Novice Trainees Research Articles

Fiberoptic Intubation vs. Video-Assisted Fiberoptic Intubation in a High-Fidelity Pediatric Simulator: A Randomized Controlled Trial.

Life-threatening hypoxemia during tracheal intubation is more likely to occur in children than adults due to its unique physiological and anatomical nature. Fiberoptic intubation is widely performed in children with difficult airways. However, mastery of fiberoptic intubation requires substantial training, and novice trainees need to attempt fiberoptic intubation in children at high risk of respiratory-related adverse events. Therefore, a safer method than traditional fiberoptic intubation for children with difficult airways is desirable for novice anesthesia trainees. This study aimed to compare the efficacy of video-assisted fiberoptic intubation (VAFI) with that of traditional fiberoptic intubation (FOI) in a high-fidelity pediatric simulator by medical professionals with no experience in tracheal intubation. This randomized, controlled, simulation-based study was conducted in a tertiary-care pediatric hospital. Registered nurses working in the operating room were enrolled in this study and randomly assigned to either the FOI or VAFI groups. Participants in the FOI group performed fiberoptic intubation without the aid of any device, whereas those in the VAFI group used a video laryngoscope to obtain a better glottic view. The primary outcome was the time from the moment the tip of the flexible bronchoscope passed between the upper and lower incisors until the completion of tracheal intubation. A total of 28 participants were enrolled in this study. There was no significant difference in the time until the completion of tracheal intubation between FOI and VAFI, with a median time of 55.0 seconds for FOI and 42.5 seconds for VAFI (P = 0.22). Secondary outcomes, including time until passing the vocal cord, the number of intubation attempts, and the first success rate, did not also illustrate the significant difference between the groups. This study did not demonstrate the superiority of VAFI over conventional FOI in a high-fidelity pediatric simulator by medical providers with no experience in tracheal intubation.

Effectiveness of Flexible Bronchoscopy Simulation-Based Training: A Systematic Review

The implementation of simulation-based training (SBT) to teach flexible bronchoscopy (FB) skills to novice trainees has increased during the last decade. However, it is unknown whether SBT is effective to teach FB to novices and which instructional features contribute to training effectiveness. How effective is FB SBT and which instructional features contribute to training effectiveness? We searched Embase, Pubmed, Scopus and Web of Science for articles on FB SBT for novice trainees until November 10, 2022. We assessed methodological quality of included studies using a modified version of the Medical Education Research Study Quality Instrument (MERSQI), evaluated risk of bias with relevant tools depending on study design, assessed instructional features and intended to correlate instructional features to outcome measures. We identified 14 studies from an initial pool of 544 studies. Eleven studies reported positive effects of FB SBT on the majority of their outcome measures. However, risk of bias was moderate or high in 8 studies and only 6 studies were of high quality (modified MERSQI score ≥ 12.5). Moreover, instructional features and outcome measures varied highly across studies and only 4 studies evaluated intervention effects on behavioral outcome measures in the patient setting. Simulation training programs in studies with the highest methodological quality and most relevant outcome measures all included curriculum integration and range in task difficulty. Although most studies reported positive effects of simulation training programs on their outcome measures, definitive conclusions regarding training effectiveness on actual bronchoscopy performance in patients could not be made, due to heterogeneity of training features and the sparse evidence of training effectiveness on validated behavioral outcome measures in a patient setting.

Are Plastic Surgery Trainees Accurate Assessors of Their Own Microsurgical Skill?

