Level Of Basic Skills Research Articles

Learning from the surgeon’s real perspective – First-person view versus laparoscopic view in e-learning for training of surgical skills? Study protocol for a randomized controlled trial

BackgroundSurgical proficiency is highly dependent on continuous and efficient training. However, efficacy of training hinges on questions such as accessibility and how intuitively the training can be translated into reality. Minimally invasive surgery (MIS) in particular relies on adequate training modalities in order to compensate for its additional psychomotor and visuospatial challenges. The increasing demand for MIS procedures longs for further enhancement of training and steep learning curves. We are investigating a nouveau training concept that continuously utilizes the first person view as addendum to laparoscopic view. We hypothesize this approach to be more intuitive thus faster and more naturally to apprehend than a laparoscopic view only and aim to establish a new standard to implement into training curricula. Methods and analysisThe present study is conducted as a monocentric, two-arm randomized trial. Participants undergo a training curriculum in laparoscopic suturing and knot tying, using e-learning video material with either the first-person perspective of the surgeon or the laparoscopic view only. Primary endpoint is the total training time needed to reach a predefined proficiency level. Participants are evaluated by blinded raters using validated checklists. Number of attempts, procedure and knot quality subscore difference as well as metric parameter analysis from the first and last knots analyzed as secondary endpoints. Furthermore, trainees are assessed with regard to surgical background, basic skills level and spatial awareness. A total sample size of 80 participants for the analysis of the primary endpoint was determined, which will be performed as a two-sided t-test. Ethics and disseminationEthical approval was obtained from the Ethics Committee of the Medical Faculty at Heidelberg University (Code S-334/2011). This trial was registered with the German Clinical Trials Register (DRKS) in Freiburg, Germany, on May 6th (DRKS00009997). The results will be published and presented at appropriate conferences.

Essential Basic Nursing Skills and Clinical Practice Satisfaction of Nursing Students

In this paper, we propose basic materials for effective education of essential basic nursing skills and empirical base supporting the strengthening of essential basic nursing skills. An investigation was conducted with nursing college students ready for an employment on the relationship between the students' knowledge level of essential basic nursing skills and their satisfaction level against the clinical practice. The collected data were analyzed using descriptive statistics, t-test, one-way ANOVA, scheffē test and Pearson's correlation coefficients. in SPSS WIN 21.0 program. The findings of this study were as follows. 1) The knowledge level of essential basic nursing skills received a score of 88.95. 'Admission management' item received the highest score of 4.96 point on a 5 point scale while 'Retention urinary catheterization' item received the lowest score of 3.06. The higher the difficulty level of essential basic nursing skills was, the lower the knowledge level of it was. 2) The satisfaction against the clinical practice received a score of 3.28. In the clinical practice area, the satisfaction against the curriculum received a score of 3.84, the satisfaction against clinical practice contents a score of 3.39, the satisfaction against clinical practice environment a score of 3.17, the satisfaction against clinical practice time a score of 3.15. There was a significant correlation between the knowledge level of essential basic nursing skills and clinical practice satisfaction. These findings indicate that a systematic education of essential basic nursing skills could improve nursing students' satisfaction against the clinical practice.

Microsurgical Training with the Three-Step Approach.

Background Microsurgery is very challenging, requiring a high degree of dexterity and manual skills that should be fully trained outside of the operating room. Common microsurgery courses usually follow a stepwise training approach beginning practice on nonliving models and proceeding with live rats. However, training on live rats raises certain issues, including ethical concerns as well as the associated costs. As such, there is an increasing drive toward alternative models. The current article describes a three-step training approach (latex glove-endovascular prosthesis-human placenta), which aims to prepare trainees for the clinical direct application. Also, to validate it, this approach was compared with microsurgical training on rats. Methods Overall, 20 residents were randomly assigned to two different microsurgical training courses, each based on one of the aforementioned approaches. Residents were evaluated in terms of correct handling of the instruments, correct use of the microscope, adventectomy, triangulation technique, posterior wall technique, success of the end-to-end anastomosis, and ability in assisting the tutor during the arterial anastomosis. Results The three-step and the live rats groups evidenced similar scores in term of acquired basic skill levels. Conclusions The three-step model allows to progressively gain skills on microsurgical techniques and to perform a good vascular anastomosis without the need of further steps on rats. The availability of both endovascular prosthesis and human placenta makes this training model definitely accessible from a practical and logistical point of view.

