Conception and prospective multicentric validation of a Robotic Surgery Training Curriculum (RoSTraC) for surgical residents: from simulation via laboratory training to integration into the operation room.

There is a lack of training curricula and educational concepts for robotic-assisted surgery (RAS). It remains unclear how surgical residents can be trained in this new technology and how robotics can be integrated into surgical residency training. The conception of a training curriculum for RAS addressing surgical residents resulted in a three-step training curriculum including multimodal learning contents: basics and simulation training of RAS (step 1), laboratory training on the institutional robotic system (step 2) and structured on-patient training in the operating room (step 3). For all three steps, learning content and video tutorials are provided via cloud-based access to allow self-contained training of the trainees. A prospective multicentric validation study was conducted including seven surgical residents. Transferability of acquired skills to a RAS procedure were analyzed using the GEARS score. All participants successfully completed RoSTraC within 1 year. Transferability of acquired RAS skills could be demonstrated using a RAS gastroenterostomy on a synthetic biological organ model. GEARS scores concerning this procedure improved significantly after completion of RoSTraC (17.1 (±5.8) vs. 23.1 (±4.9), p < 0.001). In step 3 of RoSTraC, all participants performed a median of 12 (range 5-21) RAS procedures on the console in the operation room. RoSTraC provides a highly standardized and comprehensive training curriculum for RAS for surgical residents. We could demonstrate that participating surgical residents acquired fundamental and advanced RAS skills. Finally, we could confirm that all surgical residents were successfully and safely embedded into the local RAS team.

The Communicative-Relational Operating Model of the Italian National Institute of Health for an Effective Telephone Intervention in Public Health, Structured on Basic Counselling Skills.

Introduction: Communication has a crucial role in public health, because it becomes an essential component of prevention; it is also a proactive tool in health promotion. From a planning perspective, it is appropriate to use communication means that can help the bidirectional communication process, such as face-to-face communication and telephone communication. Materials and methods: In relation to this, the Italian National Institute of Health has developed the "Modello Operativo Comunicativo-Relazionale" (the "Communicative-Relational Operating Model"). It is based on the fundamental skills of the counselling, this gives a protocol to the health professionals that is replicable and organized and it allows health professionals to carry out a telephone communication that is efficient with the user through technical-scientific and communication-relational skills. The goal is to answer in a customized way to the various users' health needs. The Operating Model was created by experts of the National AIDS and Sexually Transmitted Infections Helpline of the Operational Unit of Psycho-Socio-Behavioural Research, Communication, Training, of the Infectious Diseases Department. Later, the Operating Model was proposed to the experts of the Helplines in the National Centre on Addictions and Doping and the National Helpline of the National Centre for Rare Diseases in the National Institute of Health that integrated this method into their telephone approach. Results: The Operating Model illustrated above was applied to several helplines of the National Institute of Health as an example of correct scientific information, updated and customized on sexual transmitted infections, addictions and rare diseases. Conclusions: This article aims to illustrate the Operating Model, the theoretical prerequisites that subtend it and its possible application in the different public health structures that use the telephone for a profes-sional relationship with their users.

Linking gender differences with gender equality: A systematic-narrative literature review of basic skills and personality.

There is controversy regarding whether gender differences are smaller or larger in societies that promote gender equality highlighting the need for an integrated analysis. This review examines literature correlating, on a national level, gender differences in basic skills-mathematics, science (including attitudes and anxiety), and reading-as well as personality, to gender equality indicators. The aim is to assess the cross-national pattern of these differences when linked to measures of gender equality and explore new explanatory variables that can shed light on this linkage. The review was based on quantitative research relating country-level measures of gender differences to gender equality composite indices and specific indicators. The findings show that the mathematics gender gap from the PISA and TIMMS assessments, is not linked to composite indices and specific indicators, but gender differences are larger in gender-equal countries for reading, mathematics attitudes, and personality (Big Five, HEXACO, Basic Human Values, and Vocational Interests). Research on science and overall scores (mathematics, science, and reading considered together) is inconclusive. It is proposed that the paradox in reading results from the interrelation between basic skills and the attempt to increase girls' mathematics abilities both acting simultaneously while the paradox in mathematics attitudes might be explained by girls being less exposed to mathematics than boys. On the other hand, a more nuanced understanding of the gender equality paradox in personality is advanced, in which a gene-environment-cultural interplay accounts for the phenomenon. Challenges for future cross-national research are discussed.