Microsurgery is a technically demanding surgical discipline with a steep learning curve. Trainees have faced several difficulties due to less hands-on theater time and pandemic-related limits on access to technical training. To overcome this, trainees engaged in self-directed training, which requires an accurate self-assessment of skill. This study aimed to assess the ability of trainees to accurately self-assess their performance while performing a simulated microvascular anastomosis. Novice and specialist plastic surgery trainees performed a simulated microvascular anastomosis on a high-fidelity chicken femoral vessel model. Each participant objectively rated the quality of their anastomosis using the Anastomosis Lapse Index (ALI). Two expert microsurgeons subsequently blindly rated each anastomosis. To determine the accuracy of self-evaluation, self-scores and expert-scores were compared using a Wilcoxon signed-rank test. Twenty-seven surgical trainees completed the simulation, with a mean time to completion (TTC) of 40.3 minutes (range 14.2-106.0 minutes). For the entire cohort, the median ALI self-score was 4 (range 3-10), while the median ALI expert-score was 5.5 (range 2.5-9.5). There was a significant difference between the ALI self-score and the expert-score (p<0.001). When grouped by experience level, there was no significant difference between self-score and expert-score within the specialist group, while there was a significant difference within the novice group (p=0.001). These findings suggest that specialist trainees are accurate assessors of their own microsurgical skills, but novice trainees tend to overestimate their technical skills. While novice trainees can engage in independent self-directed microsurgical training, they should seek expert feedback to ensure targeted training.

Muscle typology influences the number of repetitions to failure during resistance training

This study examined whether muscle typology (muscle fiber type composition) is related to maximal strength and whether it can explain the high inter-individual variability in number of repetitions to failure during resistance training. Ninety-five resistance training novices (57 males) were assessed for their maximal isometric knee extension strength and muscle typology. Muscle typology was estimated by measuring carnosine in the soleus, gastrocnemius and/or vastus lateralis using proton magnetic resonance spectroscopy. Forty-four subjects (22 males) performed dynamic strength tests (1RM) and 3 sets of leg extensions and curls to failure (60%1RM) to determine the association between muscle typology and (total) number of repetitions. Twenty-one subjects performed additional biceps curls and triceps extensions (60%1RM) to assess influence of exercise, 23 subjects performed additional leg extensions and curls at 80% and 40%1RM to evaluate influence of training load. There was a weak but significant relationship between muscle typology and maximal isometric strength (r = 0.22, p = 0.03) favoring the fast typology individuals. Slow and fast typology individuals did not differ in upper arm and upper leg 1RM. Total number of repetitions was related to muscle typology at 80% (r = -0.42; p = 0.04) and 60% (p = -0.44; p = 0.003) but not at 40%1RM. Slow typology individuals performed more repetitions to failure at 60%1RM in the leg extension (p = 0.03), leg curl (p = 0.01) and biceps curl (p = 0.02). In conclusion, muscle typology has a small contribution to maximal isometric strength but not dynamic strength and partly determines the number of repetitions to failure during resistance training. This insight can help individualizing resistance training prescriptions.

Video-based training of situation awareness enhances minimally invasive surgical performance: a randomized controlled trial

BackgroundMany training curricula were introduced to deal with the challenges that minimally invasive surgery (MIS) presents to the surgeon. Situational awareness (SA) is the ability to process information effectively. It depends on general cognitive abilities and can be divided into three steps: perceiving cues, linking cues to knowledge and understanding their relevance, and predicting possible outcomes. Good SA is crucial to predict and avoid complications and respond efficiently. This study aimed to introduce the concept of SA into laparoscopic training.MethodsThis is a prospective, randomized, controlled study conducted at the MIS Training Center of Heidelberg University Hospital. Video sessions showing the steps of the laparoscopic cholecystectomy (LC) were used for cognitive training. The intervention group trained SA with interposed questions inserted into the video clips. The identical video clips, without questions, were presented to the control group. Performance was assessed with validated scores such as the Objective Structured Assessment of Technical Skills (OSATS) during LC.Results72 participants were enrolled of which 61 were included in the statistical analysis. The SA-group performed LC significantly better (OSATS-Score SA: 67.0 ± 11.5 versus control: 59.1 ± 14.0, p value = 0.034) and with less errors (error score SA: 3.5 ± 1.9 versus control: 4.7 ± 2.0, p value = 0.027). No difference in the time taken to complete the procedure was found. The benefit assessment analysis showed no difference between the groups in terms of perceived learning effect, concentration, or expediency. However, most of the control group indicated retrospectively that they believed they would have benefitted from the intervention.ConclusionThis study suggests that video-based SA training for laparoscopic novices has a positive impact on performance and error rate. SA training should thus be included as one aspect besides simulation and real cases in a multimodal curriculum to improve the efficiency of laparoscopic surgical skills training.

