Learning Of Technical Skills Research Articles

The role and validity of surgical simulation.

In the last three decades, simulation has become a key tool in the training of doctors and the maintenance of patient safety. Simulation offers an immersive, realistic way of learning technical skills. Recent changes to the training schemes in many surgical specialities mean that the hours spent working between senior house officer and consultant have been reduced. This, combined with other pressures (such as reduced operating hours), means that surgery has moved away from its traditional apprenticeship model and toward a competency-based one. Simulation can be a standardized and safe method for training and assessing surgeons. Use of simulation for training has become significant alongside the development of laparoscopic techniques, and evidence suggests that skills obtained in simulation are applicable in real clinical scenarios. Simulation allows trainees to make mistakes, to ask the "what if?" questions, and to learn and reflect on such situations without risking patient safety. Virtual reality simulators have been used to allow experts to plan complicated operations and assess perioperative risks. Most recently, fully immersive simulations, such as those with whole theater teams involved, and patient-centered simulations allow development of other key skills aside from purely technical ones. Use of simulation in isolation from traditional teaching methods will furnish the surgeon in training with skills, but the best time and place to use such skills comes only with experience. In this article we examine the role of simulation in surgical training and its impact in the context of reduced training time.

Extended score interval in the assessment of basic surgical skills

IntroductionThe Basic Surgical Skills course uses an assessment score interval of 0–3. An extended score interval, 1–6, was proposed by the Swedish steering committee of the course. The aim of this study was to analyze the trainee scores in the current 0–3 scored version compared to a proposed 1–6 scored version.MethodsSixteen participants, seven females and nine males, were evaluated in the current and proposed assessment forms by instructors, observers, and learners themselves during the first and second day. In each assessment form, 17 tasks were assessed. The inter-rater reliability between the current and the proposed score sheets were evaluated with intraclass correlation (ICC) with 95% confidence intervals (CI).ResultsThe distribution of scores for ‘knot tying’ at the last time point and ‘bowel anastomosis side to side’ given by the instructors in the current assessment form showed that the highest score was given in 31 and 62%, respectively. No ceiling effects were found in the proposed assessment form. The overall ICC between the current and proposed score sheets after assessment by the instructors increased from 0.38 (95% CI 0.77–0.78) on Day 1 to 0.83 (95% CI 0.51–0.94) on Day 2.DiscussionA clear ceiling effect of scores was demonstrated in the current assessment form, questioning its validity. The proposed score sheet provides more accurate scores and seems to be a better feedback instrument for learning technical surgical skills in the Basic Surgical Skills course.

Tiv Traditional Religion and Its Contribution to the Trado-Educational and Technological Development of the Tiv Society

The European Missionaries failed to understand the important virtues of the Tiv traditional religion and technology and condemned the Tiv religion. The use of Western technology and tools destroyed the technical proficiency of the Tiv people, moral teachings and disciplines coming from the blacksmithing workshop was no longer there and this has accounted for moral decadence and retardation or thwarting in technical skill learning of the people. The study therefore, looks at Tiv traditional religion and its contribution to the trado-educational and technological development of the Tiv society. The study sampled 384 Traditional Priests, Traditional Engineers or Blacksmiths and the general Tiv people. Mean and standard deviation statistics were used to answer research questions while Chi-Square was used for testing the hypotheses formulated at 0.05 level of significance. It was discovered that the Tiv traditional religion has contributed to the technological development of the Tiv society. The study recommended that stakeholders such as Ator a Tiv (Tiv Council of Chiefs or Tiv Traditional Council), Mdzough u Tiv (Tiv Mutual Union), Governments, Nongovernmental Organizations, Private Individuals and Potential Practitioners of Tiv Indigenous Religion should encourage the practice of Tiv Traditional Religion among the Tiv people. Hence Tiv Traditional (Indigenous) Religion is intertwined with Tiv Trado-educational and technological practices of the Tiv in which blacksmithing constitutes a cardinal aspect of it, the Tiv Religion should be encouraged as it is as good as encouraging the technology.