Basic skills level of health literacy and its influencing factors in permanent residents in Fujian province in 2020 / 中华健康管理学杂志

Objective:To investigate and analyze on the basic skills level of health literacy and its influencing factors in permanent residents in Fujian province in 2020.Methods:In this cross-sectional study, from April to November in 2020, 3 304 urban and rural permanent residents aged 15-69 years in 13 counties (cities or districts) in Fujian province were selected by stratified multistage cluster sampling and random sampling for household questionnaire survey. Based on “Health literacy of Chinese citizens—basic knowledge and skills”, the questionnaire included three aspects: basic knowledge and concept, healthy lifestyle and behavior and basic skills. There were 50 questions in total, including 12 questions about basic skills with a total score of 16 points. A score of 13 points and above was considered as having basic skills. A total of 3 304 questionnaires were issued and reclaimed, and among which 3 250 questionnaires were valid. According to the data of the Sixth National Census in 2010 in Fujian province and the basic data collected in the monitoring process, the basic weight, no response and post-stratification adjustment of the samples were made to obtain the representative data of the province. The χ2 test and multivariate logistic regression were applied to analyze the influencing factors of basic skill level of health literacy in permanent residents in Fujian province in 2020. Results:According to the weighted data, the basic skill level of health literacy in permanent residents in Fujian province in 2020 was 26.02%, and it was higher in urban area than that in rural area (35.00% vs 20.15%). It was higher in people aged 25-34 years (35.36%), people with high education level (college/undergraduate and above 47.20%), civil servants (47.49%), medical personnel (44.00%), people with chronic diseases (27.04%) and people with good health condition (31.31%), respectively (all P<0.05). Among the 12 questions on basic skills, the correct rate in 6 questions was ≥50%. The question with the highest correct rate was “The correct practices after the occurrence of severe infectious diseases in the local area” (88.2%), and the question with the lowest correct rate was “Correctly identify drugs with‘OTC’ printed on the label”(28.7%). Education level (illiterate/less literate, OR=0.036, 95% CI: 0.018-0.073; primary school, OR=0.091, 95% CI: 0.053-0.155; junior high school, OR=0.230, 95% CI: 0.148-0.357; senior high school/vocational high school/technical secondary school, OR=0.351, 95% CI: 0.232-0.532; college/undergraduate and above, OR=1.000) was positively correlated with the basic skill level of residents′ health literacy ( P<0.001). Conclusions:The overall level of basic health skills in permanent residents in Fujian province in 2020 is relatively high, educational level is a positive correlation factor.

[Experiencing continuing education-experience of future urologists]. / Weiterbildung erlebt ­ Erfahrung des urologischen Nachwuchses.

Structured residency programmes within dedicated associations of hospitals, practices and medical care centres offer the opportunity to improve the quality of training and to increase the attractiveness of urology through fixed rotations of doctors in continued training. The implementation of such programmes is guided by the framework conditions of the respective location. Possible rotations range from andrology to paediatric urology and uro-gynaecology to interdisciplinary uro-oncology. An outpatient training period also offers the chance for a change of perspective and supports career orientation. Rotations in the interdisciplinary intermediate care unit offer the opportunity to become familiar with the care of complex disease processes, including the differential diagnostic assessment of abdominal diseases, which is important in urology. In summary, the diversity of urological training available can enable junior urologists to receive more individualised and targeted training by promoting multilayered, intersectoral as well as interprofessional training.

Basic Skills in Higher Education: An Analysis of Attributed Importance.

