terceiro ano. Resultados: Foram distribuídos 230 protocolos. 113 protocolos foram incluídos. A amostra incluiu 71 homens e 41 mulheres. 34 eram de serviços cadastrados pela Sociedade Brasileira de Cirurgia Plástica (SBCP) e 71 eram de serviços cadastrados pelo Ministério da Educação e SBCP. 96 afirmaram que em seus serviços são realizados procedimentos puramente estéticos, com média de 54,3% de procedimentos estéticos. O procedimento com menos confiança em realizar foi transplante capilar, e mais confiança foi abdominoplastia. Área de interesse mais requisitada foi rinoplastia e a menos foi abdominoplastia. Os especializandos estão regularmente satisfeitos com seus programas, com média de 3,89, em uma escala de 1 a 5. O procedimento que deve ser mais realizado foi rinoplastia, sendo necessário, do ponto de vista deles, realizar mais de 10 procedimentos. Os especializandos sentem-se bem preparados pela programa, com média de 3,8 em uma escala de 1 a 5. 65% deles acham necessário fazer fellow, sendo o mais requisitado de mastologia. O procedimento mais realizado foi mamoplastia redutora. A maioria dos especializandos quer trabalhar em clínica privada. Conclusão: Visando aprimorar a formação acadêmica, é necessário que os serviços credenciados se adequem aos requisitos necessários para a boa formação dos especializandos.


Introduction: Much has been discussed about the training of a plastic surgeon nationally and internationally. There is a need to improve and standardize training to ensure the future of this specialty. Methods: Questionnaires were filled by third year trainees at the Brazilian Congress of Plastic Surgery (Belo Horizonte). Results: A total of 230 questionnaires were distributed and 113 were included in the study. The respondents included 71 men and 41 women; 34 were from institutions recognized by the Brazilian Society of Plastic Surgery (SBCP) and 71 were from institutions recognized by the Ministry of Education and the SBCP. Ninety-six respondents revealed that purely aesthetic procedures were conducted in their institutions, with an average of 54.3% of aesthetic procedures. The respondents had the least confidence in performing hair transplants and the most confidence in performing an abdominoplasty. The topic most requested for training was rhinoplasty and the least requested was abdominoplasty. The trainees were fairly satisfied with their programs, with an average satisfaction level of 3.89, on a scale of 1 to 5. The procedure that needed to be performed more frequently was rhinoplasty (more than 10 procedures). Most trainees felt that the program prepared them to practice surgeries, with an average of 3.8 on a scale of 1 to 5. Further, 65% found it necessary to have a fellowship, with mastology being the most requested. The most common procedure was reduction mammoplasty. Most of the trainees wanted to work in a private clinic. Conclusion: In order to improve the level of education, the accredited institutions should meet the requirements necessary for good preparation of the trainees.


Subject(s)
Humans , Surgery, Plastic/education , Surgery, Plastic/methods , Surgery, Plastic/ethics , Work Capacity Evaluation , Surveys and Questionnaires/statistics & numerical data , Education, Continuing/methods , Education, Continuing/organization & administration , Educational Measurement/methods , Esthetics/education , Surgeons/education , Surgeons/statistics & numerical data
19.
Clinics ; 74: e777, 2019. tab, graf
Article in English | LILACS | ID: biblio-1011900

ABSTRACT

OBJECTIVE: To analyze our experience and learning curve for robotic pyeloplasty during this robotic procedure. METHODS: Ninety-nine patients underwent 100 consecutive procedures. Cases were divided into 4 groups of 25 consecutive procedures to analyze the learning curve. RESULTS: The median anastomosis times were 50.0, 36.8, 34.2 and 29.0 minutes (p=0.137) in the sequential groups, respectively. The median operative times were 144.6, 119.2, 114.5 and 94.6 minutes, with a significant difference between groups 1 and 2 (p=0.015), 1 and 3 (p=0.002), 1 and 4 (p<0.001) and 2 and 4 (p=0.022). The mean hospital stay was 7.08, 4.76, 4.88 and 4.20 days, with a difference between groups 1 and 2 (p<0.001), 1 and 3 (p<0.001) and 1 and 4 (p<0.001). Clinical and radiological improvements were observed in 98.9% of patients. One patient presented with recurrent obstruction. CONCLUSIONS: Our results demonstrate a high success rate with low complication rates. A significant decrease in hospital stay and surgical time was evident after 25 cases.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Ureteral Obstruction/surgery , Laparoscopy/education , Learning Curve , Robotic Surgical Procedures/education , Surgeons/education , Kidney Pelvis/surgery , Postoperative Complications , Analysis of Variance , Treatment Outcome , Laparoscopy/methods , Statistics, Nonparametric , Operative Time , Robotic Surgical Procedures/methods , Length of Stay
20.
Rev. bras. cir. plást ; 33(4): 609-618, out.-dez. 2018. ilus, tab
Article in English, Portuguese | LILACS | ID: biblio-980175

ABSTRACT

Introdução: A Cirurgia Plástica exige inúmeras habilidades, conhecimentos e competências, e seu escopo de atuação é amplo e desafiador. Dessa forma, todos os cirurgiões plásticos passam por uma extensa educação/formação, que se inicia durante a residência e continua ao longo da vida. O objetivo deste estudo foi delinear um treinamento formal em documentação fotográfica bidimensional padronizada para complementar o treinamento cirúrgico e científico durante a residência em Cirurgia Plástica. Métodos: Os componentes (as estratégias, os tópicos abordados e os processos de aquisição de habilidades e feedback) do treinamento em documentação fotográfica durante a residência em Cirurgia Plástica foram detalhados. Resultados: As atividades dos residentes, as interações entre os residentes o fotógrafo profissional e os cirurgiões/ preceptores e os tópicos abordados (estúdio fotográfico, câmeras fotográficas, objetivas, princípios fotográficos [exposição, abertura, velocidade, ISO e profundidade de campo], iluminação, preparo e posicionamento dos pacientes e da câmera fotográfica, situações fotográficas, vistas fotográficas, banco fotográfico, formatos de imagens, fotogrametria computadorizada e questões éticas e médico-legais) do programa de treinamento em documentação fotográfica foram delineados. Conclusão: O treinamento em documentação fotográfica complementa o arsenal de habilidades necessários aos residentes de Cirurgia Plástica em formação, com o intuito de melhor prepará-los para as carreiras futuras.


Introduction: Plastic surgery requires diverse skills, knowledge, and competencies, and its scope is broad and challenging. Thus, all plastic surgeons go through extensive education/training, which begins during residency and continues throughout their lives. This study aims to outline a formal training program in 2-dimensional standardized photographic documentation ("photodocumentation") to complement surgical and scientific training during residency in Plastic Surgery. Methods: The components (strategies, topics covered, skills acquisition, and feedback processes) of training in photodocumentation during residency in Plastic Surgery were detailed. Results: Topics in the photodocumentation training program included resident activities, interactions among residents, professional photographers, and surgeons/preceptors, studio settings, cameras, lenses, principles (exposure, aperture, speed, ISO, and depth of field), lighting, preparation and positioning of patients and the camera, photoshoot conditions, photo views, photo database, image formats, computerized photogrammetry, and ethical and medical-legal issues. Conclusion: Training in photodocumentation complements the arsenal of skills needed by residents in Plastic Surgery for continuing education, in order to better prepare them for future careers.


Subject(s)
Humans , Surgery, Plastic/education , Surgery, Plastic/methods , Documentation/methods , Documentation/standards , Education, Medical/methods , Education, Medical/trends , Photograph , Surgeons/education
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