SURGICAL TEAMS WHO TRAIN TOGETHER IN VIRTUAL REALITY OUTPERFORM THOSE WHO TRAIN INDIVIDUALLY: A RANDOMIZED CONTROLLED TRIAL FOR LEARNING ANTERIOR APPROACH TOTAL HIP ARTHROPLASTY

Current evidence suggests that superior surgical team performance is linked to fewer intra-operative errors, reductions in mortality and even improved patient outcomes. Virtual reality has demonstrated excellent efficacy in training surgeons and scrub nurses individually, however its impact on training teams is currently unknown. This study aimed to assess if training together (scrub nurse and surgeon) in an innovative multiplayer virtual reality program was superior to single player training for novices learning anterior approach total hip arthroplasty (AA-THA).40 participants (20 novice surgeons (CT1-ST3 level) and 20 novice scrub nurses) were enrolled in this study and randomised to individual or team virtual reality training. Individually-trained participants played with virtual avatar counterparts, whilst teams trained live in pairs (surgeon and scrub nurse). Both groups underwent 5 VR training sessions over 6 weeks. Subsequently, they underwent a real-life assessment in which they performed AA-THA on a high-fidelity model with real equipment in a simulated operating theatre. Teams performed together and individually-trained participants were randomly paired up with a solo player of the opposite role. Videos of the assessment were marked by two blinded expert assessors. The primary outcome was team performance as graded by the validated NOTECHs II score. Secondary outcomes were procedure time and number of technical errors from an expert pre-defined protocol.Teams outperformed individually-trained participants for non-technical skills in the real-world assessment (NOTECHS-II score 50.3 ± 6.04 vs 43.90 ± 5.90, p=0.0275). They completed the assessment 28.1% faster (31.22 minutes ±2.02 vs 43.43 ±2.71, p=0.01), and made close to half the number of technical errors when compared to the individual group (12.9 ± 8.3 vs 25.6 ± 6.1, p=0.001).Multiplayer, team training appears to lead to faster surgery with fewer technical errors and the development of superior non-technical skills.

Teaching robotic cystectomy: prospective pilot clinical validation of the ERUS training curriculum.

To provide the first clinical validation of the European Association of Urology Robotic Urology Section (ERUS) curriculum for training in robot-assisted radical cystectomy with intracorporeal urinary diversion (iRARC). The ERUS proposed a structured curriculum, divided into 11 steps, to train novice surgeons and help overcome the steep learning curve associated with iRARC. In this study, one trainee completed the curriculum under the mentorship of an expert. Twenty-one patients were operated on by the trainee following the proposed iRARC curriculum [(t)iRARC group] and were compared with 42 patients treated with the standard of care by the mentor [(m)iRARC group]. To evaluate curriculum safety, peri-operative outcomes, surgical margins and complications were assessed. Propensity-score matching (1:2) was used to identify comparable (t)iRARC and (m)iRARC cases. Matched variables included age, body mass index, neoadjuvant therapy, American Society of Anesthesiologists score and cT stage. Mann-Whitney and chi-squared tests were used to compare peri- and postoperative outcomes between the two cohorts. To evaluate curriculum efficacy, steps attempted and completed by the trainee were assessed and studied as a function of growing surgical experience of the trainee. The trainee progressed in proficiency-based training through steps of increasing difficulty. No differences in estimated blood loss, positive soft tissue margins, number of resected lymph nodes, overall and high-grade complications, or 90-day readmissions between the (t)iRARC and (m)iRARC groups were observed (all P> 0.05). However, operating time was significantly longer in the (t)iRARC group (P= 0.01). Of the 209 available steps, the trainee attempted 168 (80%) and successfully performed 125 (60%). Increasing experience was associated with more steps being successfully performed (P< 0.001). The proposed ERUS curriculum assists naïve surgeons during the learning curve for iRARC and should be encouraged in order to guarantee optimal outcomes during the learning phase of this procedure.

