Box Trainer Research Articles

3D vs. 2D-4 K: Performance and self-perception of laparoscopic novices in a randomized prospective teaching intervention using standard tasks and box trainers

ObjectiveThe use of three-dimensional (3D) laparoscopy in surgical practice and training has been an area of research and discussion. Studies have suggested that 3D vision can improve speed and precision compared to traditional two-dimensional (2D) displays, while other authors found no benefits on the learning curves of laparoscopic novices. Modern two-dimensional laparoscopy with a resolution of 3840 × 2160 pixels (2D-4 K) seems to improve laparoscopic view and helps learners orient without stereopsis. However, evidence comparing these systems for laparoscopic training is limited. Therefore, the impact of viewing mode (2D-4 K vs. 3D) on learning and task proficiency remains unclear.DesignWe performed a two-hour teaching intervention on basic laparoscopic skills for novices. In this parallel group randomized study, we randomly assigned learners to 2D-4 K or 3D teaching and performed tasks of increasing difficulty and complexity using standard laparoscopy box trainers. Before the last and most challenging task, learners had to crossover to the other laparoscopy setup. Our hypothesis was that learners would be faster and more precise when using a 3D setup. The primary endpoint was task proficiency measured by speed and failure rate. Secondary outcomes were performance using the viewing mode of the other group without familiarization, self-perception, and career aspirations before and after the teaching intervention, expressed on a Likert scale.SettingThe study was performed by the Department of General, Visceral and Thoracic Surgery at the German Armed Forces Hospital Ulm, which is an academic teaching hospital of the University of Ulm.ParticipantsThirty-eight laparoscopic novices, including medical students and junior residents, participated voluntarily in this teaching intervention. Group allocation was performed via the virtual coin flip method. Apparently, participants and tutors were not blinded to group assignment. No formal approval by the ethics committee was needed for this noninvasive study in compliance with the World Medical Association Declaration of Helsinki as discussed with the ethics committee of the University of Ulm.ResultsThirty-eight laparoscopy novices were randomized in the study. The 3D group (n = 19) was significantly faster than the 2D-4 K group (n = 19) (p = .008) in a standard box trainer model, with 134.45 ± 41.45 s vs. 174.99 ± 54.03 s for task 1 and 195.97 ± 49.78 s vs. 276.56 ± 139.20 s for task 2, and the effect was consistent throughout the learning curve. The failure rate was not significantly affected by the viewing mode. After crossover to the other laparoscopy system, precision and time were not significantly different between the groups. Learners rated the difficulty of laparoscopy lower on a Likert scale after having two hours of basic laparoscopy training. The study was funded by the hospital’s teaching budget.ConclusionsLaparoscopic novices can benefit from a 3D laparoscopy training setup. Exclusive 3D training prior to a complex task on a 2D-4 K setup does not negatively affect the learner’s performance.

Foundational Segmentation Models and Clinical Data Mining Enable Accurate Computer Vision for Lung Cancer.

This study aims to assess the effectiveness of integrating Segment Anything Model (SAM) and its variant MedSAM into the automated mining, object detection, and segmentation (MODS) methodology for developing robust lung cancer detection and segmentation models without post hoc labeling of training images. In a retrospective analysis, 10,000 chest computed tomography scans from patients with lung cancer were mined. Line measurement annotations were converted to bounding boxes, excluding boxes < 1cm or > 7cm. The You Only Look Once object detection architecture was used for teacher-student learning to label unannotated lesions on the training images. Subsequently, a final tumor detection model was trained and employed with SAM and MedSAM for tumor segmentation. Model performance was assessed on a manually annotated test dataset, with additional evaluations conducted on an external lung cancer dataset before and after detection model fine-tuning. Bootstrap resampling was used to calculate 95% confidence intervals. Data mining yielded 10,789 line annotations, resulting in 5403 training boxes. The baseline detection model achieved an internal F1 score of 0.847, improving to 0.860 after self-labeling. Tumor segmentation using the final detection model attained internal Dice similarity coefficients (DSCs) of 0.842 (SAM) and 0.822 (MedSAM). After fine-tuning, external validation showed an F1 of 0.832 and DSCs of 0.802 (SAM) and 0.804 (MedSAM). Integrating foundational segmentation models into the MODS framework results in high-performing lung cancer detection and segmentation models using only mined clinical data. Both SAM and MedSAM hold promise as foundational segmentation models for radiology images.

