Three-Dimensional Peripheral Bloodstream Model of the Uterus for Laparoscopic Radical Hysterectomy.

Trainees require extensive experience to perform radical hysterectomy. Before starting training during an actual operation, trainees should be familiar with the pelvic anatomy and should simulate surgical procedures. Many simulators are available for virtual reality training of laparoscopic operations, but they are very expensive. The materials required to construct our model included sponges and colored wires sold in home improvement stores that allowed for superior cost effectiveness. The model represented almost all peripheral vessels and nerves around the uterus, including the minor vessels. Attaching and detaching the vessels was easy, facilitating reconstruction of the dissected vessels. The wires were easy to bend, ensuring high operability. This model allows for the simulation of laparoscopic radical hysterectomy in a dry box. Our model was superior to a 2-dimensional picture for the memorization of branching and positional relationships of the blood vessels. Comparison of our model with actual operative videos showed that the dry box provided an identical surgical view of an actual laparoscopic radical hysterectomy. We developed a peripheral bloodstream model of the uterus for repeated simulation of laparoscopic radical hysterectomy with an actual surgical view using a dry box.

[Students of medicine are turning medical education on its head; from a closed to an open learning environment]. / Medisch student zet geneeskundeonderwijs op zijn kop.

These days, students are gathering their own source materials using Google and leave the required textbooks on the shelves. This means the future of medical education lies in facilitating and freely sharing modern learning resources. This rapid shift, away from traditional textbooks, is causing unrest in academic education. The faculty is losing control and the overall picture. Existing teaching materials with strict copyrights have made it difficult for teachers and students to learn from each other. The productivity and professional curiosity of a sector that not only desires but also requires life-long learning, is being undermined by meaningless barriers and duplication of work. Free learning resources are making it easier for both students and professionals to learn, share and quickly get access to the right information. In this article, we explain what this means for medical education, what is needed and we provide a few examples.

Low cost simulator for heart surgery training

Abstract Objective: Introduce the low-cost and easy to purchase simulator without biological material so that any institution may promote extensive cardiovascular surgery training both in a hospital setting and at home without large budgets. Methods: A transparent plastic box is placed in a wooden frame, which is held by the edges using elastic bands, with the bottom turned upwards, where an oval opening is made, "simulating" a thoracotomy. For basic exercises in the aorta, the model presented by our service in the 2015 Brazilian Congress of Cardiovascular Surgery: a silicone ice tray, where one can train to make aortic purse-string suture, aortotomy, aortorrhaphy and proximal and distal anastomoses. Simulators for the training of valve replacement and valvoplasty, atrial septal defect repair and aortic diseases were added. These simulators are based on sewage pipes obtained in construction material stores and the silicone trays and ethyl vinyl acetate tissue were obtained in utility stores, all of them at a very low cost. Results: The models were manufactured using inert materials easily found in regular stores and do not present contamination risk. They may be used in any environment and maybe stored without any difficulties. This training enabled young surgeons to familiarize and train different surgical techniques, including procedures for aortic diseases. In a subjective assessment, these surgeons reported that the training period led to improved surgical techniques in the surgical field. Conclusion: The model described in this protocol is effective and low-cost when compared to existing simulators, enabling a large array of cardiovascular surgery training.

Low Cost Simulator for Heart Surgery Training.

Objective: Introduce the low-cost and easy to purchase simulator without biological material so that any institution may promote extensive cardiovascular surgery training both in a hospital setting and at home without large budgets. Methods: A transparent plastic box is placed in a wooden frame, which is held by the edges using elastic bands, with the bottom turned upwards, where an oval opening is made, "simulating" a thoracotomy. For basic exercises in the aorta, the model presented by our service in the 2015 Brazilian Congress of Cardiovascular Surgery: a silicone ice tray, where one can train to make aortic purse-string suture, aortotomy, aortorrhaphy and proximal and distal anastomoses. Simulators for the training of valve replacement and valvoplasty, atrial septal defect repair and aortic diseases were added. These simulators are based on sewage pipes obtained in construction material stores and the silicone trays and ethyl vinyl acetate tissue were obtained in utility stores, all of them at a very low cost. Results: The models were manufactured using inert materials easily found in regular stores and do not present contamination risk. They may be used in any environment and maybe stored without any difficulties. This training enabled young surgeons to familiarize and train different surgical techniques, including procedures for aortic diseases. In a subjective assessment, these surgeons reported that the training period led to improved surgical techniques in the surgical field. Conclusion: The model described in this protocol is effective and low-cost when compared to existing simulators, enabling a large array of cardiovascular surgery training.

Monitoring the use of anatomical teaching material using a low-cost radio frequency identification system: A comprehensive assessment.