Today, the skills-based approach is increasingly in demand by companies due, in large part, to the fact that it favors the management of human resources by focusing on individual capabilities; which, finally, improves the job profile of a company. As a result, choosing the right candidates has become increasingly selective. Universities, therefore, need to teach skills to improve the incorporation of graduates into the workplace making it as successful as possible. For this reason, it is of special relevance to know if college students consider that the acquisition of skills is key for their incorporation into the workplace. The main objective of this study was to analyze and compare the importance assigned to the acquisition of basic skills in the university education of 694 students studying four different bachelor degrees: pedagogy, early childhood education, primary education, and psychology. For this purpose, a Likert-type questionnaire on basic skills was distributed with four possible options and the following five dimensions that grouped basic skills: organizational and planning capacity; access to information sources; analysis and synthesis of texts, situations, and people; teamwork; and problem solving. The results show that as a whole all students across different bachelor degrees gave a high score to the acquisition of basic skills, with early childhood education students giving it greater importance compared to the students from other disciplines and, more specifically, differences were observed in some dimensions depending on the bachelor degree that they have started.

Proficiency-based progression training for robotic surgery skills training: a randomized clinical trial.

OBJECTIVE: To determine whether proficiency-based progression (PBP) training leads to better robotic surgical performance compared to traditional training (TT), given that the value of PBP training for learning robotic surgical skills is unclear. MATERIALS AND METHODS: The PROVESA trial is a multicentric, prospective, randomized and blinded clinical study comparing PBP training with TT for robotic suturing and knot-tying anastomosis skills. A total of 36 robotic surgery-naïve junior residents were recruited from 16 training sites and 12 residency training programmes. Participants were randomly allocated to metric-based PBP training or the current standard of care TT, and compared at the end of training. The primary outcome was percentage of participants reaching the predefined proficiency benchmark. Secondary outcomes were the numbers of procedure steps and errors made. RESULTS: Of the group that received TT, 3/18 reached the proficiency benchmark versus 12/18 of the PBP group (i.e. the PBP group were ~10 times as likely to demonstrate proficiency [P = 0.006]). The PBP group demonstrated a 51% reduction in number of performance errors from baseline to the final assessment (18.3 vs 8.9). The TT group demonstrated a marginal improvement (15.94 vs 15.44) in errors made. CONCLUSIONS: The PROVESA trial is the first prospective randomized controlled trial on basic skills training in robotic surgery. Implementation of a PBP training methodology resulted in superior surgical performance for robotic suturing and knot-tying anastomosis performance. Compared to TT, better surgical quality could be obtained by implementing PBP training for basic skills in robotic surgery.

Pretraining of basic skills on a virtual reality vitreoretinal simulator: A waste of time.

PURPOSE: To investigate whether pretraining of basic skills in virtual vitreoretinal surgery affected the performance curve when proceeding to procedure-specific modules. METHODS: This study was a prospective, randomized, controlled, two-centre study. Medical students were randomized into two groups: Group 1 pretrained basic psycho-motor skills (Navigation Training level 2 and Bimanual Training level 3) until they reached their performance curve plateau. Hereafter, both groups trained on the procedure-specific modules (Posterior Hyaloid level 3 and ILM Peeling level 3) until they reached their performance curve plateau. Plateau was defined as three consecutive sessions with the same score with an acceptable variation. The primary outcome was time used to reach performance curve plateau in the procedure-specific modules. RESULTS: A total of 68 medical students were included, and equally randomized into two groups. The participants in Group 1 used a median time of 88 minutes to reach plateau in the basic skills modules but did not differ from Group 2 in time to reach plateau on the procedure-specific modules (183 min versus 210 min, p = 0.40) or in the amplitude of plateau. Group 1 and 2 differed significantly in the starting score of ILM peeling level 3 (0 (0-0) versus 3.5 (0-75), p = 0.03). CONCLUSION: We were not able to show positive skill transfer from basic skills training to the procedure-specific modules in time, starting score or amplitude of plateau. Thus, we recommend that aspiring vitreoretinal surgeons proceed directly to simulation-based training of procedures instead of spending valuable training time on basic skills training.