Trial of an Inexpensive Training Simulation Model for Laparoscopic Appendicectomy.

Introduction Laparoscopic surgery is now the gold standard for many common procedures; however, there has been a lack of emphasis on laparoscopic training at the junior level. Simulation is an effective form of training in surgery, but surgical simulation models and courses can be expensive and inaccessible to medical students and foundation doctors. With procedures becoming more minimally invasive, it is key that we train laparoscopic skills at an earlier stage; and to do so, we need to remove the barriers of cost and accessibility. Our study aims to develop and assess the effectiveness of a simulated laparoscopic appendicectomy training model in developing laparoscopic knowledge, skills, and confidence in a cohort of foundation doctors. Methods A simulated mesoappendix model was fashioned from supermarket chicken wings with the bone removed, and it was put inside a laparoscopic box trainer with laparoscopic tools and equipment. This was trialed in a surgical-themed hub day for foundation doctors in the East of England Deanery, UK, and the simulated model was set up as a workshop following a teaching session detailing the steps of a laparoscopic appendicectomy. Participants completed questionnaires pre- and post-session to assess perceived skills, experience, and confidence in laparoscopic surgery, laparoscopic skills, and the usefulness of this training model. Results A total of 29 foundation doctors with limited formal surgical training completed the survey. The model is quick to prepare and assemble, costing around £0.30 ($0.40). Trainees found the model acceptable and helpful in developing their laparoscopic skills and knowledge of laparoscopic surgery. There was also an increase in self-perceived confidence in performing laparoscopic procedures under supervision. Discussion This modification to the model allows the dissection and division of a simulated mesoappendix using only laparoscopic scissors and forceps in a box trainer. This simulation model is a promising and inexpensive tool which can be used for early-stage laparoscopic training for medical students and junior doctors.

Neural density functionals: Local learning and pair-correlation matching.

Recently, Dijkman etal. [arXiv:2403.15007] proposed training classical neural density functionals via bulk pair-correlation matching. We show their method to be an efficient regularizer for neural functionals based on local learning of inhomogeneous one-body direct correlations [Sammüller etal., Proc. Natl. Acad. Sci. USA 120, e2312484120 (2023)0027-842410.1073/pnas.2312484120]. While Dijkman etal. demonstrated pair-correlation matching of a global neural free-energy functional, we argue in favor of local one-body learning for flexible neural modeling of the full Mermin-Evans density-functional map. Using spatial localization gives access to accurate neural free-energy functionals, including convolutional neural networks, that transcend the training box.

K-12 Outreach: Experiential Learning in Human Factors with Laparoscopic Surgery Trainer Box

K-12 Outreach: Experiential Learning in Human Factors with Laparoscopic Surgery Trainer Box

Development and validation of a virtual teaching method for minimally invasive surgery skills: a prospective cohort study.

The COVID-19 pandemic led to a significant reduction in operative exposure for surgical trainees, necessitating alternative training methods to mitigate the impact on surgical education. This study sought to evaluate whether minimally invasive surgery (MIS) skills could be taught remotely using widely available technology with objective assessments of proficiency. This was a pilot observational study with comparative assessment of face-to-face (F2F) and virtual training of novice learners in MIS skills. Performance and objective cognitive workload parameters (Surgical Task Load Index (SURG-TLX) score, heart rate and pupil metrics) were evaluated. The assessments were peg transfer (McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS)) and suturing (Suturing Training and Testing (SUTT)) tasks performed using box trainers. Virtual teaching was conducted by expert trainers using a web-based streaming platform. Technical challenges of delivering a virtual MIS skills course were addressed after a pilot course. Participants (n = 20) in the final course had similar baseline characteristics and were randomly allocated to F2F (n = 8) and virtual (n = 12) teaching groups. Participants in the online group completed the peg transfer task faster than the F2F group (11.25 minutes vs. 16.88 minutes; P = 0.015). There were no significant differences in all other MISTELS and SUTT performance measures between groups. Cognitive workload parameters (SURG-TLX score, heart rate and pupil metrics) were also similar between groups. This study has demonstrated that virtual teaching of MIS skills using a web-based streaming platform is feasible and effective, providing the foundation for low-cost, effective, and scalable MIS skills programs in the future.

