Subject(s)
Disease Management , Laryngeal Diseases/therapy , Laryngoscopy/adverse effects , Larynx/injuries , Otolaryngology/methods , Wounds, Penetrating/therapy , Adult , Female , Follow-Up Studies , Humans , Iatrogenic Disease , Laryngeal Diseases/etiology , Male , Middle Aged , Retrospective Studies , Wounds, Penetrating/etiologySubject(s)
Catheterization/adverse effects , Esophageal Stenosis/diagnosis , Esophageal Stenosis/therapy , Stents/adverse effects , Vocal Cord Paralysis/etiology , Aged, 80 and over , Carcinoma, Squamous Cell/complications , Carcinoma, Squamous Cell/diagnosis , Catheterization/methods , Esophageal Neoplasms/complications , Esophageal Neoplasms/diagnosis , Esophageal Stenosis/etiology , Esophagoscopy/methods , Follow-Up Studies , Humans , Laryngoscopy/methods , Male , Prosthesis Failure , Severity of Illness Index , Tomography, X-Ray Computed , Tracheostomy , Vocal Cord Paralysis/diagnosis , Vocal Cord Paralysis/surgeryABSTRACT
BACKGROUND: Education in basic laparoscopic skills training is performed ideally in an inanimate laboratory. Monitoring of basic skills progression, which is essential during this tranining, often may be difficult because of the resources and manpower. This study investigated the differences between self-reported and observed scores during basic laparoscopic exercises. METHODS: First-and second-year medical students involved in practice sessions using the LTS 2000 box trainer were included in the study. All the students were allowed to practice four tasks: placing pegs with their dominant and nondominant hands, transferring pegs from one hand to another starting with the dominant and nondominant hands, cannulating a pipe cleaner into a plastic tube, and progressing from one end of a rope to the other. Each student recorded his or her times and errors for each task. After these practice sessions, each student underwent an observed session (OS), performing all of the tasks, and was graded by a surgeon involved in laparoscopic education. All the students were asked to record another practice session. The self-reported performances from the session immediately before the OS (pre-OS) and the session immediately after the OS (post-OS) were compared with the performance in the OS. RESULTS: A total of 36 students were included in this study. The mean time and mean error were similar between all the sessions. Although the scores in the OS did slightly differ from the scores in the pre-OS and post-OS, post hoc analysis showed that there was no statistically significant difference between the OS score and either the pre-OS or the post-OS score for any of the laparoscopic exercises. CONCLUSIONS: No differences between observed scores and self-reported scores were noted. The use of self-reported scores may be a good method for monitoring performance during training in laparoscopic basic skills. The self-reporting of basic laparoscopic exercises may conserve resources.
Subject(s)
Clinical Competence , Education, Medical , Educational Measurement , Endoscopy/education , Laparoscopy , Students, Medical/psychology , Adult , Educational Measurement/methods , Educational Measurement/standards , Educational Measurement/statistics & numerical data , Female , General Surgery , Humans , Learning , Male , Models, Anatomic , Physicians/psychology , Psychomotor Performance , Reproducibility of Results , Self Disclosure , Time FactorsABSTRACT
BACKGROUND: Laparoscopic surgery requires specialized dexterity even beyond that required for open surgery. Decreased tactile feedback, different eye-hand coordination, and translation of a two-dimensional video image into a three-dimensional working area are just some of the obstacles in the performance of laparoscopic surgery. Possession of certain nonsurgical skills may help in overcoming some of these obstacles. Prediction of baseline laparoscopic surgery skills may help further to refine the education of basic laparoscopic surgery skills. This investigation explores whether nonsurgical skills and demographic data can predict baseline laparoscopic surgery tasks. METHODS: First- and second-year students were given a survey regarding nonsurgical dexterity skills. The survey inquired about typing skills, play with computer games, ability to sew, skill with music instruments, use of chopsticks, and experience operating tools. Demographic data were requested as well. All the students underwent four tasks: placing a piece of bowel in a retrieval bag, placing a stapler on the bowel, measuring a piece of bowel, and performing a liver biopsy in a porcine animal model. Both objective (time and error) and subjective evaluation were assessed for all the tasks. Statistical analysis using analysis of variances (ANOVA) Kruskal-Wallis test with post hoc tests, two-tailed unpaired t-tests/Mann-Whitney test, and Fischer's exact tests/chi-square tests was performed when appropriate. RESULTS: There were 68 students in this investigation. Gender, medical student year, ethnicity, desire to enter a surgical field, and age were not associated with increased performance in any of the tasks. Chopstick use was associated with statistically significantly better mean time in placing a piece of bowel in a retrieval bag and measuring a piece of bowel (p < 0.04). The other nonsurgical dexterity skills did not statistically increase performance, as indicated by time, errors, or subjective scores, for the four tasks. CONCLUSIONS: It is difficult to predict baseline laparoscopic surgery skills.