Application effect of simulation teaching combined with CBL mode on the practice of thoracic surgery nursing students / 中华医学教育探索杂志

Objective:To explore the effect of simulation teaching combined with case-based learning (CBL) on the practice of thoracic surgery nursing students.Methods:Cluster sampling method was adopted to select 30 practice nurses of the thoracic surgery department of 2019 as the control group, and traditional teaching was adopted. Another 30 thoracic surgery practice nurses of 2020 were selected as the research group, and simulation teaching combined with CBL was adopted. After the training, the two groups of practice nurses were assessed on theory and basic skills, and the nurses' recognition of teaching was assessed through questionnaire surveys. SPSS 22.0 was used for t test and chi-square test. Results:After the training of practical nurses, the research group had better performances of theoretical and basic skills tests than the control group, with significant differences ( P<0.001). The practice nurses of the research group did significantly better than those of the control group in such 8 dimensions as improving basic nursing skills, improving autonomous learning ability, improving the clinical thinking ability, enhancing our emergency response ability, improving the ability of theory combined with practice, improving training interest in learning, training team cooperation ability, cultivating the ability of doctor-patient communication and so on ( P<0.05). Conclusion:The combination of simulation teaching and CBL applied in the practice of thoracic surgery nursing students can improve the proficiency of nurses' nursing skills and improve the quality of clinical teaching.

Measuring Explicit Instruction Using Classroom Observations of Student-Teacher Interactions (COSTI).

This article describes the development and technical adequacy of the Classroom Observations of Student Teacher Interactions (COSTI) instrument, a tool for measuring the frequency and rate of explicit instructional interactions, such as those used in Direct Instruction curricula, for teaching children basic reading and math skills. COSTI was originally developed to provide teachers with coaching feedback to improve their explicit reading instructional practices, and has been shown in multiple studies to be a reliable and valid predictor of student gains in beginning reading and math skills. This article discusses potential uses of the instrument for training and coaching across curricula with varying instructional design features, and lays out a future research agenda to further improve COSTI and related observation tools for studying explicit instructional practices and their contribution to student learning.

Evaluation of arthroscopic skills with a virtual reality simulator in first-year orthopaedic residents.

PURPOSE: This study of residents' initial performance was performed to determine which factors predisposed residents for success in demonstrating the best arthroscopic skills. METHODS: Each orthopaedic first-year resident was officially invited to take part in a one hour evaluation on a VirtaMed™ ArthroS™ simulator. On the FAST module, the Periscoping exercise was chosen to test for use of angled optics. The Shoulder Module was chosen to test their ability to extract intra-articular foreign bodies using the Catch the Stars exercise. The variables such as time, camera alignment, camera path length, and grasper path length were analysed. Residents completed a questionnaire prior to the evaluation. Their results were analysed according to gender, orientation assessment, and surgical history. RESULTS: A total of 34 women and 82 men were included in the study. In the Periscoping exercise, a significant difference between women and men in the time variables was noticed (275 ± 82 and 195 ± 71; p < 0.00001) and camera path length (207 ± 60 and 170 ± 66; p = 0.00094). For the Catch the Stars exercise, there was a significant difference between women and men for the time values (249 ± 114 and 201 ± 99; p = 0.01246) and grasper path length (290 ± 130 and 229 ± 108; p = 0.00493). After multivariate analysis, no influence of self-assessed spatial perception (p=0.1), number of arthroscopic procedures (p=0.39), or laparoscopic procedures (p=0.43) to which they had already assisted was found. CONCLUSIONS: This study shows a significant difference in skills regarding spatial recognition and triangulation related to gender at the beginning of specialization training. It also demonstrates that male medical students are more attracted by surgical departments during their medical training.

Trainee Performance After Laparoscopic Simulator Training Using a Blackbox versus LapMentor.

