Hand Surgical Simulation in the Pandemic Era: A Systematic Review

Introduction: The COVID-19 pandemic and duty hour restrictions have illuminated a role for surgical simulation in trainees that permits meaningful technical experience outside the operating room. There is a need for the implementation of surgical simulation infrastructure adjacent to clinical training with practical considerations for complexity and cost. This systematic review analyzes surgical simulations that train hand surgical techniques and procedures with subjective or objective competency assessment. Method(s): A systematic review was conducted according to PRISMA- P guidelines using the PubMed, Medline, Scopus, Embase, Web of Science, and Cochrane databases. Selected search terms included procedures relevant to the field of hand surgery and various types of simulation training. Data, including skills and techniques taught and assessed, model type, equipment, cost, and emphasis placed in training for each article, were extracted. Result(s): Of 2,519 articles, 40 met inclusion criteria. Models were described as: synthetic benchtop/3D-printed (40.0%), animal (22.5%), cadaveric (20.0%), augmented and virtual reality (AR/ VR;12.5%), and other computer simulation (12.5%). Three models incorporated both a physical benchtop component and an AR/ VR component. The procedures most represented included tendon repair (30.0%), fracture fixation (27.5%), wrist arthroscopy (15.0%), and carpal tunnel release (15.0%). Sixty-five percent of articles emphasized the importance of surgical simulation in a surgeon's training. Conclusion(s): A diversity of surgical simulation models exist for the practice of various aspects of hand surgery. The existing literature demonstrates their utility for increasing expertise with surgical techniques and procedures in a low-risk setting.

Advances in multiscale rock physics for unconventional reservoirs

The multiscale rock physics of unconventional reservoirs have drawn increasing attention in recent years, which involves several essential issues, including measuring method, transport property, physics model, characteristic scale, and their application. These issues vastly affect science and engineering regarding the exploration and development of unconventional reservoirs. To encourage communication on the advances of research on the rock physics of unconventional reservoirs, a conference on Multiscale Rock Physics for Unconventional Reservoirs was jointly organized by the journals Energies and Advances in Geo-Energy Research. Due to the limitations of movement caused by COVID-19, 21 experts introduced their work online, and the conference featured the latest multiscale theories, experimental methods and numerical simulations on unconventional reservoirs. © 2022, Yandy Scientific Press. All rights reserved.

FELLOW EXPERIENCES WITH ENDOSCOPY SIMULATION BEFORE AND DURING THE COVID-19 PANDEMIC: AN INTERNATIONAL SURVEY

Background With the COVID-19 pandemic there was an acute drop in procedural volume for trainees, highlighting the need and potential of simulation-based training (SBT). Prior to the pandemic, the uptake of simulation was poorly categorized and inconsistent across programs despite the variety of endoscopic simulators available. We aimed to evaluate the current state of endoscopy training internationally in the wake of the pandemic as perceived by trainees. Methods This cross-sectional study utilized a survey composed of 21 questions eliciting demographic data, COVID-19-related training experiences, and experience with SBT. This survey was distributed internationally (USA, Canada, EU, Philippines, Singapore) to gastroenterology trainees between August 2021 to October 2021. Results The questionnaire was completed by 182 fellows, with 55 (30.2%) from the USA and 127 (69.8%) from other countries. Of the respondents, 79.1% were fellows during the first year of the pandemic. A majority (69.2%) found endoscopy training in general to be negatively impacted. Of those who reported a negative impact from the pandemic, 75.0% attributed it to a decline in endoscopic volume, 40.0% to institutional/regional guidelines, 25.0% to a shortage of personal protective equipment. Overall, 47.2% of respondents believed COVID-19 will negatively affect their endoscopic proficiency upon fellowship completion. A total of 71 respondents (39.0%) had experienced SBT before or during fellowship, with 27 from the USA (49.1% of respondents from USA) and 44 from other countries (34.6% of respondents from other countries). In the USA, 63.0% had used virtual reality (VR), 37.0% mechanical models, and 37.0% animal models compared to 47.7% VR, 68.2% mechanical models, and 27.3% animal models in other countries. Respondents agreed that SBT was most helpful with developing technical skills such as ergonomic handling, torque steering, and fine tip control. A majority (52.1%) found SBT appropriate to their level of training. Respondents believed increased access to SBT (43.7%) and mentored training (54.9%) would improve the experience. Conclusion While current data supports the use of SBT early in training, the cumulative uptake of SBT across programs before and during the COVID-19 pandemic remained low. In the USA and abroad, fellows perceive a negative impact of COVID-19 on their training and proficiency upon graduation. Compared to other countries, the USA had higher utilization of VR and lower utilization of mechanical models. Decrease in endoscopic volume was reported as the main factor negatively impacting endoscopic training. This survey highlights the potential benefit of SBT with low case volumes and further prospective evaluation of SBT in achieving endoscopic competence. (Table Presented)