Diagnostic Inventory Research Articles

Preoperative Psychological Competitive Ability Is Associated With Emotional States Six Months After Anterior Cruciate Ligament Reconstruction With Hamstring Autograft: A Prospective Study.

Background Psychological state has been reported as one of the factors strongly related to a return to sports after anterior cruciate ligament (ACL) reconstruction. However, its relationship with the emotional state remains unclear. The aim of this study was to investigate whether patients who have undergone ACL reconstruction and have a higher preoperative psychological competitive ability have a better emotional status preoperatively and six months postoperatively. Methods Patients with a Tegner activity score of ≥6 who underwent ACL reconstruction between 2015 and 2020 were divided into two groups according to their grades on the Diagnostic Inventory of Psychological Competitive Ability for Athletes (DIPCA.3). The emotional states preoperatively and at six months postoperatively were assessed using the Profile of Mood States Second Edition (POMS2) and compared between the two groups. Furthermore, the possibility of returning to sports was compared between the groups based on participation in the entire practice at six months postoperatively. Results Eighty-four patients were included and divided into the high (DIPCA.3 grades ≥4, n = 23) and low (DIPCA.3 <4, n = 61) groups. Vigor-activity and friendliness were significantly higher in the high group than in the low group preoperatively. The difference was even greater at six months after ACL reconstruction. In addition, the high group showed significantly better results postoperatively for fatigue-inertia and total mood disturbance. Rates of return to sports did not differ significantly between the high and low groups (56.5% vs. 54.1%). Conclusions Those with a higher preoperative psychological competitive ability were in a positive emotional state preoperatively and six months after ACL reconstruction. However, the psychological competitive ability did not affect the rate of participation in the entire practice at six months postoperatively.

대학생 미래 리터러시 진단도구 개발 및 타당화

Objectives The purpose of this study is to develop and validate diagnostic tools for futures literacy. To achieve this, definitions of future literacy, identification of sub-elements, and diagnostic items were proposed. Methods Through analysis of previous research, the definition, components, and diagnostic items of future literacy were identified, and feasibility was reviewed through the Delphi survey technique targeting 11 experts. To ensure the construct validity and reliability of the items, data were collected from 244 college students. Exploratory factor analysis was performed on the collected data, and confirmatory factor analysis was performed using the AMOS program to specifically verify the model suitability and validity of the factors and items. Results Reflecting the results of the construct validity and reliability analysis of 68 items, a total of 39 items were deleted, and a diagnostic tool consisting of a total of 29 items was completed. When examining the results of factor analysis and reliability analysis for a total of 29 diagnostic items, the Bartlett sphericity test result was significant at p &lt; .001, and KMO was .861, which was above .5, so it appeared to be a matrix suitable for factor analysis. Conclusions Ultimately, the definition and components of future literacy and 29 diagnostic items defined by factor were confirmed, which can be used as a quantified diagnostic inventory in planning and operating future literacy education programs.

Cold sensitivity among female clinical nurses in Japan: A nationwide study

ObjectivesThis study aimed to clarify the nature of cold sensitivity in female nurses working in hospitals in Japan. DesignA cross-sectional post survey research design. SettingsThe questionnaire targeted nurses working in 14 hospitals across ten prefectures throughout Japan. Participants1,138 female nurses MethodsThe survey captured participants’ characteristics, work environment, health, and lifestyle. The factors investigated were perceived cold sensitivity, cold sensitivity according to the Hiesho Sensation Scale, and cold sensitivity during nursing care. The Diagnostic Inventory of Health and Life Habits (DIHAL.2) assessed health and lifestyle habits. ResultsOf the respondents, 44.3 % were aware of daily cold sensitivity and 21.4 % had a cold sensitivity disorder. The majority of respondents (63.1 %) felt cold in their hands when providing nursing care, and 28.1 % felt discomfort due to the coldness of their hands. Individuals diagnosed with cold sensitivity disorders exhibited poorer overall health compared to those without such disorders. However, there was no statistically significant difference in the overall health status between individuals who reported perceiving cold sensitivity and those who did not. The group with perceived cold sensitivity had significantly lower scores on exercise behavior, meal regularity, rest, sleep regularity, and sleep sufficiency. The proportion of female nurses working in Japanese hospitals who experienced cold sensitivity was similar to that of Japanese women with the same sensitivity. Most female nurses experienced cold in their hands while providing care. Nearly 30 % of the respondents experienced discomfort owing to cold hands. ConclusionsThe study underscores the widespread issue of cold sensitivity among female nurses in Japanese hospitals, emphasizing the critical need for targeted interventions to improve their comfort and optimize care provision.

