853 ON SCREEN FRAME OF REFERENCE SYSTEM AND STANDARDIZED COMMUNICATION PROMOTES SAFE AND EFFICIENT LAPAROSCOPIC TEACHING A THREE ARMED RANDOMIZED CONTROL TRIAL

Abstract

You have accessJournal of UrologyTechnology & Instruments: Surgical Education & Skills Assessment/Ureteroscopy I1 Apr 2012853 ON SCREEN FRAME OF REFERENCE SYSTEM AND STANDARDIZED COMMUNICATION PROMOTES SAFE AND EFFICIENT LAPAROSCOPIC TEACHING A THREE ARMED RANDOMIZED CONTROL TRIAL Rami Elias, Kiara Hennessey, Bechir Hage, David Williams, Forough Farrokhyar, and Edward Matsumoto Rami EliasRami Elias Hamilton, Canada More articles by this author , Kiara HennesseyKiara Hennessey Hamilton, Canada More articles by this author , Bechir HageBechir Hage Hamilton, Canada More articles by this author , David WilliamsDavid Williams Hamilton, Canada More articles by this author , Forough FarrokhyarForough Farrokhyar Hamilton, Canada More articles by this author , and Edward MatsumotoEdward Matsumoto Hamilton, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.946AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES During minimally invasive procedures, the staff surgeon frequently needs to direct the novice trainee to certain points on a surgical field. Variability between verbal instructions may be a source of errors, confusion, and conflicts. To have a successful outcome, errors need to be minimized and communication clear between involved members. We have developed a novel on screen frame of reference (FOR) system, coupled with standardized verbal commands to facilitate intra-operative teaching. The objective of this study was to determine the impact of two novel FOR systems used with a standardized language on performance of laparoscopic tasks when compared to standard techniques. METHODS Sixty-three medical students were randomized to three groups. Group 1 (control) performed tasks with no overlay. The commands were limited to simple directions such as left, right, up and down. Group 2 performed tasks on an overlay with commands based on a clock and x:y triangulation (Fig 1). Group 3 performed tasks on an overlay with an alphanumeric coordinate system. All subjects performed three different trials, each consisting of six object transfers, while instructed with one of the three methods. Time to task completion and error score defined as the number of times the object is moved to a wrong circle were recorded and analyzed using non-parametric statistics. RESULTS Group 2 (69, 70, 56) was significantly faster than the control (86, 80, 71, p<0.05) as well as Group 3 (92, 85, 68, p<0.05) across all three trials. Group 2 (0.94, 0.97, 0.26) had fewer errors than the control (1.43, 1.14, 0.81) across trials 1 and 3 (p<0.05) but similar error scores to Group 3 (0.68, 0.68, 0.23). Although Group 3 had similar time to completion to the control, there were statistically fewer errors (0.68, 0.68, 0.23, p<0.05). CONCLUSIONS Using a frame of referencing overlay and standardized communication for directing laparoscopy promotes safe and efficient endoscopic teaching. This data has given impetus to the development of an on screen, real time video overlay of a frame of referencing system for endoscopic monitors. This system is the first of its kind that has been validated with proven literature and will ultimately help improve teaching and patient safety during endoscopic surgery. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e348 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rami Elias Hamilton, Canada More articles by this author Kiara Hennessey Hamilton, Canada More articles by this author Bechir Hage Hamilton, Canada More articles by this author David Williams Hamilton, Canada More articles by this author Forough Farrokhyar Hamilton, Canada More articles by this author Edward Matsumoto Hamilton, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...