Validation of a novel, low-fidelity virtual reality simulator and an artificial intelligence assessment approach for peg transfer laparoscopic training

Simulators are widely used in medical education, but objective and automatic assessment is not feasible with low-fidelity simulators, which can be solved with artificial intelligence (AI) and virtual reality (VR) solutions. The effectiveness of a custom-made VR simulator and an AI-based evaluator of a laparoscopic peg transfer exercise was investigated. Sixty medical students were involved in a single-blinded randomised controlled study to compare the VR simulator with the traditional box trainer. A total of 240 peg transfer exercises from the Fundamentals of Laparoscopic Surgery programme were analysed. The experts and AI-based software used the same criteria for evaluation. The algorithm detected pitfalls and measured exercise duration. Skill improvement showed no significant difference between the VR and control groups. The AI-based evaluator exhibited 95% agreement with the manual assessment. The average difference between the exercise durations measured by the two evaluation methods was 2.61 s. The duration of the algorithmic assessment was 59.47 s faster than the manual assessment. The VR simulator was an effective alternative practice compared with the training box simulator. The AI-based evaluation produced similar results compared with the manual assessment, and it could significantly reduce the evaluation time. AI and VR could improve the effectiveness of basic laparoscopic training.

862 An Overview of Laparoscopic Surgical Training Modalities – How Does Augmented Reality Simulation Compare?

Abstract Aim Compare different types of laparoscopic training modalities and assess how AR compares to the education system using the apprenticeship model on patients and alternative training modalities, including human cadavers, box trainers, and virtual reality (VR) simulators. AR is a novel introduction to laparoscopic surgical training and can superimpose digital images and physical models with the unique advantage of combining visual realism with true-to-life haptic feedback. Method 31 papers were systematically reviewed, and the findings were compiled. Results for the available products and the technology as an educational modality were evaluated. Results Studies reported increased speed of learning, improved ability to multitask, procedural accuracy, hand-eye coordination and bimanual operation in a reduced practice time and increased success rate with AR in healthcare education. One of the limitations of AR it doesn’t reflect the non-technical skills required in the operation. Compared with other modalities AR provided faster skill acquisition and was widely preferred, except when compared to the cadaver model for straight laparoscopic colorectal skills acquisition. AR tends to have a higher initial purchasing cost but does not require the costly specialist facilities or services that cadaver or animal models do, 150 trusts in the NHS preliminary data show an estimated annual saving of £117m. Conclusions AR simulation has the potential to become the new gold standard for laparoscopic surgical training, and beyond, pending further development of literature to increase knowledge of the technology and its capabilities, on top of technological evolution to increase clinical realism.

363 Development and Validation of a Virtual Teaching Method for Minimally Invasive Surgery Skills

Abstract Aim Remote teaching of surgical skills has rapidly emerged as a promising alternative to the traditional face-to-face (F2F) format. This study sought to evaluate whether minimally invasive surgery (MIS) skills could be taught remotely using available technology with objective assessments of proficiency. Method In a pilot study, we compared face-to-face (F2F) and virtual training for novice MIS learners, evaluating proficiency through objective parameters. The pilot refined methods, and the subsequent course was the evaluation basis. Virtual training shifted from conventional to personalised teaching in the second round, introducing headphones for enhanced guidance. Optimisation achieved comparable online teaching quality to F2F. Evaluation tasks included peg transfer (MISTELS) and suturing (SUTT) on box trainers. Results Technical challenges in delivering a virtual MIS skills course were successfully addressed, particularly through the personalised approach in an isolated fashion in the second pilot course. Participants (n = 20) in the final course had similar baseline characteristics and were randomly allocated to F2F (n = 8) and virtual (n = 12) teaching groups. Participants in the virtual group demonstrated faster completion of the peg transfer task compared to the F2F group (11.25 minutes vs. 16.88 minutes; p = 0.015). However, no significant differences were observed in other MISTELS and SUTT performance measures or cognitive workload. parameters. Conclusions This study demonstrates that virtual teaching of MIS skills using a web-based streaming platform is feasible and effective, providing the foundation for scalable future programs. Online surgical skills teaching offers simultaneous access for learners in different regions and reduces costs and travel time.