Considerations in Designing and Validating the Diagnostic Inventory for Self-Regulated Language Learning (DISLL): Status of the Process

This article describes a new questionnaire, the “Diagnostic Inventory for Self-Regulated Language Learning” (DISLL), for assessing self-regulated learning strategies of students of English as an additional language. We discuss self-regulated learning models, evaluate existing questionnaires for assessing language learners’ self-regulated strategy use, and present a rationale for the DISLL. We explain Zimmerman’s (2000) three-phase model, adapted with simplified phase names: planning, doing, and reflecting. Every DISLL phase starts with a brief scenario to help learners judge how often they employ each strategy in that phase. Already completed are a review of the DISLL 1.0 by 18 international researchers, the step-by-step creation of the DISLL 1.1, and the profiling of vocabulary in the DISLL 1.1 to ensure the simplicity necessary for intermediate-level learners. We present an argument-based validation framework, to be supported by piloting the DISLL 1.2 in Iran, Saudi Arabia, Spain, and Poland and even broader piloting of the DISLL 1.3. Statistical analyses will involve quantitative methods, e.g., exploratory and confirmatory factor analysis, reliability analysis, and confirmatory composite analysis. At least one site will also use qualitative think-aloud protocols. The DISLL will be released into the public domain for free use after version 1.3.

Ab. No. 93 Prevalence of Learning Disability in School-Going Kids of Government School in District Patiala, Punjab

Introduction: The purpose of the study is to determine the prevalence of learning disability in school-going children from the IIIrd –Vth class of government schools by using the Learning Disability Diagnostic Inventory (LDDI). The study contributes to expanding the role of physiotherapy in multidisciplinary teams by fostering effective therapeutic approaches to promote balanced development of children with learning disability. Methods: A total of 80 students belonging to the class III-V between the 8-11 years of age group from different government schools were selected as participants in the present study. Methods: The study was conducted using convenience sampling method. A detailed questionnaire was used to document each student’s academic performance. The students were then subjected to a series of assessments, including visual auditory perception tests and an IQ based (Colored Progressive Matrices) CPM test followed by LDDI filled by the teacher of each student. The data was analysed through descriptive statistics and inferences. Results: The findings of the study were that out of total 80 students the prevalence of Learning Disability in Writing domain constitutes (10%), Reading (7.5%), Speaking (21.25%),Reasoning (6.25%),Listening (25%), Arithmetic disability (8.75%). Students of primary class IIIrd-Vth were at higher risk of learning disability in government schools. Conclusion: The study concluded that the learning disability is more prevalent in early aged students between age of 8-11. Institutional based educational strategies are required for appropriate modifications in education and teaching techniques. Implications: The present study helps in making early diagnosis of learning disability at school level and further widens the spectrum for planned effective therapeutic interventions to enhance the academic performance of students with learning disability and enhance the overall quality of life.

Preoperative psychological competitive ability has little relationship with subjective knee function and return to sports at 6 months postoperatively in patients with anterior cruciate ligament reconstruction