Desktop-Based Computer-Assisted Orthopedic Training System for Spinal Surgery

Simulation and surgical training has moved on since its inception during the end of the last century. The trainees are getting more exposed to computers and laboratory training in different subspecialties. More needs to be done in orthopedic simulation in spinal surgery. To develop a training system for pedicle screw fixation and validate its effectiveness in a cohort of junior orthopedic trainees. Fully simulated computer-navigated training system is used to train junior orthopedic trainees perform pedicle screw insertion in the lumbar spine. Real patient computed tomography scans are used to produce the real-time fluoroscopic images of the lumbar spine. The training system was developed to simulate pedicle screw insertion in the lumbar spine. A total of 12 orthopedic senior house officers performed pedicle screw insertion in the lumbar spine before and after the training on training system. The results were assessed based on the scoring system, which included the amount of time taken, accuracy of pedicle screw insertion, and the number of exposures requested to complete the procedure. The result shows a significant improvement in amount of time taken, accuracy of fixation, and the number of exposures after the training on simulator system. This was statistically significant using paired Student t test (p < 0.05). Fully simulated computer-navigated training system is an efficient training tool for young orthopedic trainees. This system can be used to augment training in the operating room, and trainees acquire their skills in the comfort of their study room or in the training room in the hospital. The system has the potential to be used in various other orthopedic procedures for learning of technical skills in a manner aimed at ensuring a smooth escalation in task complexity leading to the better performance of procedures in the operating theater.

Identifying students’ difficulties when learning technical skills via a wireless sensor network

Practical training and actual application of acquired knowledge and techniques are crucial for the learning of technical skills. We established a wireless sensor network system (WSNS) based on the 5E learning cycle in a practical learning environment to improve students’ reflective abilities and to reduce difficulties for the learning of technical skills. Student learning was investigated using a Technical Expertise Assessment Form and Reflective Abilities Investigation Tool that we had developed. Results of the forms showed that the 5E learning cycle-based WSNS helped improve students’ reflection and the ease in acquiring technical skills. Students’ reflection was also shown to be significantly correlated with the learning of technical skills. We concluded that reflection provided by the sensory functions of the WSNS was able to reduce students’ difficulties when learning technical skills.

Teacher Development and ICT: The Effectiveness of a Training Program for In-service School Teachers

Information and Communications technologies (ICT) are becoming crucial tools for teaching because they improve students’ performance and motivation. For this reason many education programs start to include them as essential grounding for teachers’ repertory. Eighty-five teachers participated in a year-long program in which they learnt to use ICT with the purpose to apply that knowledge into their teaching. The program consisted of three training modules: information and operating systems (i.e. programs for teaching –word, ppt, etc.-, use of internet); Interactive tools (i.e. Digital boards, Android Systems); and multimedia materials and teaching strategies (i.e. web designing, web 2.0). As part of their training they completed a Likert type questionnaire (154 items) about (a) ICT uses, (b) attitudes in classroom and (c) satisfaction with the training received (Cronbach alpha = .89). Descriptive statistics, Factorial Analyses and ANOVA were applied to data. Main findings from the third part of the questionnaire indicate that teachers were highly satisfied with the course syllabus: specially the methodology and the resources. A second reading shows that the learning of teaching strategies and creation of new materials for classroom (module 3) was better valued than the learning of technical skills to manage the suggested programs and technologies. Conclusions point out that advancing towards an effective use of ICT in classroom would further require guided mentoring in practice and peer collaboration besides traditional training.

Student Perceptions of Engineering Service Experiences as a Source of Learning Technical and Professional Skills

A dramatic increase in engineering student participation during the last decade indicates heightened student and faculty interest in engineering service experiences. The first step towards understanding why students are drawn to such opportunities is to examine how students perceive engineering service experiences as an important source of learning technical and professional skills involved in the engineering disciplines. The following study investigates how students compare their service experience with their traditional coursework experience as a source of learning professional and technical skills in engineering. Students’ perception of where they learned professional and technical knowledge or skills provides an insight into the potential impact service-based interventions creates. This study compares service experiences with traditional coursework-based learning to examine the impact of service on students’ perception of learning sources. Students participating in an eclectic and large variety of engineering service experiences were surveyed. Engineering students on average identified that 45% of what they have learned about technical skills and 62% of what they have learned about professional skills was gained through their engineering service experience. Female students credited service experiences as their source of both professional and technical skills significantly higher than male students, and were consistent across academic years. Engineering students’ perceive service-based learning experiences, relative to their traditional course-based learning, to significantly impact what they know about technical and professional engineering outcomes.