Laparoscopic training workshop to assess medical students’ skill acquisition and interest in surgical careers

BackgroundWith its minimally invasive approach, laparoscopic surgery has transformed the medical landscape. As the demand for these procedures escalates, there is a pressing need for adept surgeons trained in laparoscopic techniques. However, current training often falls short of catering to medical school education. This study evaluates the impact of a custom-designed laparoscopic training workshop on medical students’ surgical skills and career aspirations.MethodsThis prospective experimental study was conducted at the E-Da hospital in Kaohsiung City, Taiwan. Medical students from Taiwanese medical schools undergoing Clerk 5, Clerk 6, and Postgraduate Year 1 and 2 were invited to participate. Medical students (n = 44) underwent an endoscopic skill training workshop consisting of lectures, box training, and live tissue training. The trainees performed multiple tasks before and after training using our objective evaluation system. The primary outcome was assessed before and after training through a questionnaire assessing the influence of training on students’ interest in surgery as a career. The secondary outcome measured improvement in skill acquisition, comparing the task completion time pre- and post-workshop. For the primary outcome, descriptive statistics were used to summarize the questionnaire responses, and paired t-tests were performed to determine significant changes in interest levels post-workshop. For the secondary outcome, paired t-tests were used to compare the time recorded pre- and post-training.ResultsPost-training, participants exhibited significant proficiency gains, with task completion times reducing notably: 97 s (p = 0.0015) for Precision Beads Placement, 88.5 s (p < 0.0001) for Beads Transfer Exercise, 95 s (p < 0.0001) for Precision Balloon Cutting, and 137.8 s (p < 0.0001) for Intracorporeal Suture. The primary outcome showcased an increased mean score from 8.15 pre-workshop to 9.3 post-workshop, indicating a bolstered interest in surgery as a career. Additionally, post-training sentiment analysis underscored a predominant inclination toward surgery among 88% of participants.ConclusionThe custom-designed laparoscopic workshop significantly improved technical skills and positively influenced students’ career aspirations toward surgery. Such hands-on training workshops can play a crucial role in medical education, bridging the gap between theoretical knowledge and practical skills and potentially shaping the future of budding medical professionals.

Original Training for Laparoscopic Surgery by Making an Origami Paper Crane.

The training box is an effective tool used by surgical trainees. Suturing training is the common method of practicing laparoscopic surgery; however, the cost of needles and threads for long-term practice remains a problem. In this study, we incorporated the original Japanese training for laparoscopic surgery by making an origami paper crane (laparoscopic origami training (LOT)) and evaluated its effect on the clinical results as a long-term practice. LOT was performed using a single 7.5 × 7.5 cm origami paper in the training box of laparoscopic surgery. In the bench-top study, the total time required to make one paper crane was measured and evaluated, and a self-efficacy questionnaire was designed to analyze the efficacy of LOT. In clinical practice, we retrospectively compared two resident groups, one that had previously trained on LOT (trained group) and the other that did not (less-trained group), by analyzing the pneumoperitoneum time (PT) for 10 cases. After making paper cranes in approximately 100 cases, the making time was reduced to approximately 10 min. Long-term results analyzing up to 1500 cases revealed that in addition to shortening the time required to make a paper crane, the shape of the crane also improved. Consequently, the median PT was significantly shorter in the trained group than in the less-trained group (129.0 (62-287) versus 208.5 (127-343) min; p<0.001). LOT contributed to introducing safe laparoscopic surgery to residents and improved their laparoscopic outcomes. We believe that this is a useful practice methodology that can be recommended to general physicians who wish to practice laparoscopic surgeries.

Differences in the Difficulty of Accessing Various 3-Dimensional Locations Under Mirror-Image Conditions During Laparoscopic Surgery.