ObjectiveThis prospective study aimed to investigate the relationship between preoperative psychological competitive ability and preoperative and 6 months postoperative subjective knee function in patients undergoing anterior cruciate ligament (ACL) reconstruction. MethodsEighty-four patients who underwent ACL reconstruction and had a Tegner Activity Scale score of 6 or more were included in this study. Preoperatively, all patients were administered the Diagnostic Inventory of Psychological Competitive Ability for Athletes (DIPCA.3) for psychological competitive ability assessment and the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form for subjective knee function assessment. The IKDC subjective score was re-evaluated 6 months postoperatively. We evaluated the associations of volition for competition, mental stability and concentration, confidence, strategic ability, and cooperation (DIPCA.3 factors) with the IKDC subjective score preoperatively and 6 months postoperatively. Furthermore, patients were classified into two groups according to whether they could return to participate in the entire practice and compared the DIPCA.3 total score and IKDC subjective score. ResultsThe DIPCA.3 confidence score negatively correlated with the preoperative IKDC subjective score (β = −0.34, p = 0.04). However, there was no association between the DIPCA.3 score for all variables and IKDC subjective score at 6 months after ACL reconstruction. Moreover, the DIPCA.3 total score was not related to return to participate in the entire practice 6 months after ACL reconstruction. ConclusionPsychological competitive ability is not associated with a return to participate in the entire practice, and a low preoperative IKDC subjective score should not be viewed too negatively.

An inexpensive foramen magnum decompression training tool: Feasibility and validation study.

Foramen magnum decompression (FMD) is a standard neurosurgical procedure, typically utilized to treat Chiari malformation. The aim of this educational project was to develop and validate a low-cost FMD simulation training model. Mold-based methods were used to develop a prototype. Feasibility was tested during an FMD training session for 17 neurosurgery trainees. Face and content validity were assessed through a Likert Scale. The perceived training benefit was determined using the Physician Performance Diagnostic Inventory Scale (PPDIS). A total of 87.5% successfully removed the C1 arch, 81.3% successfully performed an FMD, and 68.8% avoided injury to the underlying structures. The model scored highly for visual and tactile realism. The median confidence rating on PPDIS significantly improved from early learner to competent. We demonstrate feasibility, content, and face validity. Furthermore, this is a low-cost, portable model that can be easily replicated and used for simulation training.

Within-person pathways among maternal depressive symptoms and offspring internalizing problems from early childhood through adolescence.

The report examined reciprocal within-person associations among maternal depressive symptoms and offspring depressive, anxiety and irritability symptoms from early childhood to adolescence using a random intercept cross-lagged panel model (RI-CLPM). Participants were 609 mother-child dyads participating in the Stony Brook Temperament Study. Child and maternal internalizing symptoms were assessed every 3 years from ages 3 to 15 using maternal report on the Child Behavior Checklist (CBCL) and Diagnostic Inventory for Depression, respectively. At the between-person level, maternal depressive symptoms, and child depressive, anxiety, and irritability symptoms were all positively associated with one another. At the within-person level, greater within-person child anxiety symptoms at age 3 predicted both greater child anxiety and depressive symptoms at age 15 via greater child anxiety from ages 6 to 12, and greater within-person child irritability at age 3 predicted greater maternal depressive symptoms at age 15 via greater child irritability from ages 6 to 12. Findings reveal novel within-person developmental pathways from early childhood internalizing problems to later internalizing problems in both the child and mother. Intervention and prevention efforts should thus focus on early identification and prevention of childhood internalizing symptoms to reduce negative effects on both child and parent symptoms.

Assessing compulsive sexual behavior disorder: The development and international validation of the compulsive sexual behavior disorder-diagnostic inventory (CSBD-DI).

The World Health Organization's International Classification of Diseases (ICD-11) includes Compulsive Sexual Behavior Disorder (CSBD), a new diagnosis that is both controversial and groundbreaking, as it is the first diagnosis to codify a disorder related to excessive, compulsive, and out-of-control sexual behavior. The inclusion of this novel diagnosis demonstrates a clear need for valid assessments of this disorder that may be quickly administered in both clinical and research settings. The present work details the development of the Compulsive Sexual Behavior Disorder Diagnostic Inventory (CSBD-DI) across seven samples, four languages, and five countries. In the first study, data were collected in community samples drawn from Malaysia (N = 375), the U.S. (N = 877), Hungary (N = 7,279), and Germany (N = 449). In the second study, data were collected from nationally representative samples in the U.S. (N = 1,601), Poland (N = 1,036), and Hungary (N = 473). Across both studies and all samples, results revealed strong psychometric qualities for the 7-item CSBD-DI, demonstrating evidence of validity via correlations with key behavioral indicators and longer measures of compulsive sexual behavior. Analyses from nationally representative samples revealed residual metric invariance across languages, scalar invariance across gender, strong evidence of validity, and utility in classifying individuals who self-identified as having problematic andexcessive sexual behavior, as evidenced by ROC analyses revealing suitable cutoffs for a screening instrument. Collectively, these findings demonstrate the cross-cultural utility ofthe CSBD-DI as a novel measure for CSBD and provide a brief,easily administrable instrument for screening for this novel disorder.

