ABSTRACT
BACKGROUND: The fundamentals of laparoscopic surgery (FLS) trainer box, which is now established as a standard for evaluating minimally invasive surgical skills, consists of five tasks: peg transfer, pattern cutting, ligation, intra- and extracorporeal suturing. Virtual simulators of these tasks have been developed and validated as part of the Virtual Basic Laparoscopic Skill Trainer (VBLaST) (Arikatla et al. in Int J Med Robot Comput Assist Surg 10:344-355, 2014; Zhang et al. in Surg Endosc 27(10):3603-3615, 2013; Sankaranarayanan et al. in J Laparoendosc Adv Surg Tech 20(2):153-157, 2010; Qi et al. J Biomed Inform 75:48-62, 2017). The virtual task trainers have many advantages including automatic real-time objective scoring, reduced costs, and eliminating human proctors. In this paper, we extend VBLaST by adding two camera navigation system tasks: (a) pattern matching and (b) path tracing. METHODS: A comprehensive camera navigation simulator with two virtual tasks, simplified and cheaper hardware interface (compared to the prior version of VBLaST), graphical user interface, and automated metrics has been designed and developed. Face validity of the system is tested with medical students and residents from the University at Buffalo's medical school. RESULTS: The subjects rated the simulator highly in all aspects including its usefulness in training to center the target and to teach sizing skills. The quality and usefulness of the force feedback scored the lowest at 2.62.
Subject(s)
Computer Simulation , Laparoscopy/education , Simulation Training , Adult , Clinical Competence , Female , Humans , Male , User-Computer Interface , Young AdultABSTRACT
BACKGROUND: The Harvard Medical School Cambridge Integrated Clerkship longitudinal cancer curriculum directly facilitates students' engagement with cancer patients to develop a comprehensive understanding of the disease and the patient's experience of illness. Third-year medical students follow newly diagnosed cancer patients over the course of a year, across all disciplines, and make formal presentations to a multidisciplinary forum at the end of the year. The aim of the study was to discover which aspects of longitudinal care were most meaningful to the students themselves. METHOD: Researchers performed a qualitative thematic analysis of students' presentations. Basing the analysis on principles of grounded theory, researchers took an inductive approach using the constant comparative method to discover core themes and to cluster themes into encompassing domains. RESULT: Researchers identified 33 individual themes among 60 presentations, reflecting five major domains: clinical issues; patient characteristics; systems problems; psychosocial response to cancer; and existential decision making. CONCLUSIONS: In this qualitative study of students' year-end final presentations after a year of cancer care experiences, two areas stood out: students perceived the complexities of medical decision making and students considered the impact of psychosocial factors on patients facing this disease over time. Which aspects of longitudinal care were most meaningful to the students(?).
Subject(s)
Neoplasms/psychology , Neoplasms/therapy , Patient-Centered Care/organization & administration , Students, Medical/psychology , Age Factors , Clinical Decision-Making , Communication , Cultural Competency , Empathy , Family/psychology , Humans , Models, Educational , Patient Care Team/organization & administration , Qualitative Research , Social Support , Socioeconomic FactorsABSTRACT
This 2014 roundtable discussion, hosted by the Canadian Association of General Surgeons, brought together general surgeons and gastroenterologists with expertise in endoscopy from across Canada to discuss the state of endoscopy in Canada. The focus of the roundtable was the evaluation of the competence of general surgeons at endoscopy, reviewing quality assurance parameters for high-quality endoscopy, measuring and assessing surgical resident preparedness for endoscopy practice, evaluating credentialing programs for the endosuite and predicting the future of endoscopic services in Canada. The roundtable noted several important observations. There exist inadequacies in both resident training and the assessment of competency in endoscopy. From these observations, several collaborative recommendations were then stated. These included the need for a formal and standardized system of both accreditation and training endoscopists.