Data science programs in U.S. higher education: An exploratory content analysis of program description, curriculum structure, and course focus

In this study, an exploratory content analysis of 30 randomly selected Data Science (DS) programs from eight disciplines revealed significant gaps in current DS education in the United States. The analysis centers on linguistic patterns of program descriptions, curriculum requirements, and DS cours e focus as pertaining to key skills and domain knowledge. The results show that a range of unique terms was used in individual program descriptions, with common terms being shared across disciplines. DS programs required varying numbers of credit hours, including practicum and capstone. Most DS courses covered the basic level of analytical skills, but upper-level skills were inadequately addressed. Programs in eight disciplines delivered information skills through their core courses, and four addressed communication skills. Six disciplines covered visualization skills through their core courses, yet just three in elective courses. The course offering on mathematics/statistics was rather weak in iSchools. While core courses in iSchools provided communication and visualization skills, their electives courses did not address such skills. These findings have implications for improving DS education in iSchools and across other disciplines.

Embedding Nursing Informatics Education into an Australian Undergraduate Nursing Degree.

Alongside the rapid rise in the adoption of electronic health records and the use of technology to support nursing processes, there is a requirement for nursing students, new graduate nurses, and nursing educators to embrace nursing informatics. Whilst nursing informatics has been taught at post graduate levels for many years, the integration of it into undergraduate studies for entry level nurses has been slow. This is made more complex by the lack of explicit nursing informatics competencies in many countries. Australia has now mandated the inclusion of nursing informatics into all undergraduate nursing curricula but there continues to be an absence of a relevant set of agreed nursing competencies. There is a resulting lack of consistency in nursing curricula content nationally. This paper describes the process used by one Australian university to integrate nursing informatics throughout the undergraduate nursing degree curriculum to ensure entry level nurses have a basic level of skills in the use of informatics.

Modular training as technology of professional skills development of mechanical engineers

There are main provisions of modular training program by “Theory of Automatic Control” for students of technical universities is treating. Analyze of advantages and disadvantages of modular training system in comparison with the traditional system in the formation of future engineers’ professional skills. Detection of changes in the level of learning, basic skills and motivational sphere of students en-rolled in the modular training program.

Exploring the Self-Reported ICT Skill Levels of Undergraduate Science Students

Computers have taken an important place in the training of science students and in the professional life of scientists. It is often taken for granted that most students have mastered basic Information and Communication Technologies (ICT) skills; however, it has been shown that not all students are equally proficient in this regard. Starting from theories of socialization and technology acceptance we report how we constructed a structural equation model (SEM) to explore the variance in the basic ICT skill levels of science students. We also present the results of a test of this model with university bachelor’s science students. Basic ICT skills were measured using a new, elaborate instrument allowing students to rate their skills in detail. Our results show that science students score high on basic ICT skills and that our SEM explains a large part of the variation in the ICT skill levels of these students. The most explanatory power is coming from four variables: the perceived ease of use and the perceived usefulness of a personal computer, the anxiety for using a personal computer, and students’ belief that ICT is necessary for scientific research.

Face, content, construct, and concurrent validity of a novel robotic surgery patient-side simulator: the Xperience™ Team Trainer.

To determine the face, content, construct, and concurrent validity of the Xperience™ Team Trainer (XTT) as an assessment tool of robotic surgical bed-assistance skills. Subjects were recruited during a robotic surgery curriculum. They were divided into three groups: the group RA with robotic bed-assistance experience, the group LS with laparoscopic surgical experience, and the control group without bed-assistance or laparoscopic experience. The subjects first performed two standard FLS exercises on a laparoscopic simulator for the assessment of basic laparoscopic skills. After that, they performed three virtual reality exercises on XTT, and then performed similar exercises on physical models on a da Vinci(®) box trainer. Twenty-eight persons volunteered for and completed the tasks. Most expert subjects agreed on the realism of XTT and the three exercises, and also their interest for teamwork and bed-assistant training. The group RA and the group LS demonstrated a similar level of basic laparoscopic skills. Both groups performed better than the control group on the XTT exercises (p<0.05). The performance superiority of the group RA over LS was observed but not statistically significant. Correlation of performance was determined between the tests on XTT and on da Vinci(®) box trainer. The introduction of XTT facilitates the training of bedside assistants and emphasizes the importance of teamwork, which may change the paradigm of robotic surgery training in the near future. As an assessment tool of bed-assistance skills, XTT proves face, content, and concurrent validity. However, these results should be qualified considering the potential limitations of this exploratory study with a relatively small sample size. The training modules remain to be developed, and more complex and discriminative exercises are expected. Other studies will be needed to further determine construct validity in the future.