Towards best practice in developing motor skills: a systematic review on spacing in VR simulator-based psychomotor training for surgical novices

ObjectiveRepeated practice, or spacing, can improve various types of skill acquisition. Similarly, virtual reality (VR) simulators have demonstrated their effectiveness in fostering surgical skill acquisition and provide a promising, realistic environment for spaced training. To explore how spacing impacts VR simulator-based acquisition of surgical psychomotor skills, we performed a systematic literature review.MethodsWe systematically searched the databases PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, ERIC and CINAHL for studies investigating the influence of spacing on the effectiveness of VR simulator training focused on psychomotor skill acquisition in healthcare professionals. We assessed the quality of all included studies using the Medical Education Research Study Quality Instrument (MERSQI) and the risk of bias using the Cochrane Collaboration’s risk of bias assessment tool. We extracted and aggregated qualitative data regarding spacing interval, psychomotor task performance and several other performance metrics.ResultsThe searches yielded 1662 unique publications. After screening the titles and abstracts, 53 publications were retained for full text screening and 7 met the inclusion criteria. Spaced training resulted in better performance scores and faster skill acquisition when compared to control groups with a single day (massed) training session. Spacing across consecutive days seemed more effective than shorter or longer spacing intervals. However, the included studies were too heterogeneous in terms of spacing interval, obtained performance metrics and psychomotor skills analysed to allow for a meta-analysis to substantiate our outcomes.ConclusionSpacing in VR simulator-based surgical training improved skill acquisition when compared to massed training. The overall number and quality of available studies were only moderate, limiting the validity and generalizability of our findings.

Implementation of a Student-Teacher-Based Blended Curriculum for the Training of Medical Students for Nasopharyngeal Swab and Intramuscular Injection: Mixed Methods Pre-Post and Satisfaction Surveys.

The COVID-19 pandemic caused a major disruption in the health care sector with increased workload and the need for new staff to assist with screening and vaccination tasks. Within this context, teaching medical students to perform intramuscular injections and nasal swabs could help address workforce needs. Although several recent studies discuss medical students' role and integration in clinical activities during the pandemic, knowledge gaps exist concerning their role and potential benefit in designing and leading teaching activities during this period. The aim of our study was to prospectively assess the impact in terms of confidence, cognitive knowledge, and perceived satisfaction of a student-teacher-designed educational activity consisting of nasopharyngeal swabs and intramuscular injections for the training of second-year medical students in the Faculty of Medicine, University of Geneva, Switzerland. This was a mixed methods pre-post surveys and satisfaction survey study. Activities were designed using evidence-based teaching methodologies based on the SMART (specific, measurable, achievable, realistic, and timely) criteria. All second-year medical students who did not participate in the activity's old format were recruited unless they explicitly stated that they wanted to opt out. Pre-post activity surveys were designed to assess perception of confidence and cognitive knowledge. An additional survey was designed to assess satisfaction in the mentioned activities. Instructional design was blended with a presession e-learning activity and a 2-hour practice session with simulators. Between December 13, 2021, and January 25, 2022, a total of 108 second-year medical students were recruited; 82 (75.9%) students participated in the preactivity survey and 73 (67.6%) in the postactivity survey. Students' confidence in performing intramuscular injections and nasal swabs significantly increased on a 5-point Likert scale for both procedures-from 3.31 (SD 1.23) and 3.59 (SD 1.13) before the activity to 4.45 (SD 0.62) and 4.32 (SD 0.76) after the activity (P<.001), respectively. Perceptions of cognitive knowledge acquisition also significantly increased for both activities. For the nasopharyngeal swab, knowledge acquisition concerning indications increased from 2.7 (SD 1.24) to 4.15 (SD 0.83), and for the intramuscular injection, knowledge acquisition concerning indications increased from 2.64 (SD 1.1) to 4.34 (SD 0.65) (P<.001). Knowledge of contraindications for both activities increased from 2.43 (SD 1.1) to 3.71 (SD 1.12) and from 2.49 (SD 1.13) to 4.19 (SD 0.63), respectively (P<.001). High satisfaction rates were reported for both activities. Student-teacher-based blended activities for training novice medical students in commonly performed procedural skills seem effective for increasing their confidence and cognitive knowledge and should be further integrated within a medical school curriculum. Blended learning instructional design increases students' satisfaction about clinical competency activities. Future research should elucidate the impact of student-teacher-designed and student-teacher-led educational activities.