Computer-Assisted Orthopedic Training System for Fracture Fixation

Surgical training has been greatly affected by the challenges of reduced training opportunities, shortened working hours, and financial pressures. There is an increased need for the use of training system in developing psychomotor skills of the surgical trainee. To develop the training system for fracture fixation and validate its effectiveness in a cohort of junior orthopedic trainees. TRAINING SYSTEM: Computer-navigated training system uses the 2 sets of images from the c-arm while the registration phantom is placed in the fluoroscopic imaging space which permits determination of the position of the x-ray source and the image plane that then guides the trainee to navigate the surgical instruments into the three-dimensional space. No further c-arm exposures are taken during the entire procedure. The training system was developed to simulate dynamic hip screw fixation. Twelve orthopedic senior house officers performed dynamic hip screw fixation before and after the training on the training system. The results were assessed based on the scoring system that included the amount of time taken, accuracy of guidewire placement, and the number of exposures requested to complete the procedure. The result shows a significant improvement in the amount of time taken, accuracy of fixation, and the number of exposures after the training on the simulator system. The paired student t-test was used and statistically significant results were obtained (p-value< 0.05). Computer-navigated training system appears to be a good training tool for young orthopedic trainees. This system can be used to augment training in the operating room and trainees acquire their skills in a "nonthreatening and unhurried environment." The system has the potential to be used in various other orthopedic procedures for learning of technical skills in a manner aimed at ensuring a smooth escalation in task complexity leading to the better performance of procedures in the operating theater.

Developments in Simulation Bronchoscopy Training

Flexible bronchoscopy is a common procedure. Training in bronchoscopy is a complex process involving learning technical skills, understanding indications and contraindications, risks and benefits of the procedure, working within the team and communicating with patients. It is expected that a competent bronchoscopist is able to maneuver the scope through the anatomically complex bronchial tree, take samples, manage the sedated patient and communicate with nursing staff. Learning the complex procedural skills in the clinical setting can be stressful, therefore current bronchoscopic training methodology should blend a number of learning methods including didactic lectures, web-based material, high and low fidelity simulators as well as supervised apprenticeship training. Simulation-based bronchoscopy training therefore has been explored as a mode of training bronchoscopy skills. In this article, the role of simulation-based bronchoscopy training is reviewed. The low fidelity and high fidelity virtual reality bronchoscopy models are described together with the evidence available to support the use of simulation for bronchoscopy training.

Kayak games and hunting enskilment: an archaeological consideration of sports and the situated learning of technical skills

Inuit kayaks are a hunting technology that requires a high degree of developed skill to operate. The practice involves special types of physical fitness, technical ability, social relationships and extensive environmental knowledge. Hunters must be able to work intuitively as a team, to recognize and react instantly to subtle environmental cues, and depend on instinctive physical capabilities that are committed to muscle memory. These requisite abilities can be developed only experientially. Kayak sports were a critical aspect of learning, and they provided simulative environments to practise and develop sub-sets of hunting skills. Through an examination of a weapon-throwing game, commonly represented at Arctic sites by stone features that are arranged to outline a kayak, this paper explores the didactic nature of sports and theorizes their value in the situated learning of skills for hunter-gatherer technologies.

Investigation of effects of virtual reality environments on learning performance of technical skills

Practical training is what brings imagination and creativity to fruition, which relies significantly on the relevant technical skills needed. Thus, the current study has placed its emphasis on strengthening the learning of technical skills with emerging innovations in technology, while studying the effects of employing such technologies at the same time. As for the students who participated in the study, technical skills had been cultivated in the five dimensions of knowledge, comprehension, simulation, application, and creativity, in accordance to the set teaching objectives and the taxonomy for students learning outcome, while the virtual reality learning environment (VRLE) has also been developed to meet different goals as the various technical skills were being examined. In terms of the nature of technology, operation of machines, selection of process parameters, and process planning in technical skills, VRLE has also designed the six modules of “learning resource”, “digital content”, “collaborative learning”, “formative evaluation”, “simulation of manufacturing process”, and “practical exercise” in particular for providing students with assistance in the development on their technical skills on a specific, gradual basis. After assessing the technical skills that have been developed for the time period of one semester, the students have reported finding VRLE to be a significantly effective method when considering the three dimensions of “operation of machines”, “selection of process parameter”, and “process planning”, though not so much so when it came to the dimension of “nature of technology”. Among the six modules, “simulation of manufacturing process” and “practical exercise” were the two that were most preferred by students for the three dimensions considered.