The correct tracking and monitoring of anatomical specimens is not only imperative in any modern body donation programs but also in any universities for which teaching the next generation of health care professionals is the primary mission. This has long been an arduous process for anatomy institutions across the world, and the recent focus of new curricula on self-directed learning adds new stress on specimens which are used by students. The radio frequency identification (RFID) technology has been proposed as a very effective tracking system in healthcare considering that it enables automatic identification and data capture of multiple items at once. In this study, the feasibility of a low-cost RFID inventory system is assessed, from its design to the performance of commercially available RFID tags in a gross anatomy laboratory. The results show that ultrahigh frequency-based RFID tags successfully performed when attached to a collection of 112 plastinated and 280 wet dissected specimens. Comparison analysis of different tags reveals, however, that careful selection of RFID tags needs to be considered when wet specimens need to be tracked as preservation fluids can absorb radio waves energy. This study demonstrates that it is economically feasible to incorporate RFID technology to closely monitor the use of anatomical teaching specimens. The described RFID inventory system was not only able to preserve the integrity of the specimens being used by limiting handling and therefore human error but was also able to identify missing or misplaced specimens and to update their status.

Experience report on teaching surgical technique without animal use.

PURPOSE: To report the experience of the school in implementing the 3 Rs replace, reduce and refine; showing time and assembling cost of the experimental models used in the teaching of Surgical Technique and Experimental Surgery. METHODS: Assembly time and costs of models: grafts and flaps performed in pork belly, model of intestinal anastomosis and jejunostomy done in Bahiana box and black box model for training videosurgery. RESULTS: Average time and cost estimate: ten minutes-pork belly, cost $ 6.00 per kilogram; two minutes-Bahiana box, cost $ 27.2; Black box-3.6 hours for manufacturing, cost $ 100.00. The repetition of each practice the cost is $ 3.20 for Bahiana box and at no cost to the black box. CONCLUSION: The experimental models presented are easily reproducible and of low cost.

Experience report on teaching surgical technique without animal use

PURPOSE: To report the experience of the school in implementing the 3 Rs replace, reduce and refine; showing time and assembling cost of the experimental models used in the teaching of Surgical Technique and Experimental Surgery. METHODS: Assembly time and costs of models: grafts and flaps performed in pork belly, model of intestinal anastomosis and jejunostomy done in Bahiana box and black box model for training videosurgery. RESULTS: Average time and cost estimate: ten minutes-pork belly, cost $ 6.00 per kilogram; two minutes-Bahiana box, cost $ 27.2; Black box-3.6 hours for manufacturing, cost $ 100.00. The repetition of each practice the cost is $ 3.20 for Bahiana box and at no cost to the black box. CONCLUSION: The experimental models presented are easily reproducible and of low cost. .

Conocimiento histórico de la estomatología pinareña: necesidad de un material docente como complemento bibliográfico / Historical knowledge of Pinar del Río dentistry: necessity for a teaching material as a bibliographical complementation

La Educación Superior Cubana centra su atención en formar profesionales capaces de orientar su actuación en la profesión con iniciativa, flexibilidad y autonomía, partir de la integración de conocimientos, habilidades, motivos y valores que se expresan en su desempeño. La limitante del diseño curricular de la asignatura Historia de la Estomatología y del libro de texto, que no incluye los elementos del contexto universitario local motivó la investigación que trazó como. Determinar las limitantes existentes de los materiales de enseñanza empleados en el proceso de aprendizaje de la asignatura Historia de la Estomatología del Plan D Investigación pedagógica con enfoque dialéctico materialista que empleo diversos métodos, materialista-dialéctico, análisis histórico-lógico y empírico. Se revisaron documentos, se realizaron encuestas, y valoraciones de expertos. Los resultados fueron analizados mediante estadística descriptiva. Los estudiantes de 2do y 4to año de la Carrera de Estomatología evidenciaron desconocimiento en mas del 80 por ciento de los encuestados sobre la Historia de la formación de recursos humanos en Estomatología en la Provincia de Pinar del Río, el 100 por ciento creyó importante conocer el desarrollo de dicha formación y coincidieron en la necesidad de literatura docente para adquirir estos conocimientos.Es insuficiente la literatura existente para el estudio de los referentes locales en la formación de recursos humanos en Estomatología y se propone elaborar un material docente para la asignatura Historia de la Estomatología, que describa La Historia de la formación de recursos Humanos en Pinar del Río desde 1959 hasta 2013(AU)