The Association Between John Henryism and Depression and Suicidal Ideation Among African-American and Caribbean Black Adolescents in the United States

PurposeThe aim of this study is to investigate the relationship between John Henryism (JH), a psychological construct indexing repeated high effort coping, and depression and SI among Black adolescents, and to explore whether these relationships vary by sex. MethodsData came from the National Survey of American Life-Adolescent Supplement, a cross-sectional, multistage probability sample of African-American and Caribbean Black adolescents aged 13–17 (N = 1,170). JH was measured using a 12-item scale (alpha = 0.71) and dichotomized at the median. Lifetime history of major depression (MD) and SI were assessed using the Composite International Diagnostic Inventory and self-report, respectively. Logistic regression was used to assess the relationship between JH and likelihood of MD and SI, adjusting for demographic and psychosocial characteristics and accounting for the complex survey design. Moderation by sex was assessed using interaction terms. ResultsLifetime prevalence of MD was 6.3% (N = 87) and lifetime history of SI was 7.6% (N = 91). In unadjusted models, high JH was inversely associated with MD (odds ratio [OR]: 0.55, 95% confidence interval [CI]: 0.34–0.90) and SI (OR: 0.45, 95% CI: 0.23–0.91). In adjusted models, the relationship between JH and MD was attenuated (OR: 0.68, 95% CI = 0.39–1.18, p = .16) and remained marginally significant for SI (OR: 0.55, 95% CI: 0.28–1.06, p = .07). These relationships were similar by sex. DiscussionConsistent with prior work in adults, JH was inversely associated with MD and SI among Black adolescents. Findings illustrate the importance of considering culturally salient protective factors for mental health among Black adolescents.

Особенности личной профессиональной перспективы старших подростков и юношей со склонностью к девиантному поведению

The article studies procedural and substantive aspects of the vocational self-determination in pupils of 9 and 10 years of schooling with a tendency to deviant behavior. The research aims to reveal the specifics of the personal job outlook in adolescents and youth with such tendencies and uses E.A. Klimov’s ideas of the personal vocational plan of a schoolchild which were further elaborated in N.S. Pryazhnikov’s works who put forward the concept of one’s personal vocational outlook (PVO). The research compares PVO components of so-ciopathic pupils (main group) and those of their classmates with relatively normative be-havior (C group), all going to the same school in Moscow. 80 schoolchildren (51 boys and 29 girls aged 15–17) took part in the main stage of the research. These were used: Method-ology for Diagnostics of one’s Tendency towards Deviant Behavior by Orel N.A.; Personal Vocational Outlook inventory by N.S. Pryazhnikov; Differential and Diagnostic Inventory (DDI) by E.A. Klimov. The results obtained for the main and C groups were compared us-ing the Mann–Whitney U test. The most problematic PVO aspects have been revealed for schoolchildren with sociopathic tendencies. Targets have been identified for psychological and educational counselling for the risk group schoolchildren in their vocational self-determination.