Risks and Benefits of Social Media for Children and Adolescents

Resources • AAP Internet safety resources site, http://safetynet.aap.org • CDC Social Media Tools Guidelines & Best Practices site, http://www.cdc.gov/SocialMedia/Tools/guidelines/ • Common Sense Media (2010). Advice for Parents. http://www.commonsensemedia.org/advice-for-parents.

Community Resources for Learning: How Capuchin Monkeys Construct Technical Traditions

The developmental importance to humans of the human-constructed physical environment, including myriad modified natural objects or manufactured objects, is well recognized. The importance of the physical dimension of the constructed niche has also been recognized in nonhuman animals with respect to dwellings (e.g., beavers’ dams, birds’ nests, and bees’ hives), but has not previously been applied to technical traditions, despite the fact that enduring alterations of the physical environment left by social partners are part of the constructed niche that supports the learning of technical skills through the phenomenon of delayed social facilitation. These alterations aid learning over a longer time scale than the actions themselves. Thus, technical skills that result in enduring physical artifacts, which themselves aid learning the skills, should be both more persistent in a population and more widespread than technical skills that do not share this feature. This perspective gives us a new lens through which to understand the origins of technical traditions in nonhuman animals, and by extension, in human ancestors. Understanding the process by which traditional technical skills are acquired in nonhuman species gives us insight into the ways that the combination of social and physical niche construction can support the evolution of technical aspects of culture from modest beginnings.

Measuring learning gain during a one-day introductory bronchoscopy course.

BackgroundRigorous assessment of medical knowledge and technical skill inspires learning, reinforces confidence, and reassures the public. Identifying curricular effectiveness using objective measures of learning is therefore crucial for competency-oriented program development in a learner-centric educational environment. The aim of this study was to determine whether various measures of learning, including class-average normalized gain, can be used to assess the effectiveness of a one-day introductory bronchoscopy course curriculum.MethodsWe conducted a quasi-experimental one-group pre-test/post-test study at the University of California, Irvine. The group comprised 24 first-year pulmonary and critical care trainees from eight training institutions in southern California. Class-average normalized gain, single-student normalized gain, absolute gain, and relative gain were used as objective measures of cognitive knowledge and bronchoscopy technical skill learning. A class-average normalized gain of 30% was used to determine curricular effectiveness. Perceived educational value using Likert-scale surveys and post-course questionnaires was determined during and 3 months after course participation.ResultsMean test scores of cognitive knowledge improved significantly from 48 to 66% (p = 0.043). Absolute gain for the class was 18%, relative gain was 37%, class average normalized gain 〈g〉 was 34%, and the average of the single-student normalized gains g(ave) was 29%. Mean test scores of technical skill improved significantly from 43 to 77% (p = 0.017). Absolute gain was 34%, relative gain was 78%, class average normalized gain 〈g〉 was 60%, and the average of the single-student normalized gains g(ave) was 59%. Statistically significant improvements in absolute gain were noted in all five elements of technical skill (p < 0.05). Likert-scale surveys, questionnaires, and surveys demonstrated strong perceived educational value.ConclusionThe effectiveness of a one-day introductory bronchoscopy curriculum was demonstrated using a pre-test/post-test model with calculation of normalized gain and related metrics.Electronic supplementary materialThe online version of this article (doi:10.1007/s00464-010-1161-4) contains supplementary material, which is available to authorized users.

Teaching the personal science: From impeccable trivia to the blooming buzzing confusion

The argument presented here is that the teaching of psychology in the UK is focused on the learning of technical skills and is missing the opportunity to enthuse and inspire students in the personal science. This focus mirrors a general educational drive in the UK towards achievement at external examinations which are assessed by narrow cognitive tasks. The modern tools of education such as Virtual Learning Environments have largely been used to track and monitor students rather than to widen their ideas about learning. Assessments have likewise gravitated towards simple tests while also retaining the redundant task of the unseen essay. This paper considers these developments and discusses alternatives.