BACKGROUND: Training using laparoscopic high-fidelity simulators (LHFSs) to proficiency levels improves laparoscopic cholecystectomy skills. However, high-cost simulators and their limited availability could negatively impact residents' laparoscopic training opportunities. We aimed to assess whether motivation and surgical skill performance differ after basic skills training (BST) using a low-cost (Blackbox) versus LHFS (LapMentor) among medical students. MATERIALS AND METHODS: Sixty-three medical students from Karolinska Institutet volunteered, completing written informed consent, questionnaire regarding expectations of the simulation training, and a visuospatial ability test. They were randomized into two groups that received BST using Blackbox (n = 32) or LapMentor (n = 31). However, seven students absence resulted in 56 participants, followed by another 9 dropouts. Subsequently, after training, 47 students took up three consecutive tests using the minimally invasive surgical trainer-virtual reality (MIST-VR) simulator, finalizing a questionnaire. RESULTS: More Blackbox group participants completed all MIST-VR tests (29/31 versus 18/25). Students anticipated mastering LapMentor would be more difficult than Blackbox (P = 0.04). In those completing the simulation training, a trend toward an increase was noted in how well participants in the Blackbox group liked the simulator training (P = 0.07). Subgroup analysis of motivation and difficulty in liking the training regardless of simulator was found only in women (Blackbox [P = 0.02]; LapMentor [P = 0.06]). In the Blackbox group, the perceived difficulty of training, facilitation, and liking the Blackbox training (significant only in women) were significantly correlated with the students' performance in the MIST-simulator. No such correlations were found in the LapMentor group. CONCLUSIONS: Results indicate an important role for low-tech/low-cost Blackbox laparoscopic BST of students in an otherwise high-tech surrounding. Furthermore, experience of Blackbox BST procedures correlate with students' performance in the MIST-VR simulator, with some gender-specific differences.

Current situation and improvement of cardiovascular clinical teaching / 中华医学教育探索杂志

There are some problems in clinical teaching of cardiovascular medicine, such as insuf-ficient attention to the "three bases" skills, not teaching trainees in accordance with their aptitude ade-quately, monotonous instructional mode, and assessment becoming a mere formality. Aiming at these prob-lems, we have explored the training methods of medical talents adapted to the modern medical model, and improved the clinical basic skills and thinking of the students and the quality of teaching through such measures as paying close attention to basic skills training, standardizing ward rounds, paying attention to teaching students in accordance with their aptitude, and reforming teaching methods and assessment modes.

Application of micro-lectures combined with high simulation human in clinical skills teaching for nursing students / 中国实用护理杂志

Objective To explore the effect of micro-lectures withadvanced simulation man in improving the practical skills teaching of nursing students, so as to promote the students' post competency. Methods Totally the 186 nursing internswere divided into control group and observation group by random number method with 93 people in each group. The control group used the traditional teaching modein the teaching of practical skills.The observation group used the micro-lectures with high simulation teaching.Comparing the two groups of nursing students comprehensive assessment test simulation results in the theory, skills, scenarios, and nursing students the evaluation of the curriculum. Results The scores of the two groups were all above the qualification line, but the scores of the observation group were significantly higher than those of the control group (P<0.05). The theoretical examinations and the situation simulation comprehensive testswas(77.89 ± 7.79), (75.60 ± 7.92)points in control group, and (93.87 ± 3.90),(92.87 ± 4.08)points in observation group, there was significant difference between two groups (t=17.67, 18.70,all P=0.000). The curriculum evaluation results of improving learning initiative, active curriculum atmosphere, clear operation demonstration, exercise clinical thinking, improve the clinical interest were 81.72％(76/93), 72.04％(67/93), 93.55％(87/93), 60.22％(56/93), 67.74％(63/93)in control group, and 96.77％(90/93), 95.70％(89/93), 100.00％(93/93), 92.47％(86/93), 98.92％(92/93)in observation group, there was significant difference between two groups(χ2=20.39, P=0.016).Conclusions The effect is significant of micro-lectures combined with high simulation of human using in clinical skills teaching. Thismold can conducive to the cultivation of clinical thinking of nursing students, and improve clinical comprehensive ability, and promote the promotion of nursing students post competency.

Enhancing the quality of life for palliative care cancer patients in Indonesia through family caregivers: a pilot study of basic skills training.