Teaching basic lung isolation skills on human anatomy simulator: attainment and retention of lung isolation skills

BackgroundLung isolation skills, such as correct insertion of double lumen endobronchial tube and bronchial blocker, are essential in anesthesia training; however, how to teach novices these skills is underexplored. Our aims were to determine (1) if novices can be trained to a basic proficiency level of lung isolation skills, (2) whether video-didactic and simulation-based trainings are comparable in teaching lung isolation basic skills, and (3) whether novice learners’ lung isolation skills decay over time without practice.MethodsFirst, five board certified anesthesiologist with experience of more than 100 successful lung isolations were tested on Human Airway Anatomy Simulator (HAAS) to establish Expert proficiency skill level. Thirty senior medical students, who were naive to bronchoscopy and lung isolation techniques (Novice) were randomized to video-didactic and simulation-based trainings to learn lung isolation skills. Before and after training, Novices’ performances were scored for correct placement using pass/fail scoring and a 5-point Global Rating Scale (GRS); and time of insertion was recorded. Fourteen novices were retested 2 months later to assess skill decay.ResultsExperts’ and novices’ double lumen endobronchial tube and bronchial blocker passing rates showed similar success rates after training (P >0.99). There were no differences between the video-didactic and simulation-based methods. Novices’ time of insertion decayed within 2 months without practice.ConclusionNovices could be trained to basic skill proficiency level of lung isolation. Video-didactic and simulation-based methods we utilized were found equally successful in training novices for lung isolation skills. Acquired skills partially decayed without practice.Electronic supplementary materialThe online version of this article (doi:10.1186/s12871-015-0169-7) contains supplementary material, which is available to authorized users.

Sustainability leadership programs in higher education: alumni outcomes and impacts

The diverse set of college and university sustainability leadership programs, which represent a growing trend in higher education, share a common goal: building skills and knowledge for aspiring environmental and sustainability professionals. However, there is little empirical research available to shape program design and implementation. To address this gap, this study builds on sustainability leadership and core competency research as well as previous analysis from the perspective of sustainability leadership program directors with the first evaluation of these programs from the perspective of alumni. The results reveal high expectations for knowledge development and skill building, which are largely being met by programs. Alumni display strong affinity for their programs and report high levels of basic sustainability knowledge and skills upon completion of the program. However, there are significant gaps between program outcomes and perceived needs in the workplace in practice and theory. Despite the realization of program directors that communication skills are the most important outcome of their programs, sustainability leadership programs tend to overemphasize self-reflection/assessment when compared to needs in the workplace. Conversely, these programs tend to underemphasize negotiation, public speaking, facilitation, and coalition-building skills from the perspective of alumni. These gaps likely result from mismatches between faculty competencies and preferences compared to the multiple audiences that these programs serve. Moreover, the literature on core competencies does not provide distinctions between competencies at this scale nor from the perspective of practitioners. Future research on the effectiveness of sustainability leadership programs from the perspective of employers and change-related outcomes would help fill these gaps and improve program design and implementation in addition to better informing the theoretical literature.

Force Variability as an Objective Measure of Surgical Skill

This study investigated the force variability of subjects with different level of surgical skills for different force levels. Twelve participants were recruited from three different levels of surgical experiences: A group of surgeon (N = 4), medical student (N = 3) and engineering student (N = 5) underwent a simple finger force control task using a custom developed ‘Force Matching’ module. Three different levels of target force were used: 2 N, 4 N, and 6 N. The task was performed simultaneously using right and left hands. The mean error of force was measured to compare the performance between the three group using Kruskal-Wallis test. A statistically significant difference was detected among the three groups at 2 N when using right hand. We also found that the surgeon group made less error compared to the two other groups at force level 4 N and 6 N for both hands. This finding has important implication for developing a parametric assessment model to evaluate basic skill level in surgical procedures. However, for most accurate result, a big sample size of subject is required.