О ТЕНДЕНЦИЯХ ИССЛЕДОВАНИЯ ЭМОЦИОНАЛЬНОГО ИНТЕЛЛЕКТА

The article covers the process of the historical development of the emotional intelligence concept; as well as the classification of modern approach to this concept in the scientific literature has been created. The purpose of the article is to systemize the modern tendencies of the emotional intelligence research as a component of thinking. To achieve this goal several tasks needed to be solved: to clarify the psychological meaning of emotional intelligence; to systemize the main aspects used in the emotional intelligence research; to describe the psychological models of emotional intelligence. The complex of theoretical methods has been used to solve the given tasks: learning and analysis of scientific literature on the research topic, the systematization of data that characterizes the main aspects and the directions of the scientific process. The given article is the systematic study. The methodological basis of the research consists of the scientific works on psychology of J. D. Mayer, D. Halpern, W. Gray, A. Ortoni, J. Klor, A. Collins, L. S. Vygotskiy, S.L. Rubinstain, A. N. Leontiev, O. K. Tikhomirov, O. Ya. Chebykin etc. The following conclusions have been made during the study: despite the significant amount of types and components of intelligence, their final establishing is still hard to find out. As the result of the current research it was pointed out that the ability models more effectively reveal the emotional intelligence concept. Because they are characterized by the greater practical development and greater reliability of the diagnostic inventory.

SOCIAL ANXIETY, DEPRESSION, COPING SELF-EFFICACY, AND COPING STRATEGIES AMONG COLLEGE STUDENTS

The transition to college and its associated social challenges could trigger social anxiety and depression among young college students. There is a paucity of literature relating coping self-efficacy, coping strategies, social anxiety and depression. The current study aims to fill this gap by finding the contributions of gender, coping self-efficacy (CSE), and coping strategies onto the levels of social anxiety and depression among college students. It also aims to find race-ethnicity differences, considering students’ level of social anxiety and depression. One hundred and fifty-eight students were recruited from the undergraduate psychology subject pool at a northeastern university. The Liebowitz Social Anxiety Scale, Diagnostic Inventory for Depression, Coping Self-Efficacy Scale and Brief COPE were used to measure the study variables. A one-way ANOVA and simultaneous multiple linear regression analyses were conducted to examine data. There were no significant race-ethnicity differences in social anxiety, depressive symptom severity, psychosocial impairment, and quality of life. However, gender and self-blame significantly predicted social anxiety; substance use, behavioral disengagement, and self-blame significantly predicted depressive symptom severity; and social support CSE significantly predicted psychosocial impairment. Gender, dysfunctional coping strategies and social-support CSE were significantly associated with social anxiety and depression among college students. The results have important implications for treatment intervention and outreach by college counseling personnel.

Transcranial direct current stimulation to enhance mathematical performance in school going developmental dyscalculic children: A single group pretest-posttest, quasi experimental study

INTRODUCTION: Developmental dyscalculia (DD) deals with impaired mathematical performance and affects the educational and day-to-day activities of children. There is evidence that transcranial direct current stimulation (tDCS) applied to the posterior parietal cortex facilitates the hypoactive neuronal structure and improves mathematical performance in individuals with DD. OBJECTIVE: The objective of this study is to investigate whether tDCS adjuvant with conventional numeracy training (CNT) would enhance the mathematical abilities of school-going children affected with DD. MATERIALS AND METHODS: Thirteen school-going children affected with DD received tDCS and CNT three sessions per week for up to 2 consecutive weeks. Left anodal and right cathodal stimulation at P3/P4 region with 2mA intensity combined with CNT for 30 minutes in a day was given. Learning disability diagnostic inventory (LDDI) was used as an outcome measure and collected at baseline and the end of the 2-week intervention. RESULTS: There was a significant improvement in the mathematical performance of school-going children. The results show statistically as well as a clinically significant improvement after the 2 weeks of intervention. CONCLUSIONS: tDCS combined with CNT is effective for improving the mathematical abilities of school-going children affected with DD. The findings of this study provide a new perspective for the rehabilitation of school-going DD children.

Diagnostic and screening inventories for temporomandibular disorders: A systematic review

ABSTRACT Objective: To evaluate reliable and validated temporomandibular disorder (TMD) diagnostic instruments for use as diagnostic tools in epidemiological surveys. Methods: Two independent reviewers performed searches in the Medline/PubMed, Cochrane Library, and Web of Science databases to identify validation studies of diagnostic and screening instruments for TMD published up to March 2021. Results: Sixteen studies were included for the systematic review. Different TMD instruments were evaluated, such as FAI, RDC/TMD, DC/TMD, Helkimo Index, and AAOP Questionnaire. The instruments differed according to the number of items. Some questionnaires appear to be effective for the initial screening of TMD patients and can be incorporated in clinical practice and epidemiological studies since they are easy and fast to apply. Conclusion: To provide an accurate TMD diagnosis, it is important to use instruments that involve a clinical examination. Authors suggest the development of a new validated diagnostic tool for use in epidemiological surveys.