BACKGROUND: Palliative care in Indonesia is problematic because of cultural and socio-economic factors. Family in Indonesia is an integral part of caregiving process in inpatient and outpatient settings. However, most families are not adequately prepared to deliver basic care for their sick family member. This research is a pilot project aiming to evaluate how basic skills training (BST) given to family caregivers could enhance the quality of life (QoL) of palliative care cancer patients in Indonesia. METHODS: The study is a prospective quantitative with pre and post-test design. Thirty family caregivers of cancer patients were trained in basic skills including showering, washing hair, assisting for fecal and urinary elimination and oral care, as well as feeding at bedside. Patients' QoL were measured at baseline and 4 weeks after training using EORTC QLQ C30. Hypothesis testing was done using related samples Wilcoxon Signed Rank. A paired t-test and one-way ANOVA were used to check in which subgroups was the intervention more significant. RESULTS: The intervention showed a significant change in patients' global health status/QoL, emotional and social functioning, pain, fatigue, dyspnea, insomnia, appetite loss, constipation and financial hardship of the patients. Male patient's had a significant effect on global health status (qol) (p = 0.030); female patients had a significant effect on dyspnea (p = 0.050) and constipation (p = 0.038). Younger patients had a significant effect in global health status/QoL (p = 0.002). Patients between 45 and 54 years old had significant effect on financial issue (p = 0.039). Caregivers between 45 and 54 years old had significant effect on patients' dyspnea (p = 0.031). CONCLUSIONS: Basic skills training for family caregivers provided some changes in some aspects of QoL of palliative cancer patients. The intervention showed promises in maintaining the QoL of cancer patients considering socio-economic and cultural challenges in the provision of palliative care in Indonesia.

[Psychomotor skills assessment in basic procedures of laparoscopic surgery in undergraduate medical students at the School of Medicine of the University of Colima]. / Evaluación de la adquisición de habilidades psicomotrices básicas en procedimientos laparoscópicos en estudiantes de pregrado de la Facultad de Medicina de la Universidad de Colima.

BACKGROUND: The changes in recent decades in the training of medical student seem to agree that the educational model for professional skills is most appropriate. The virtual simulator translates skills acquired the operating room, in the Faculty of Medicine of the University of Colima noticed the need to prepare the students of pregrade transferring surgical trainees' skills in basic laparoscopic activities that require a simple cognitive effort. OBJECTIVE: The hypothesis in this study was to evaluate the acquisition of skills in laparoscopic simulator in students of pregrade. METHODS: Educational research, analytical comparison, which was conducted within the activities of the program of Problem Based Learning in the program of Education and Surgical Technique, Faculty of Medicine of the University of Colima. RESULTS: All participants in the simulator achieved a significantly better during the task one after three repetitions (p= 0.001). The evaluation of final students calcification, we observed significant differences in means being lower during the initial assessment (8.60 ± 0.76) compared to the end (8.96 ± 0.58) p= 0.001. CONCLUSIONS: The acquisition of skills in the simulator is longer but at the end is better than the acquisition of skills from the traditional method, showing that leads to the acquisition of skills that promote the transfer of skills to the surgical environment.

Antecedentes: la educación basada en competencias señala que el estudiante debe dominar tres rubros: saber, saber hacer y ser. El primero se refiere al conjunto de conocimientos teórico-prácticos, el segundo a las habilidades psicomotrices y el tercero al comportamiento profesional. El estudiante de Medicina adquiere las primeras destrezas en cirugía laparoscópica a través de modelos animales y simuladores virtuales. Sin embargo, no hemos evaluado la trascendencia de esta capacitación. Objetivo: evaluar en alumnos de pregrado las destrezas en cirugía laparoscópica obtenidas después de un curso con un simulador virtual. Material y métodos: estudio de investigación educativa, analíticocomparativo efectuado como parte de las actividades del programa de Aprendizaje Basado en Problemas de la asignatura de Educación y Técnica Quirúrgica de la Facultad de Medicina de la Universidad de Colima. Resultados: todos los participantes alcanzaron en el simulador un mejor nivel durante la tarea 1 después de tres repeticiones (p= 0.001). En la evaluación de la calificación final de los alumnos se observaron diferencias significativas en las medias que fueron más bajas durante la evaluación inicial (8.60 ± 0.76) en comparación con la final (8.96 ± 0.58) p= 0.001. Conclusiones: la adquisición de habilidades en el simulador es más prolongada y al final es superior a la adquisición de habilidades basada en el método tradicional; demuestra que conduce a la adquisición de competencias que favorecen la transferencia de habilidades al entorno quirúrgico.