Migration background and overall satisfaction with pre-hospital emergency care

ObjectivesThis study was designed to explore how sociodemographic factors of the patient/patient's relatives including migrant status and service-related aspects influence overall satisfaction with pre-hospital emergency care. MethodsA descriptive–analytical study was conducted on 218 persons (57 migrants and 161 nonmigrants) who had received pre-hospital emergency care directly (as a patient) or indirectly (as a significant other) in Germany. Sociodemographic data and service-related aspects were entered into a hierarchical regression analysis in order to identify their influence on overall satisfaction. ResultsAltogether, 58.3% of the variance of the overall satisfaction with pre-hospital emergency care can be explained by the final model. Of this sum, only 9.8% is explained by sociodemographic factors and 47.3% by service-related aspects. Migrant status per se did not show any significant influence, whereas no or a basic level of German language skills is significantly negatively associated with overall satisfaction. Professional and emotional/social competencies of the emergency personnel are significantly positively associated with overall satisfaction with pre-hospital emergency care. ConclusionsSociodemographic-related factors, excepted from language skills, seem to be largely unrelated to overall satisfaction with pre-hospital emergency care. Service-related factors such as the emergency personnel's professional and social/emotional competencies appear as the main factors determining overall satisfaction with pre-hospital emergency care.

Short-term visual deprivation reduces interference effects of task-irrelevant facial expressions on affective prosody judgments.

Several studies have suggested that neuroplasticity can be triggered by short-term visual deprivation in healthy adults. Specifically, these studies have provided evidence that visual deprivation reversibly affects basic perceptual abilities. The present study investigated the long-lasting effects of short-term visual deprivation on emotion perception. To this aim, we visually deprived a group of young healthy adults, age-matched with a group of non-deprived controls, for 3 h and tested them before and after visual deprivation (i.e., after 8 h on average and at 4 week follow-up) on an audio–visual (i.e., faces and voices) emotion discrimination task. To observe changes at the level of basic perceptual skills, we additionally employed a simple audio–visual (i.e., tone bursts and light flashes) discrimination task and two unimodal (one auditory and one visual) perceptual threshold measures. During the 3 h period, both groups performed a series of auditory tasks. To exclude the possibility that changes in emotion discrimination may emerge as a consequence of the exposure to auditory stimulation during the 3 h stay in the dark, we visually deprived an additional group of age-matched participants who concurrently performed unrelated (i.e., tactile) tasks to the later tested abilities. The two visually deprived groups showed enhanced affective prosodic discrimination abilities in the context of incongruent facial expressions following the period of visual deprivation; this effect was partially maintained until follow-up. By contrast, no changes were observed in affective facial expression discrimination and in the basic perception tasks in any group. These findings suggest that short-term visual deprivation per se triggers a reweighting of visual and auditory emotional cues, which seems to possibly prevail for longer durations.

Evaluation of New Primary Education Curriculum Based on Constructivist Learning Approach through the Viewpoints of Teachers

This study aims to determine the implementation levels of common basic skills in the new curriculum based on constructivist learning approach specified by Ministry of Education from the viewpoints of teachers. The scope of the study is limited to the implementation levels of eight common basic skills and the viewpoints of 713 teachers working at first and second grade of primary education. At the study, descriptive method was used. According to the findings, while no significant difference was found at any aspect of the study regarding with the gender variable, according to the variable of institution from which they were graduated, the teachers graduated from faculties of vocational education are better than the other teachers graduated from other schools, and according to the variable of seniority, it is observed that the novice teachers adopt better than the experienced ones and according to the teaching field, classroom teachers are more successful than the other field teachers in implementing new program.

The Availability of Advanced Airway Equipment and Experience with Videolaryngoscopy in the UK: Two UK Surveys.