Laparoscopic colon surgery frequently requires performing maneuvers under mirror-images conditions; the complexity differs depending on the surgical site location in the abdominal cavity. However, no previous reports have examined this. Eleven surgeons participated in this study. Operations were performed on 25 points placed at the bottom and sides of a laparoscopic training box under mirror-image conditions. The mean time-point required to operate at each point and variation between surgeons were evaluated. When the right hand was used, time-points to touch the right side-superficial ends were 0.50 to 0.58 and 0.27 to 0.45 for the other sites. With the left hand, time-points to touch the left side-superficial ends were 0.58 to 0.63 and 0.28 to 0.51 for the other sites, indicating that the most difficult manipulation was at the proximal site of the surgical port. The variation in the difficulty according to the spots increased with a decrease in the surgeon's experience (right hand, r =-0.248; left hand, r =-0.491). In performing laparoscopic surgery under mirror-image conditions, the technical difficulty varies by location, and operating in locations close to the forceps port is the most difficult.

How to integrate robotic training in surgical residency? An example of a 2-week robotic rotation.

General surgery residents should be proficiently trained in robotic surgery. However, there is currently no standardized robotic training curriculum. We aimed to evaluate two approaches to a robotic curriculum and how implementing a virtual reality (VR) simulation curriculum improves trainee robotic performance. From 2019 to 2022, two models of a robotic training curriculum were examined: an in-unit rotation (IUR) and a 2-week curriculum (2WR). The VR curriculum was completed using the da Vinci® Skill Simulator. The curriculum used a pre/post-test design. Residents completed a pre-test that consisted of 4 VR exercises (graded 0-100%) and 3 inanimate box trainer exercises (graded using modified Objective Structured Assessment of Technical Skills). Then, residents completed a VR curriculum of 23 modules. Following the curriculum, residents were given a post-test with the same pre-test exercises. Time necessary to complete the curriculum and compliance were recorded. Of the 11 residents who participated in the IUR, 4 completed the VR curriculum. Comparatively, 100% (n = 23) of residents in the 2WR completed the curriculum. Average time to complete the VR curriculum was 3.8h. After completion of the 2WR curriculum, resident performance improved from pre-test to post-test: VR test scores increased (160% vs 223%, p < 0.001), OSATS scores increased (15.0 vs 21.0, p < 0.001), and time to complete inanimate exercises decreased (1083 vs 756s, p = 0.001). Residents who mastered all modules had higher post-test VR scores (241% vs 214%, p = 0.024). General surgery residents demonstrated improved compliance with the 2WR. The VR curriculum improved resident robotic performance in both virtual and inanimate domains.

Image Guided Interpedicular Screw Placement Simulation System for Training and Skill Evaluation. Proof of Concept

IntroductionPresent work introduces SpineST-01 system, an image guided vertebrae cannulation training system. During task execution, the computer calculates performance based metrics displaying different visual perspectives (LV, AV, APV) with the position of the instrument inside it. Finally, a report with the metrics is generated as performance feedback. MethodsA training box holds a 3D printed spine section. The computer works with two orthogonal disposed cameras, tracking passive markers placed on the instrument. Eight metrics were proposed to evaluate the surgical task’s execution performance. A preliminary study, with 25 participants divided into three groups: 12 Novices, 10 intermediates and 3 Experts, was conducted to determine the feasibility of the system to evaluate and assess the performance differences of each group using Kruskal-Wallis analysis and U Mann-Whitney. In both, Kruskal-Wallis analysis and U Mann-Whitney, a p-value ≤0.05 was considered statistically significant. ResultsWhen comparing Experts vs Novices and the three groups, the statistical analysis showed significant differences in six of the eight metrics. (Axial angle error (°), Lateral angle error (°), Average Speed (mm/s), Progress between shots (mm), Time (s), Shots) The metrics that did not show any statistically significant difference were time between shots (s), and speed between shots (mm/s). As well the average result comparison placed the Experts as the best performance group. ConclusionOn the SpineST-01 presentation, initial testing demonstrated potential for the system to practice image guided cannulation task on lumbar vertebrae. Results show objective differences between Experts, Intermediates, and Novices on the proposed metrics. Making this system a feasible option for developing basic navigation system skills, without the risk of radiation exposure and objectively evaluate task performance.