A better way to teach knot tying: a randomized controlled trial comparing the kinesthetic and traditional methods.

BACKGROUND: Knot tying is a fundamental and crucial surgical skill. We developed a kinesthetic pedagogical approach that increases precision and economy of motion by explicitly teaching suture-handling maneuvers and studied its effects on novice performance. METHODS: Seventy-four first-year medical students were randomized to learn knot tying via either the traditional or the novel "kinesthetic" method. After 1 week of independent practice, students were videotaped performing 4 tying tasks. Three raters scored deidentified videos using a validated visual analog scale. The groups were compared using analysis of covariance with practice knots as a covariate and visual analog scale score (range, 0 to 100) as the dependent variable. Partial eta-square was calculated to indicate effect size. RESULTS: Overall rater reliability was .92. The kinesthetic group scored significantly higher than the traditional group for individual tasks and overall, controlling for practice (all P < .004). The kinesthetic overall mean was 64.15 (standard deviation = 16.72) vs traditional 46.31 (standard deviation = 16.20; P < .001; effect size = .28). CONCLUSIONS: For novices, emphasizing kinesthetic suture handling substantively improved performance on knot tying. We believe this effect can be extrapolated to more complex surgical skills.

Evaluación del mejoramiento de habilidades básicas para cirugía laparoscópica por medio del entrenamiento con un videojuego / Evaluation of Basic Skills Improvement for Laparoscopy by Training with a Video Game / Avaliação do melhoramento de habilidades básicas para cirurgia laparoscópica por meio do treinamento com um videojogo

Introducción: debido a las crecientes limitaciones éticas y de recursos en el entrenamiento de aprendices en cirugía mínimamente invasiva (CMI, E. G. laparoscopia) en pacientes, se pretende evaluar el efecto de la práctica continua con un videojuego en particular en el desarrollo de las habilidades fundamentales a la hora de ejecutar una de estas cirugías. Materiales y métodos: se seleccionaron tres actividades esenciales (corte, sutura y coordinación mano-ojo) por realizar en simuladores laparoscópicos, con el fin de establecer si la práctica con el videojuego es efectiva en el desarrollo de las habilidades necesarias en CMI. Se evaluaron en total ocho variables de desempeño en las tres actividades seleccionadas. Con base en esto, se evaluaron catorce aprendices médicos sin experiencia en laparoscopia, divididos en dos grupos (control e intervención), antes y después de un programa de entrenamiento estandarizado con el videojuego Marblemanía® y una duración de un mes. Resultados: se evidenció que la práctica continua con el videojuego Marblemanía® mejoró todas las variables de desempeño. Estos resultados positivos fueron significativamente diferentes a favor del grupo que tuvo acceso al programa de entrenamiento con el videojuego en 3 de las 8 variables de desempeño medidas en las tres actividades seleccionadas: errores en la actividad de sutura (p = 0,003), y el tiempo de ejecución y errores en la actividad coordinación mano-ojo (p = 0,025 y 0,001, respectivamente).

Introduction: Due to the growing economical and ethical limitations in surgeons training for minimally invasive surgery (MIS, e.g. laparoscopy), this study aims at evaluating the effect of a continuous practice of a particular videogame on the development of the fundamental and specific skills needed to perform this type of procedure successfully. Materials and methods: To evaluate the effectiveness of video game practicing, three essential and common activities were chosen (cutting, suturing, and eye-hand coordination) to be performed in laparoscopic simulators. Eight different indexes or variables of performance were measured in the three activities. Fourteen voluntaries without previous experience in surgery were divided in two groups (intervention and control) and their performance was evaluated before and after a one-month standardized training program with the video game Marble Mania®. Results: A general improvement of all the performance variables was observed after one month training in the intervention group. This improvement was significant with respect to the control group in three of the eight variables: suturing errors (p = 0.003), and the execution and number of errors in the eye-hand coordination (p = 0.025 and 0.001, respectively).