Disposition Effect: Does Investor Confidence Matter? Examining Service From Securities Brokerages

Purpose: This study aims to analyze the role of training program to develop novice investors confidence in buying a stock. Novice investors undergo dilemma to buy stock due to limited knowledge which resulting disposition effect. Research regarding disposition effect which associated with training for novice investors is still limited&#x0D; &#x0D; Theoretical framework: The disposition effect is the tendency when investors sell stocks that have the potential to experience future profits early, otherwise investors tend to hold stocks that have the potential to experience losses for too long so that investors tend to experience losses. &#x0D; &#x0D; Design/methodology/approach: The research using quantitative approach and employ purposive sampling method with a total sample of 192 respondents. Respondent criteria are novice investor and have limited knowledge in stock market. Each respondent is required to fill questionnaire to obtain data which consist of strongly disagree and strongly agree. Validity, reliability, and hypothesis testing is examined&#x0D; &#x0D; Findings: The results indicate investor training influence investor experience. The result also showed that the training program and investor experience impact investor confidence. The result implies investor need training and experience to reduce disposition effect. The result represents training program, investor experience, and investor confidence affect investor satisfaction&#x0D; &#x0D; Research, Practical &amp; Social implications: The research is asserted that novice investor with limited experience and knowledge need do practice. Novice investor understanding to buy stock will develop investor confidence.&#x0D; &#x0D; Originality/value: The result elaborate training for novice to develop investor confidence and experience. The more experienced investor will reduce disposition effect. Previous research is lack of disposition effect elaboration and its implication on investor satisfaction.

Deriving Expert Knowledge of Situational Awareness in Policing: a Mixed-Methods Study

Situational awareness (SA) is the most important skill required by police to effectively assess and respond to encounters, including critical incidents. Incomplete or sub-optimal SA strategies can lead to errors in subsequent judgement, decision-making, and action, including tactics and use of force (UOF). Errors in UOF, especially lethal force, in training or operational field settings, have severe consequences for learning, occupational health, and public safety. Therefore, adequately defining and instructing SA is an important gap to fill in existing applied police literature and practice. Using a mixed-methods approach, the current study aimed to define and conceptualize SA in police-specific contexts. Participants included 23 novice trainees and 11 experienced officers and instructors in tactics and UOF. Participants were shown 13 static images of various staged encounters, ranging from non-threatening to high-threat. Following each image, participants were interviewed and asked to describe what they saw and how they would respond. Thematic analyses of the interview data revealed the following seven themes that are highly interrelated and more completely define police-specific SA: distance/time laws; partner/roles; profiling the suspect; tactical options and opportunities; ongoing assessment of own tactical activities and outcomes; surrounding environment and conditions; and dangerous objects. Expert officers provided more detailed and multidimensional descriptions of the themes and statistical analyses confirmed that experts identified more themes compared to novices. By making tacit knowledge visible, the current findings establish a professional standard for SA formation, which can inform evidence-based police training in SA, tactical decision-making, and UOF while improving operational safety.

Objective assessment of intraoperative skills for robot-assisted partial nephrectomy (RAPN)