Transferability of motor skills from piano training to learning new laparoscopic surgical skills

There is a widely held belief that musicians make better surgeons based on the far transfer of their established fine motor skills when learning new surgical skills. There is, however, a deficit of quantified knowledge on the transfer of fine motor skills from one domain of expertise to another. In this study, pianists and controls were provided with daily laparoscopic training sessions for five consecutive days. Each session consisted of six tasks on a Train Anywhere Skill Kit laparoscopic training box. Performance was evaluated each day and retention was evaluated one week later by measuring the speed and accuracy of task completion. Except for the bead to peg transfer task, no statistical differences were found between participant groups. The only significant confounding variable was that the control group was more interested in surgery than the musician group (p = .037). This research addressed limitations of previous studies by measuring the long-term performance and retention of laparoscopic surgical skills. The results of this study demonstrate that, contrary to expectations, piano performance training did not far transfer to laparoscopic surgery. Our findings indicate that fine motor skills are domain specific to music and surgery, respectively.

Measuring Small Bowel Length in Bariatric Surgery: An Ex Vivo Laparoscopic Training Experiment.

Determining limb length in gastric bypass procedures is a crucial step to ensure significant weight loss without risking malnutrition. This study investigated the effect of ex vivo training on the skills needed to determine limb lengths. This was a single-center ex vivo training experiment in a teaching hospital in the Netherlands. We designed a training exercise with marked ropes in a laparoscopic trainer box. All ten surgical residents participated and practiced the skill of estimating limb length. Before and after the two-week period their results on a 150-centimeter limb length task were evaluated. Before training, 10 surgical residents estimated 150centimeters of small bowel with an absolute deviation of 21% [range 9-30]. After the training experiment, the residents measured with 8% [2-20] deviation (P = .17). The 8 residents who trained sufficiently improved statistically significantly to an absolute deviation of 5% [2-17] (P = .012). Over 70% of the participants felt their skills had improved. With sufficient training, surgical residents' skills in measuring small bowel length improved when tested in an ex vivo model. Residents became more confident in their laparoscopic measurement skills. This ex vivo training model is a alternative and addition to on-site training.

129 LaparoscopiX: Expanding Minimally Invasive Surgery Training in Kenya

OBJECTIVES/GOALS: Open surgery prevails in low- and middle-income countries (LMICs) due to scarcity of laparoscopic equipment and poor access to training. LaparosopiX is a box trainer system designed for teaching hospitals in LMICs; it includes an open-source laser print design and an app to allow surgical trainees to receive feedback from laparoscopic experts. METHODS/STUDY POPULATION: This study aims to assess the usability of Laparoscopix for surgical trainees and mentors at five large teaching hospitals in Kenya. Surgical trainees and mentors who participate in this study will be observed while setting up and using the app to identify natural pain-points. A post-session survey will be conducted to assess immediate perceptions of the platform including ease of navigation and intuitive design. Over three months, aggregate data regarding platform usage at these hospital sites will be collected and analyzed to assess user retention rates, usage and traffic patterns, and skill progression over time. Surveys will be sent out to assess attitudes towards the platform and to elucidate any aspects of the system we can improve. RESULTS/ANTICIPATED RESULTS: We hope to find overall positive impressions towards the LaparoscopiX system during this study. We expect there to be some pain-points that arise during navigation of the app, but we expect no large changes to the application architecture required. We anticipate an immediate increase and eventual plateau of users recruited. We hope to see that surgical trainees are advancing through the app while gaining practice and confidence. We will gather insightful data on which aspects of the app were helpful for trainees, and which can be improved. We also hope to learn what factors may play into trainee and mentor retention in the system. DISCUSSION/SIGNIFICANCE: Through this study, we hope to elucidate ways in which we can improve the LaparoscopiX platform, identify which features to prioritize, and determine the direction of future app development. We believe and hope that LaparoscopiX can expand access to laparoscopic surgical mentorship to improve surgical outcomes and health equity worldwide.