Introdução: devido às crescentes limitações éticas e de recursos no treinamento de aprendizes em cirurgia minimamente invasiva (CMI, e.g. laparoscopia) em pacientes, pretende-se avaliar o efeito da prática contínua com um videojogo em particular no desenvolvimento das habilidades fundamentais na hora de executar uma destas cirurgias. Materiais e métodos: se selecionaram três atividades essenciais (corte, sutura e coordenação mão-olho), a realizar em simuladores laparoscópicos, com o fim de estabelecer se a prática com o videojogo é efetiva no desenvolvimento das habilidades necessárias em CMI. Em total, avaliaram-se oito variáveis de desempenho nas três atividades selecionadas. Com base nisso, avaliaram-se catorze aprendizes médicos sem experiência em laparoscopia, divididos em dois grupos (controles e intervenção), antes e depois de um programa de treinamento estandardizado com o videojogo Marblemanía® em uma duração de um mês. Resultados: se evidenciou que a pratica contínua com o videojogo Marblemanía® melhorou todas as variáveis de desempenho. Estes resultados positivos foram significativamente diferentes a favor do grupo que teve acesso ao programa de treinamento com o videojogo em três das oito variáveis de desempenho medidas nas três atividades selecionadas: erros na atividade de sutura (p = 0.003), o tempo de execução e erros na atividade coordenação mão-olho (p = 0.025 y 0.001, respectivamente).

Relación entre el funcionamiento de un hogar/residencia protegida para personas con trastorno mental severo, el apoyo social del cuidador y las habilidades de la vida diaria de los residentes / Relation between the functioning of sheltered housing/supported home for people with severe mental disorder, the social support of the caregiver and the daily life skills of the residents

Residential programs fulfill an important role in the overall operation of the people with severe mental disorders and they are considered promoters of the improvements observed in them. The study is aimed on determining the relation between the operation of a protected home/residence and the social support of the caregivers, with the daily life skills of the residents. Method: 122 users that reside in protected homes and residences from the Maule and Biobío Regions were interviewed, as well as 30 caregivers/monitors that worked in those places. Results: Both age and gender of the residents shows no significant relation with "skills of the overall daily life". However, a relation was found between the age of the residents and the subscale "activity and social relationships": the older the age, the lesser activity and social relationships of the users. Regarding the restrictiveness variable of the device, it was found that the lesser restrictiveness, the greater basic skills of the daily life of the residents was presented, especially in areas such as domestic and community skills. A relation between daily life skills of the residents and the perceived social support was not found. Nevertheless, a greater perception of social support, greater "activity and social relationships" of the users that reside in Protected Homes and Residences was observed. Conclusions: The restrictiveness of the device by being a relevant variable for daily life skills of the residents must be taken into account in the organization and structure of the residential programs in Chile.

Los programas residenciales cumplen un rol importante en el funcionamiento general de las personas con trastornos mentales severos y son considerados favorecedores de las mejoras observadas en ellos. El estudio tiene como objetivo determinar la relación entre el funcionamiento de un hogar/residencia protegida y el apoyo social de los cuidadores, con las habilidades de la vida diaria de los residentes. Método: Fueron entrevistados 122 usuarios que viven en hogares y residencias protegidas de las regiones del Maule y Bío Bío, además de 30 cuidadores/monitores que trabajaban en el lugar. Resultados: La edad y el sexo de los residentes no muestran una relación significativa con las "habilidades de la vida diaria general". Sin embargo, se encontró relación entre la edad de los residentes y la sub escala "actividad y relaciones sociales"; a mayor edad, menor actividad y relaciones sociales de los usuarios. Respecto de la variable restrictividad del dispositivo se encontró que a menor restrictividad mayores habilidades básicas de la vida diaria en los residentes, especialmente en áreas como "habilidades domésticas" y "habilidades comunitarias". No se encontró relación entre las habilidades de la vida diaria de los residentes y el apoyo social percibido. No obstante, se vio que a mayor percepción de apoyo social, mayor "actividad y relaciones sociales" de los usuarios que viven en hogares y residencias protegidas. Conclusiones: La restrictividad del dispositivo al ser una variable relevante en las habilidades de la vida diaria de los residentes, debe ser considerada en la organización y estructura de los programas residenciales en Chile.