Cuban Higher Education centers its attention towards training professional capable of directing their performance profile with initiative, flexibility and autonomy, starting from the integration of knowledge, skills, motivation, and values expressed in their performance. The limiting component of the syllabus design for the subject History of Dentistry and the textbook, not including the elements of the university local context, motivated this research.The objective was to determine the limiting aspects existing in regard to the teaching material used in the learning process of the subject History of Dentistry in the D Syllabus Plan. Cross-sectional descriptive research using diverse methods: materialistic-dialectical, historic and logical analysis and empirical ones. Papers were reviewed, surveys were conducted, and experts were interviewed for their evaluations. The results were analyzed by means of descriptive statistics. The second and fourth years Dentistry students showed lack of knowledge in more than 80 per cent of the surveyed, regarding the history of human resources training in Dentistry in Pinar del Río Province. The total 100 per cent considered important to know the development of such training and coincided in the idea that the teaching materials and bibliography are needed to acquire these knowledge.The existing literature is insufficient for the study of the local referents in the training of human resources in Dentistry, and it has been proposed to elaborate a teaching material for the subject History of Dentistry, which describes the history of human resources training in Pinar del Río from1959 to 2013(AU)

[Design and validation of a simulator for training in continuous circular capsulotomy for phacoemulsification]. / Diseño y validación de un simulador para el entrenamiento en la capsulotomía circular continua en la facoemulsificación.

INTRODUCTION: To design and validate a simulator for learning and training in the capsulorhexis technique. METHODS: The system consists of a methacrylate support inclined 15° for the surgeon's hand, an area of commercially available aluminum foil, and another one of similar characteristics, where the student performs the technique through some slots that are previously made in the support. In order to evaluate the feasibility of this simulator, data were collected from 65 ophthalmologists performing the technique during training activities. The ophthalmologists were randomly divided into one group of 30 specialists who start their learning on the eyes of an animal cadaver, and into another of 35 specialists who previously started with this simulator. RESULTS: A simulator is developed for training in the capsulorhexis technique. The students from the simulator group achieved a reduction in the use of cadaver eyes, and a higher efficiency in correct capsulorhexis, unlike the group who started directly on the cadaver eyes. CONCLUSIONS: This simulator is an innovation in training of the capsulorhexis technique as regards simplicity, cost, and reuse, as compared to other virtual simulators with more expensive computer equipment (CE) equipment that are more difficult to transport. It is an important step prior to the use of cadaver parts and experimental animals, decreasing the number of both, and therefore the teaching costs.

4273π: bioinformatics education on low cost ARM hardware.

BACKGROUND: Teaching bioinformatics at universities is complicated by typical computer classroom settings. As well as running software locally and online, students should gain experience of systems administration. For a future career in biology or bioinformatics, the installation of software is a useful skill. We propose that this may be taught by running the course on GNU/Linux running on inexpensive Raspberry Pi computer hardware, for which students may be granted full administrator access. RESULTS: We release 4273π, an operating system image for Raspberry Pi based on Raspbian Linux. This includes minor customisations for classroom use and includes our Open Access bioinformatics course, 4273π Bioinformatics for Biologists. This is based on the final-year undergraduate module BL4273, run on Raspberry Pi computers at the University of St Andrews, Semester 1, academic year 2012-2013. CONCLUSIONS: 4273π is a means to teach bioinformatics, including systems administration tasks, to undergraduates at low cost.

Five really easy steps to build a homemade low-cost simulator.

AIM: The aim of this study was to evaluate how simple it is to build a homemade low-cost simulator using a simple 5-step scheme. METHODS: A scheme explaining how to build an endoscopic surgery simulator in 5 easy steps was presented to 26 surgeons. The simulator required a pair of scissors and easy-to-find materials. Its total cost was less than €35. The participants assessed the simulator using common endoscopic training toys or ex vivo tissue and completed an anonymous query comparing it with other commercial simulators that they had experienced before. RESULTS: In all, 84.6% found the simulator really easy to build. Every participant felt that he or she could do the same simulator themselves. Comparing with other commercial available box simulators, the majority of participants found the homemade simulator easier to (a) mount and dismount, (b) transport, (c) clean, and (d) use when practicing alone. CONCLUSIONS: Anyone can build its own simulator for a small amount of money.

Phase II Practice-based Evidence in Nutrition (PEN) evaluation: interviews with key informants.