RAPN training usually takes place in-vivo and methods vary across countries/institutions. No common system exists to objectively assess trainee capacity to perform RAPN at predetermined performance levels prior to in-vivo practice. The identification of objective performance metrics for RAPN training is a crucial starting point to improve training and surgical outcomes. The authors sought to examine the reliability, construct and discriminative validity of objective intraoperative performance metrics which best characterize the optimal and suboptimal performance of a reference approach for training novice RAPN surgeons. Seven Novice and 9 Experienced RAPN surgeons video recorded one or two independently performed RAPN procedures in the human. The videos were anonymized and two experienced urology surgeons were trained to reliably score RAPN performance, using previously developed metrics. The assessors were blinded to the performing surgeon, hospital and surgeon group. They independently scored surgeon RAPN performance. Novice and Experienced group performance scores were compared for procedure steps completed and errors made. Each group was divided at the median for Total Errors score, and subgroup scores (i.e., Novice HiErrs and LoErrs, Experienced HiErrs and LoErrs) were compared. The mean inter-rater reliability (IRR) for scoring was 0.95 (range 0.84–1). Compared with Novices, Experienced RAPN surgeons made 69% fewer procedural Total Errors. This difference was accentuated when the LoErr Expert RAPN surgeon’s performance was compared with the HiErrs Novice RAPN surgeon’s performance with an observed 170% fewer Total Errors. GEARS showed poor reliability (Mean IRR = 0.44; range 0.0–0.8), for scoring RAPN surgical performance. The RAPN procedure metrics reliably distinguish Novice and Experienced surgeon performances. They further differentiated performance levels within a group with similar experiences. Reliable and valid metrics will underpin quality-assured novice RAPN surgical training.

Simulation-Based Training on Basic Obstetrics and Gynecology Ultrasound Skills During COVID Pandemic.

COVID-19 pandemic led to an alarming rise in sickness absenteeism among the radiologists. Anticipating a continued shortage of experienced radiologists in future COVID waves, it is essential to train the medical professionals in basic skills related to ultrasonography to enable them to perform basic Obstetrics and Gynecology (OG) scans safely in emergencies. Virtual reality simulation training is an alternative to conventional ultrasound training. A cross-sectional study was conducted during 8-day-long workshop to identify the trainees' basic, after training knowledge and skills in OG ultrasound and to document their perceptions of the training. Statistical analysis was done using descriptive statistics (percentages and mean standard deviations) and paired t test for comparisons. A total of 80 health care professionals underwent ultrasound simulation training. It was found that the post-test score in the knowledge domain, instrument handling, basic gynecological skills, and first-trimester antenatal ultrasound skills in the practical domain was significantly higher than the pre-test score (P-value < 0.0001). Out of 80 participants, 45 (56.25%) agreed that ultrasound simulation is an ideal method of teaching and training basic OG skills to the novice. Sixty-six out of 80 (82.5%) felt that the principles of handling a human mannequin are the same as those of real patients. Forty-eight participants out of 80 (60.0%) felt that ultrasound simulation can be used as an ideal tool for self-assessment of health care professionals. The study showed that ultrasound-based simulation can provide a realistic setting for training and assessment of novices in learning basic skills.

Exploring exercise adherence and quality of life among veteran, novice, and dropout trainees.

The purpose of this study was to identify and reveal the different contexts, variables, and factors that may influence adherence to physical activity among veteran, novice, and dropout trainees, such as the frequency of the weekly training units, the trainees preferred type of exercise, the purpose of the physical activity, and the relationship between support and supervision by fitness instructors and professionals. This study also examined the relationships between trainees, seniority and the strength of the habit and adherence to physical activity, the effects of personal variables such as age and gender on adherence to physical activity, and how the seniority and adherence of trainees may affect their quality of life. A total of 460 participants drawn from the broader Israeli exercise community, which encompasses a diverse range of individuals within the general adult population, were engaged in this study. These participants included seasoned exercisers, individuals who had recently initiated exercise routines, and those who had previously engaged in physical activity. Each participant completed a comprehensive set of questionnaires, including the Self-Report Habit Index, the Exercise Adherence Rating Scale, and the World Health Organization (WHO) Quality of Life Scale. In addition to the questionnaire responses, demographic data and inquiries concerning their physical activity were also collected. The results show that the average frequency of the weekly training units of veteran trainees was significantly higher than that of novice trainees: 3.95 and 2.93, respectively (p < 0.0001). We found no significant differences between novice and veteran trainees regarding their training goal preferences (p = 0.07). Veteran trainees who had been in training for more than a year appeared to have higher self-efficacy since 31.16% reported receiving no supervision compared to 16.67% among novice trainees. In addition, people over 45 appear to have more health-related goals compared to their younger counterparts (p < 0.001). The quality of life scores of the trainees was related to their seniority in physical training, but only by a small magnitude (R2 = 0.06), p < .001). Those who trained in resistance training showed the greatest rate of adherence in relation to flexibility and aerobic training (p < 0.001), and women preferred more body toning and had more weight loss goals than men (p < 0.001). The results indicate that there are central and important factors that may affect adherence to physical activity, and that all these aspects must be taken into account when planning a training program or when there is a desire to maintain or increase adherence to physical activity. The research findings indicate that the main factors that can influence adherence to physical activity are identifying and increasing the trainee's self-efficacy, maintaining weekly training units with sufficient frequency to form a habit and incorporating resistance training into the training regime, as resistance training has shown high levels of adherence. Moreover, it seems that people with different degrees of experience in physical training have distinct and varied training goals, and there is no one goal that fits all. In addition, specific factors such as age and gender must also be taken into account, because the age and gender of the trainees may significantly affect the goals of physical training.