Designing a dental curriculum for the twenty-first century

A healthcare curriculum must be up-to-date, fit for purpose and relevant to the population it serves wherever that population might be, worldwide. In this paper we describe the rationale for the design and implementation of a curriculum in a new dental school in UK. We assessed the general and dental health needs of our local population and proposed a set of core skills our dentists will need on graduation and in the future. This core learning falls into three domains of learning. The psychomotor domain covers the learning of technical skills for which we use the shorthand 'hands'. The affective domain covers empathy and behaviour management, that is the 'heart'; and the cognitive domain including critical thinking, the 'head'. The three domains require different ways of learning but all are delivered in context in an integrated, case-based spiralling curriculum building in complexity year on year. Students treat patients from half way through year 1, which helps them appreciate the relevance of the 'hands', 'heart' and 'head' of dentistry as they begin to build their knowledge and experience.

Enabling, Implementing, and Validating Training Methods in Laparoscopic Surgery

The challenges of teaching and learning technical skills for laparoscopic surgery have limited the use of laparoscopy for complex abdominal surgery. In an attempt to facilitate learning these skills, surgical educators are using simulators, but there is little conclusive evidence that simulators can predict improved performance by surgical trainees receiving training on them (predictive validity). In the present study the results of three attempts to establish predictive validity for a virtual laparoscopic simulator were reviewed. In each study, the performance of surgery residents before and after training on the simulator was documented by means of a validated assessment tool, and then the results were compared. Some task performance was improved by training on the simulator, but predictive validity could not be established for the simulator in any of the three attempts to do so. Although predictive validity for the virtual simulator was not conclusively established, reasons for this failure are discussed. Based on the evidence that training on simulators results in some task performance improvement, future studies are justified to better define more effective use of the simulator.

Technical Skills Rotation for General Surgery Residents

Technical skills are an important part of any general surgery residency curriculum. With the demands of limited work weeks, it is imperative that educators create novel methods of teaching technical skills to their residents. Our program utilizes a dedicated month to help accomplish this. This study hypothesized that general surgery residents would report a positive effect of a dedicated technical skills rotation. Residents who had undergone a 1 mo rotation in technical skills during their first year were asked to fill out a survey concerning their experience. During the 1-mo rotation, the residents had almost no clinical responsibilities. Teaching of technical skills was performed with various activities, including video content (VC), virtual reality simulators (VR), open foam procedures (OF), laparoscopic box trainers (BT), surgical equipment in-service (SE), and animate sessions (AS). Responses were given on a Likert scale (1-10) with higher numbers being more positive responses. There were seven residents in this study. The residents gave a very positive response to the overall rotation (9.4) and exposure to laparoscopic procedures (9.6). The other responses were enthusiastic as well: exposure to open procedures (8.9) and preparation for operative room (9.4). After their rotation, the residents were comfortable performing a laparoscopic cholecystectomy (9.2), a hand-sewn anastomosis (8.7), and a stapled anastomosis (9.4). The residents found theses activities helpful in increasing order: VC (7.8), VR (8.0), BT (9.0), ES (9.7), OF (9.8), and AS (9.8). A 1-mo dedicated technical skills rotations was perceived to be extremely positive by the residents. The residents felt very comfortable performing a laparoscopic cholecystectomy, a hand-sewn anastomosis, and a stapled anastomosis. With the 80-h work week, alternatives to learning technical skills in the operating room are essential. Further studies need to be performed to determine if this rotation aids in accomplishing this goal.

Picture of Norwegian clinical learning laboratories for undergraduate nursing students

Clinical preparation for practice is a vital part of undergraduate education in nursing. This study explored contemporary constructions of clinical skills laboratories in two nursing undergraduate programs in Norway using qualitative collective case study methods. Data were gathered using individual and group interviews and observation during site visits. The data revealed slightly different ways of organizing teaching and experimenting with use of pedagogical methods to facilitate learning of technical skills as well as encouraging students to activate relevant theoretical knowledge. While there was a lively and striking enthusiasm among staff about the way learning was managed within the laboratories, the pedagogical underpinnings for their particular approaches were less certain amongst participants. The paper concludes with the necessity to provide evidence for the outcome of laboratories learning and investigate suitable pedagogical methods for effective teaching and learning of practice skills. Hence, a need for research on transfer of knowledge and skills between the different sites (academy, clinical settings, and laboratories) is identified.

Factors Associated with Learning of Technical Skills in Rehabilitation Nursing

Factors Associated with Learning of Technical Skills in Rehabilitation Nursing