Enhancing Early Childhood Education Teachers' Creativity through Professional Development Training Program

This study aimed to examine the implementation and impact of professional development on the creativity of early childhood educators, focusing on creating an innovative teaching medium known as the Magic Box. This research used a qualitative approach with a case study method; the research subjects comprised ten early childhood educators, one resource person, and one training manager. Data were collected using in-depth interviews, observations, and document studies. The Miles and Huberman method was used to analyze the collected data. The research findings reveal a substantial transformation in educators' creativity levels after participating in Magic Box's professional development and training programs. Through a structured and hands-on approach, educators gain practical experience and motivation to infuse creativity into their teaching practices. Educators report increased confidence in generating creative ideas for teaching materials and a shift in their instructional approach to encourage more engaging and interactive learning experiences for children.

The Effect of Knee Tuck Jump and Jump-To-Box Plyometric Training on Female Students’ Leg Muscle Strength and Flexibility in Volleyball Extracurricular Activity

Study purpose. This study aimed to investigate the effects of Knee Tuck Jump or Jump to Box plyometric training and to determine their effectiveness in increasing leg muscle strength and flexibility in female students participating in volleyball extracurriculars. Materials and methods. This study used a quasi-experimental design. Twenty-four female students were randomly selected as samples and then divided into two categories: 12 students receiving Knee Tuck Jump training (age: 17.08±0.51) and 12 students receiving Jump to Box training (age: 17.00±0.60). All participants performed the initial and final tests using the Vertical Jump and sit-and-reach tests. To analyze the data, the t-test was used to determine the differences in variables between the pretest and posttest in the experimental group. Results. In the Knee Tuck Jump group, a significant improvement in VJ (P=0.000) and sit-&amp;-reach tests (P=0.000) was observed. In addition, Knee Tuck Jump was considered to be more effective in increasing the students’ flexibility, because the t value of sit-&amp;-reach test (14.075) was higher than that of VJ (13.811). Similarly, the Jump to Box group also showed a significant improvement in VJ (P=0.000) and sit-&amp;-reach (P=0.000) tests. However, Jump to Box was deemed to be more effective in increasing the students’ leg muscle strength, as the t value of VJ (26.086) was higher than that of sit-&amp;-reach test (9.594). Conclusions. Based on the research findings, it can be concluded that plyometric exercises, specifically KTJ and JB, have a significant and positive impact on the lower limb muscle strength and flexibility in female students participating in volleyball extracurricular activities. Despite both demonstrating significant positive effects, KTJ training is more effective in improving flexibility compared to JB, while JB is more effective in enhancing lower limb muscle strength compared to KTJ.

There is a need for a paradigm shift in laparoscopic surgical training: results of a nationwide survey among teaching hospitals in Switzerland.

Surgical training curricula have changed little over the past decades. Current advances in surgical techniques, especially in minimally invasive surgery, as well as the rapidly changing socioeconomic environment pose a major challenge for the training of young surgeons. The aim of this survey was to provide a representative overview of the surgical training landscape in Switzerland focusing on laparoscopic surgical training: How do department chairs of teaching hospitals deal with the above challenges, and what should a future training curriculum look like? This is a prospective, questionnaire-based, cross-sectional study among the heads of departments of all certified surgical teaching hospitals in Switzerland. The overall response rate was 56% (48/86) and 86% (19/22) for tertiary centers. Two-thirds of the centers (32) organize themselves in training networks. Laparoscopic training courses are offered in 25 (52%) hospitals, mainly in tertiary centers. Self-training opportunities exist in 40 (83%) hospitals. In addition to commercial (27) and self-built (7) box trainers, high-fidelity trainers are available in 16 (33%) hospitals. A mandatory training curriculum exists in 7 (15%) facilities, and a training assessment is performed in 15 (31%) institutions. Thirty-two (65%) heads of departments indicated that residents have sufficient practical exposure in the operating room, but the ability to work independently with obtaining the specialist title is seen critically (71%). They state that the surgical catalog does not adequately reflect the manual skills of the resident (64%). The desire is for training to be restructured from a numbers-based to a performance-based curriculum (53%) and for tools to assess residents' manual skills (56%) to be introduced. Department chairs stated that the existing curriculum in Switzerland does not meet the requirements of a modern training curriculum. This study highlights the need to create an improved, competency-based curriculum that ensures the training of a new generation of surgeons, taking into account the growing evidence of the effectiveness of state-of-the-art training modalities such as simulation or proficiency-based training.