ВІДМІННОСТІ СУБ’ЄКТИВНОГО ДОСВІДУ ПІКОВИХ ПЕРЕЖИВАНЬ ТА ГІПОМАНІЇ: ФЕНОМЕНОЛОГІЧНЕ ДОСЛІДЖЕННЯ З ВИКОРИСТАННЯМ ІНТЕРВ’Ю PEXI

The borderline nature of hypomania may be a cause of widely reported issues with accurate bipolar disorder or recurrent depression differential diagnosis. It is understandable as long as there is a subtle difference between criteria for hypomania and normal (more or less extreme) elevated mood conditions, such as peak experiences of a self-actualizing person. In such cases, there are possibilities for taking one for another that leads both to a false-positive hypomania diagnosis for healthy subjects and subjects suffering from recurrent depression rather than from bipolar disorder, and to a false-negative perception of actual hypomania as just a highly good mood, brilliant efficiency and holistic existential feelings. This paper focuses on the phenomenological study of subjective experiences of such states in groups of healthy individuals with high or moderate self-actualization levels and individuals diagnosed with bipolar disorder without comorbidity. A Peak Experiences Interview has been developed to collect phenomenological data for further extraction of substantial features of subjective experiences for both groups. The study shows that the differences in phenomenology of peak experiences and hypomania state encompass various components, such as cognitive, emotional, somatic, behavioural, imaginative, existential. These findings may be used for developing diagnostic manuals and inventories as well as self-monitoring tools for patients and psychoeducational materials. The PEXI itself has shown its capacity for collecting phenomenological data and detecting relatively subtle differences in experiences of various modalities. Nevertheless, it shall undergo more trials with larger samples and cross-validation. Theoretical and practical insights from using such an approach may contribute greatly both in clinical psychology and personality studies.

Autism Spectrum Disorder Symptom Profile Across the RASopathies

Dysregulation of the Ras MAPK signaling pathway is implicated in the pathogenesis of autism spectrum disorder (ASD). The RASopathies, a group of disorders caused by mutations of the Ras/MAPK pathway genes, share many overlapping clinical features. Studies suggest a high prevalence of ASD in the RASopathies, but detailed characterization of the ASD profile is lacking. The aim of this study was to compare the ASD symptom profile of three distinct RASopathies associated with both gain-of-function and loss-of-function mutations: neurofibromatosis type 1 (NF1), Noonan syndrome (NS), and cardiofaciocutaneous syndrome (CFC). Participants were drawn from existing databases if they had a diagnosis of a RASopathy, met the criteria for ASD, and were able to communicate verbally. We compared the phenotypic profile of NF1 + ASD (n = 48), NS + ASD (n = 11), and CFC + ASD (n = 7) on the Autism Diagnostic Inventory (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS). We found subtle but non-significant group differences with higher levels of social impairments and lower restricted repetitive behaviors in the NF1 group as compared with the NS and CFC groups. We observed group differences in developmental milestones with most severe delays in CFC, followed by NS and NF1. Our results suggest that despite developmental differences, the ASD profile remains relatively consistent across the three RASopathies. Though our results need confirmation in larger samples, they suggest the possibility that treatment and mechanistic insights developed in the context of one RASopathy may be generalizable to others and possibly to non-syndromic ASD associated with dysregulation of Ras/MAPK pathway genes.

Emotion regulation strategies during competitive games:

The purpose of the present study was to investigate the relationship between emotion regulation strategies (reappraisal and expressive suppression) and psychological competitive ability during sports games. A total of 492 athletes completed the Japanese version of the Emotion Regulation Questionnaire (EQR-J) and the Diagnostic Inventory of Psychological-Competitive Ability for Athletes (DIPCA.3). The DIPCA.3 was used to assess psychological competitive ability as the dependent variable, and multiple regression analysis was conducted to analyze the effects of reappraisal and expressive suppression on psychological competitive ability. The results indicated that reappraisal had a positive effect on all 5 factors of the DIPCA.3. The participants were also classified into 3 clusters: the first cluster comprised players who had a strong tendency to use reappraisal, the second cluster comprised players who had a strong tendency to use expressive suppression, and the third cluster comprised players who did not use either of the emotion regulation strategies. Subsequently, one-way analysis of variance was conducted with each cluster as an independent variable and the DIPCA.3 as the dependent variable. The players who had a weak tendency to use both reappraisal and suppression had the lowest scores for 4 of the 5 factors. These findings indicate that athletes who use reappraisal or suppression as an emotion regulation strategy have better psychological competitive ability during competitive games.