Fibreoptic intubation, high frequency jet ventilation, and videolaryngoscopy form part of the Royal College of Anaesthetists compulsory higher airway training module. Curriculum delivery requires equipment availability and competent trainers. We sought to establish (1) availability of advanced airway equipment in UK hospitals (Survey I) and (2) if those interested in airway management (Difficult Airway Society (DAS) members) had access to videolaryngoscopes, their basic skill levels and teaching competence with these devices and if they believed that videolaryngoscopy was replacing conventional or fibreoptic laryngoscopy (Survey II). Data was obtained from 212 hospitals (73.1%) and 554 DAS members (27.6%). Most hospitals (202, 99%) owned a fiberscope, 119 (57.5%) had a videolaryngoscope, yet only 62 (29.5%) had high frequency jet ventilators. DAS members had variable access to videolaryngoscopes with Airtraq 319 (59.6%) and Glidescope 176 (32.9%) being the most common. More DAS members were happy to teach or use videolaryngoscopes in a difficult airway than those who had used them more than ten times. The majority rated Macintosh laryngoscopy as the most important airway skill. Members rated fibreoptic intubation and videolaryngoscopy skills equally. Our surveys demonstrate widespread availability of fibreoptic scopes, limited availability of videolaryngoscopes, and limited numbers of experienced videolaryngoscope tutors.

A investigation on cognitive attitude towards male nurses and operational skills of male nurses in different population of five top hospitals in Chengdu

Objective We sought to learn the cognition and attitude of doctors, nurses, patients and patients' family members for male nurses and compare the differences in nursing skills between men and women in order to provide basic information and a basis for further improving the quality of hospital care and promote the comprehensive development of nursing disciplines. Methods Some doctors, female nurses, patients and their family members of patients from the five top hospitals were randomly selected as research subjects to investigate the cognitive attitudes towards male nurses. 50 male nurses from the five top hospitals were randomly selected, then 50 female nurses with the same academic level and specialty were selected as the control group, and nursing skills were compared between the two groups. Results This study investigated a total of 304 doctors, 522 female nurses, 258 patients, 176 patients' family members. The cognition attitude to male nurses by doctors, female nurses, patients and their families showed statistically significant differences. Emergency department, operating room, intensive care unit were four departments which were considered to be in great need of male nurses. The differences were statistically significant between men and women nurses in scores of aseptic technique, intravenous infusion operation, suction operation, single unarmed CPR skills. Pearson correlation analysis was conducted between education, working years and scores and total score of four operation skills, the results showed that working life was correlated with aseptic technique score of female nurses, the correlation coefficient was 0.409, the scores of the remaining skills did not showed correlation with education and working years yet. Conclusions Doctors, female nurses, patients and patients' families showed a certain degree of acceptance and positive attitude to male nurses. Male nurses showed advantages in the emergency department, operating room, intensive care unit and other nursing post. Male and female nurses demonstrated the same level of basic nursing skills. Key words: Male nurses; Cognitive attitude; Operational skills; Investigation

Role of testing before teaching basic laparoscopic skills

Background. The urgency of the problem with training specialists in laparoscopic techniques is due to the wide introduction of minimally invasive technologies into surgical practice. Previously untrained, a surgeon runs considerable difficulties with the coordination of movements and the use of tools, which may lead to both the longer life of surgical aids and damage to the viscera and vascular structures in a patient. Many factors influence the level of manual skills in the audience at the beginning of training, which further affect its duration and hence cost. Objective. To evaluate the effect of initial level of basic manual skills for the duration of the study. Materials and methods. The investigation enrolled 255 listeners: medical students, interns, residents, and practicing surgeons. Manual skills as single successive performance of exercises 1 (peg transfers) and 2 (cutting a circle) in an endotrainer box were tested before training. The correlation of the results of testing for the rate of formation of basic laparoscopic skills was then analyzed. Results. According to the results of the testing, only 20 % of the physicians showed a result of less than 110 s and were ready for being further taught in intracorporeal suturing techniques. The authors consider that all students and interns/residents and most physicians must start their training in laparoscopic technique from a series of basic exercises. The analysis revealed a correlation between the results of doing exercises 1 and 2 and the number of their repetitions to achieve the needed level (r = 0.66). Conclusion. The single performance of peg transfers and cutting a circle exercises before training could objectively measure the performance of laparoscopic skills, define an individual plan, and optimize the costs of the training.

