What ring tone should be used for patient safety? Early results with a Blackberry-based telementoring safety solution.

OBJECTIVE: Technology currently exists for the application of remote guidance in the laparoscopic operating suite. However, these solutions are costly and require extensive preparation and reconfiguration of current hardware. We propose a solution from existing technology, to send video of laparoscopic cholecystectomy to the Blackberry Pearl device (RIM Waterloo, ON, Canada) for remote guidance purposes. This technology is time- and cost-efficient, as well as reliable. METHODS: After identification of the critical maneuver during a laparoscopic cholecystectomy as the division of the cystic duct, we captured a segment of video before it's transection. Video was captured using the laparoscopic camera input sent via DVI2USB Solo Frame Grabber (Epiphan Ottawa, Canada) to a video recording application on a laptop. Seven- to 40-second video clips were recorded. The video clip was then converted to an .mp4 file and was uploaded to our server and a link was then sent to the consultant via e-mail. The consultant accessed the file via Blackberry for viewing. After reviewing the video, the consultant was able to confidently comment on the operation. RESULTS: Approximately 7 to 40 seconds of 10 laparoscopic cholecystectomies were recorded and transferred to the consultant using our method. All 10 video clips were reviewed and deemed adequate for decision making. CONCLUSION: Remote guidance for laparoscopic cholecystectomy with existing technology can be accomplished with relatively low cost and minimal setup. Additional evaluation of our methods will aim to identify reliability, validity, and accuracy. Using our method, other forms of remote guidance may be feasible, such as other laparoscopic procedures, diagnostic ultrasonography, and remote intensive care unit monitoring. In addition, this method of remote guidance may be extended to centers with smaller budgets, allowing ubiquitous use of neighboring consultants and improved safety for our patients.

A pilot study of comprehensive ultrasound education at the Wayne State University School of Medicine: a pioneer year review.

OBJECTIVE: Ultrasound is a versatile diagnostic modality used in a variety of medical fields. Wayne State University School of Medicine (WSUSOM) is one of the first medical schools in the United States to integrate an ultrasound curriculum through both basic science courses and clinical clerkships. METHODS: In 2006, 25 portable ultrasound units were donated to WSUSOM. First-year medical students were provided an ultrasound curriculum consisting of 6 organ-system sessions that addressed the basics of ultrasound techniques, anatomy, and procedural skills. After the last session, students were administered 2 anonymous and voluntary evaluations. The first assessed their overall experience with the ultrasound curriculum, and the second assessed their technical skills in applying ultrasound techniques. RESULTS: Eighty-three percent of students agreed or strongly agreed that their experience with ultrasound education was positive. On the summative evaluation, nearly 91% of students agreed or strongly agreed that they would benefit from continued ultrasound education throughout their 4 years of medical school. Student performance on the technical assessment was also very positive, with mean class performance of 87%. CONCLUSIONS: As residency programs adopt ultrasound training, medical school faculty should consider incorporating ultrasound education into their curriculum. Portable ultrasound has the potential to be used in many different settings, including rural practice sites and sporting events. The WSUSOM committee's pilot ultrasound curriculum will continue to use student feedback to enhance the ultrasound experience, helping students prepare for challenges that they will face in the future.

Developing a scoring rubric for resident research presentations: a pilot study.

BACKGROUND: A requirement for all Accreditation Council for Graduate Medical Education (ACGME) approved residencies is the provision of "an opportunity for residents to participate in research." To comply with this requirement, most training programs encourage their residents to conduct research and to report their results. Few guidelines exist, however, for assessing the efficacy of the presentations. The goal of this pilot study was to develop a valid, one-page scoring rubric to be used during oral resident research presentations. Such a scoring rubric will facilitate acceptable agreement among faculty raters. METHODS: Content validity was addressed by adhering to the Standards for Educational and Psychological Testing. A one-page, five-domain, behaviorally worded scoring rubric was developed. Inter-rater reliability was derived and three ACGME General Competencies were also addressed within the rubric. RESULTS: The initial scoring rubric was tested with 11 resident oral presentations. The inter-rater reliability was 0.56 using Cronbach's alpha. The rubric was modified and the scale restricted to a 3-point scale. It was then tested with 17 additional presentations, which were independently rated by two general surgery faculty members. Cronbach's Alpha increased to 0.61. CONCLUSIONS: An objective method to evaluate a resident's oral research presentation has been successfully piloted. This content valid rubric possesses good inter-rater reliability according to established guidelines. Clearly defined behaviors have been outlined within the rubric. Program directors will have psychometrically sound evidence for the ACGME. Future research will address generalizability and concurrent validity using other types of resident assessment data.