Simulation with 3D Neuronavigation for Learning Cortical Bone Trajectory Screw Placement.

Learning a new technique in neurosurgery is a big challenge especially for trainees. In recent years, simulations and simulators got into the focus as a teaching tool. Our objective is to propose a simulator for placement of cortical bone trajectory (CBT) screws to improve results and reduce complications. We have created a platform consisting of a sawbone navigated with a 3D fluoroscope to familiarize our trainees and consultants with CBT technique and later implement it in our department. Objective Structured Assessment of Technical Skills (OSATS) and Physician Performance Diagnostic Inventory Scale (PPDI) were obtained before and after the use of the simulator by the five participants in the study. Patients who were operated on after the implementation of the technique were retrospectively reviewed. During the simulation, there were 4 cases of pedicle breach out of 24 screws inserted (16.6%). After having completed simulation, participants demonstrated an improvement in OSATS and PPDI (p = 0.039 and 0.042, respectively). Analyzing the answers to the different items of the tests, participants mainly improved in the knowledge (p = 0.038), the performance (p = 0.041), and understanding of the procedure (p = 0.034). In our retrospective series, eight patients with L4-L5 instability were operated on using CBT, improving their Oswestry Disability Index (ODI) score (preoperative ODI 58.5 [SD 16.7] vs. postoperative ODI 31 [SD 13.4]; p = 0.028). One intraoperative complication due to a dural tear was observed. In the follow-up, we found a case of pseudoarthrosis and a facet joint violation, but no other complications related to misplacement, pedicle fracture, or hardware failure. The simulation we have created is useful for the implementation of CBT. In our study, consultants and trainees have valued very positively the learning obtained using the system. Moreover, simulation facilitated the learning of the technique and the understanding of surgical anatomy. We hope that simulation helps reducing complications in the future.

The effect of simulation training on resident proficiency in thoracolumbar pedicle screw placement using computer-assisted navigation.

Residency work-hour restrictions necessitate efficient, reproducible training. Simulation training for spinal instrumentation placement shows significant benefit to learners' subjective and objective proficiency. Cadaveric laboratories are most effective but have high cost and low availability. The authors' goal was to create a low-cost, efficient, reproducible spinal instrumentation placement simulation curriculum for neurosurgery and orthopedic surgery residents using synthetic models and 3D computer-assisted navigation, assessing subjective and objective proficiency with placement of thoracolumbar pedicle screws. Fifteen neurosurgery and orthopedic surgery residents participated in a standardized curriculum with lecture followed by two separate sessions of thoracolumbar pedicle screw placement in a synthetic spine model utilizing 3D computer-assisted navigation. Data were collected on premodule experience, time and accuracy of screw placement, and both subjective and objective ratings of proficiency. Fifteen of 15 residents demonstrated improvement in subjective (Physician Performance Diagnostic Inventory Scale [PPDIS]) and 14 in objective (Objective Structured Assessment of Technical Skills [OSATS]) measures of proficiency in navigated screw placement with utilization of this curriculum (p < 0.001 for both), regardless of the number of cases of previous experience using thoracolumbar spinal instrumentation. Fourteen of 15 residents demonstrated decreased time per screw placement from session 1 to session 2 (p = 0.006). There was no significant difference in pedicle screw accuracy between session 1 and session 2. A standardized curriculum using synthetic simulation training for navigated thoracolumbar pedicle screw placement results in significantly improved resident subjective and objective proficiency. Development of a nationwide competency curriculum using simulation training for spinal instrumentation placement should be considered for safe, efficient resident training.