Between building foundational skills and instilling self-guided learning: Solfège pedagogy in higher music education

While in some educational systems solfège is taught systematically from a young age (whether in specialized music schools or in classroom music), in other countries it is a compulsory discipline only in professional education. In the latter case, students start learning solfège as teenagers or young adults but by that time they have already developed some of the solfège skills through years of playing an instrument. What these skills exactly are, and what overall musical knowledge students already have, differs from one student to another. Some are already familiar with certain chord progressions, some have general knowledge about keys and intervals, some have never sung before, and some can already play by ear on their instrument. Students themselves are not always aware of the level of their skills or may have the wrong impression about them. Teachers need time to obtain an objective picture of each student’s abilities. If the teacher wants to build on the students’ pre-knowledge, it can be difficult to decide exactly where to start and which route to take towards the goal. Starting at the level of basic skills makes this much longer and might demotivate students; starting at too high a level will unavoidably leave gaps in knowledge. Many music theory pedagogues choose to start “half way,” after first having systematized all the knowledge and skills that should already have been developed—which might turn out to be both too low and too high at the same time. While there is much research in the domain of solfège issues in music psychology and there are many publications concerning classroom music, almost the only sources of information about solfège methodology for college-level students are solfège method books and textbooks. Conservatory students without previous solfège training are not problematized as a specific group of solfège-learners. In this article I am proposing that conservatory beginners are seen as a specific group of learners who are experienced and novice at the same time. I will point out and discuss several issues that are relevant to the design of the solfège method for this group, especially concerning the first months of learning where the foundation is being built. I will argue that learning solfège in general is a process with its own particularities, and that the awareness of these should be the starting point for the planning of the learning sequence. A solid foundation is seen as the requirement for any further learning, and the role of the teacher is crucial in developing or strengthening it in students. In this context the concepts such as preparation, readiness for learning, repetition, routine, challenge and independent learning are discussed. Through a comparison of methods for children and adult beginners, I aim to explain some of the problems that are encountered in the solfège pedagogy.

Effectiveness of Basic Life Support Instruction in Physical Education Students—A Pilot Study

Background: According to the literature, 40% of injuries affecting school-age children are sports related. The role of physical education students, as future teachers, seems to be of high importance in terms of protecting children's safety during sports classes. Purposes: The aim is to evaluate the level of basic life support (BLS) knowledge and skills in physical education students instructed with the use of different methods. Methods: Second-year physical education students (n = 104, M age = 20 ± 0.6 years) were randomly assigned to three groups: experimental 1 (E1), experimental 2 (E2), and control (C). Group E1 students participated in a 2-hour BLS course based on computer-assisted presentations. Group E2 trainees practiced BLS algorithm in pairs during a 2-hour course. No manikins were used in both intervention groups. Students of Group C were asked to learn BLS algorithm on their own. All groups fulfilled a 10-question multiple-choice test on BLS at the beginning and the end of the experiment. After completing the course participants performed BLS on a manikin. Results: The results of knowledge test were not significant before an experiment but differed essentially among the groups afterward (analysis of variance contrast analysis, p <.05). Regardless of teaching method used, no significant differences were found among the students in preparatory BLS actions and cardiopulmonary resuscitation (CPR) performance on a manikin. The level of CPR performance was very low in all groups. Conclusions: Students of both intervention groups improved their BLS knowledge after the training. Teaching methods used in the current study seemed to be ineffective in terms of practical CPR skills. Access to greater number of modern manikins should improve the BLS training in physical education students. Moreover, permanent consultation on instructional methods with emergency medicine experts is recommended for university teachers.

Experimental Study of Surgeon's Psychomotor Skill Using Sensor-based Measurement

The aim of this study was to identify the measurable parameters to evaluate psychomotor skills and hand dexterity for surgical procedures. An expert surgeon and a group of non-surgeons underwent a simple reaching and pointing task and the data was collected using positional sensor on haptic device. A few parameters were extracted and analyzed from hand movement data such as trial time, trajectories errors, motion smoothness, economy of path length and position errors from target. These parameters were used to compare the performance of psychomotor hand movement between surgeon and non-surgeon. The result shows that the performance of surgeon was better than non-surgeon group for almost all parameters studied. The finding also shows that three out of five parameters were significant to differentiate the performance between surgeon and non-surgeon which are trial time, motion smoothness and errors from the target point. This finding has important implication for developing a parametric assessment model to evaluate basic skill level in surgical procedures.