PURPOSE: Dietitians of Canada has collaborated with experts in knowledge translation and transfer, technology, and dietetic practice to develop and implement an innovative online decision-support system called Practice-based Evidence in Nutrition (PEN). A study was conducted to evaluate the perceived facilitators and barriers that enable dietitians to use or prevent them from using PEN. METHODS: As part of the overall evaluation framework of PEN, a qualitative descriptive research design was used to address the research purpose. Individual, semi-structured telephone interviews with 17 key informants were completed, and the interview transcripts underwent qualitative content analysis. RESULTS: Respondents identified several facilitators of and barriers to PEN use. Facilitators included specificity to dietetics, rigorous/expert review, easy accessibility, current content, credible/secure material, well-organized/easy-to-use material, material that is valuable to practice, and good value for money. Barriers included perceived high cost, fee structuring/cost to students, certain organizational aspects, and a perceived lack of training for pathway contributors. CONCLUSIONS: This formative evaluation has indicated areas in which PEN could be improved and strategies to make PEN the standard for dietetic education and practice. Ensuring that PEN is meeting users' knowledge needs is of the utmost importance if dietitians are to remain on the cutting edge of scientific inquiry.

Education in the management of low back pain: literature review and recall of key recommendations for practice.

INTRODUCTION: Therapeutic patient education (TPE) is a continuous medical care process whose role in lower back pain (LBP) has yet to be well defined. OBJECTIVE: To evaluate the role and impact of TPE in the medical and surgical management of LBP. METHOD: A non-systematic literature review. RESULTS: Few formal TPE programmes have been rigorously evaluated in the context of LBP. In most cases, TPE tools have been combined with other interventional measures that vary according to the conceptual models used - thus limiting the extent to which the effect of TPE alone can be judged. Information that complies with the guidelines modifies knowledge and inappropriate beliefs. Whether formalized or not, TPE appears to modify (i) the physical disability and pain related to LBP and (ii) the patient's choice of therapy (e.g. surgery). The impact appears to be more marked in the (sub)acute phases. DISCUSSION: National and international guidelines suggest that TPE based on a biopsychosocial model has a positive impact on the patients' behaviour and treatment compliance. The cost/benefit ratio appears to be favourable. CONCLUSION: Therapeutic patient education appears to reduce the negative consequences of fear-avoidance behaviour and thus promotes treatment compliance in LBP patients, from the acute phase onwards.

Testing and validation of a low-cost cystoscopy teaching model: a randomized controlled trial.

OBJECTIVE: To estimate whether the use of a low-cost cystoscopy model effectively trains residents in cystourethroscopy and to validate the model as a teaching tool. METHODS: A randomized, controlled, and evaluator-blinded study was performed. Twenty-nine obstetrician-gynecologist residents had access to fresh-frozen cadavers on which baseline cystoscopic skills were assessed using the validated Objective Structured Assessment of Technical Skills checklists for cystourethroscopy. Subsequently, residents were randomized to one of two arms, a didactic study arm using the cystoscopy model and a control arm. Repeated technical skills testing was performed. RESULTS: The study group demonstrated statistically significant decreases in cystoscope assembly time (128.8 seconds at baseline to 54.9 seconds postintervention; P=.005), and increases in task-specific checklist scores (from 59.3 at baseline to 92.9 postintervention; P<.001) and in global rating scale scores (from 61.0 at baseline to 87.8 postintervention; P<.001). Further, there was a significant improvement in task-specific checklist (P<.001), global rating scale (P=.002), and knowledge quiz scores (P=.011) in the study arm compared with the control arm. CONCLUSION: Use of the bladder model exhibited validity in enhancing performance and knowledge of cystourethroscopy among ob-gyn residents. LEVEL OF EVIDENCE: I.

Newsletters and adherence to a weekly home spirometry program after lung transplant.

CONTEXT: Newsletters are a common intervention for patients in clinical trials. However, it is not clear whether newsletters are associated with increased adherence to the health regimen, and if so, which aspects of the newsletter are reported as most helpful to patients. OBJECTIVE: To examine the association between patients' ratings of worthwhileness of a quarterly newsletter and adherence with a home spirometry regimen. DESIGN: Patients (n=48) were in a research-based spirometry program after lung transplant and had received at least 1 newsletter; 24 (50%) returned completed surveys via postal mail. MAIN OUTCOME MEASURES: Adherence for forced vital pulmonary function tests for respondents versus nonrespondents, number of weeks they were adherent, ratings they gave the newsletter, and which components of the newsletters were helpful to the respondents. RESULTS: Respondents had more forced vital capacity pulmonary function tests ("blows") overall, blew more times weekly, and blew more consistently from week to week than did nonrespondents. Although it was not statistically significant, a mild correlation was found between the number of weeks that the respondents were adherent and their ratings of the newsletter (r = 0.36, P = .08). Most respondents reported that newsletter length was "about right", and 86% reported that newsletters helped encourage regular spirometer use, maintain interest in the study, educate about general health, and alert readers to seasonal health risks. IMPLICATIONS FOR PRACTICE: High ratings for newsletters used to encourage participation among adults in our home spirometry study were associated with higher adherence.