A Cognitive Assistant for Operators: AI-Powered Knowledge Sharing on Complex Systems

Operating a complex and dynamic system, such as an agile manufacturing line, is a knowledge-intensive task. It imposes a steep learning curve on novice operators and prompts experienced operators to continuously discover new knowledge, share it, and retain it. In practice, training novices is resource-intensive, and the knowledge discovered by experts is not shared effectively. To tackle these challenges, we developed an AI-powered pervasive system that provides cognitive augmentation to users of complex systems. We present an AI cognitive assistant that provides on-the-job training to novices while acquiring and sharing (tacit) knowledge from experts. Cognitive support is provided as dialectic recommendations for standard work instructions, decision-making, training material, and knowledge acquisition. These recommendations are adjusted to the user and context to minimize interruption and maximize relevance. In this article, we describe how we implemented the cognitive assistant, how it interacts with users, its usage scenarios, and the challenges and opportunities.

Surgical Anatomy and Exercises Using the Chicken Thigh Sciatic Nerve for Microsurgery Training

Introduction Vessel repair in a chicken thigh is commonly used in microsurgery training model. The sciatic nerve is closely associated with the vessels and has been used for training nerve coaptation, which has different technical considerations from vessel anastomosis. We describe in detail the relevant surgical anatomy and training exercises that can be used with this model.Methods With 32 fresh store-bought chicken thighs, 16 were used to analyze the gross and histological features of the sciatic nerve, and 16 were intended to create and perform training models.Results The average visible length of the nerve in the thigh was 51 mm (standard deviation [SD] 2.57 mm). The average diameter of the nerve was 2 mm (SD 0.33 mm) and was largest at its proximal end (3.21 mm, SD 0.27 mm). The nerve consistently branched into two along the chicken thigh, with more branching subsequently. This simulation model is appropriate not only for the classical end-to-end epineural suture, but also for advanced exercises, in terms of longitudinal fasciculus dissection, mismatched size nerve transfer, injured nerve preparation, and vein conduit technique. Dyeing of nerve fascicles enhanced the visibility of nerve surface quality.Conclusion The sciatic nerve in the chicken thigh is a suitable and accessible model for microsurgery training. The branching and fascicular patterns of the nerve lends itself well to both novice training and advanced simulation. We have incorporated this model into our training curricula.

ПСИХОЛОГО-ПЕДАГОГИЧЕСКАЯ ПОДГОТОВКА НАСТАВНИКОВ ЭКСПЛУАТАЦИОННЫХ СЛУЖБ ГУП «МОСКОВСКИЙ МЕТРОПОЛИТЕН» В КОРПОРАТИВНОМ УНИВЕРСИТЕТЕ ТРАНСПОРТНОГО КОМПЛЕКСА

The article describes the unique practical experience of the development and implementation in the educational process of the Corporate University of the Transport Complex of Moscow of the program of psychological and pedagogical training of mentors of operational services of the State Unitary Enterprise “Moscow Metro”. This training is implemented to prepare mentors for the implementation of non-professional pedagogical activities on an ongoing basis for the adaptation and introduction of new employees into the work process. A brief description of the relevance of mentoring activities in the system of industrial training and adaptation of novice workers is given. The author emphasizes that currently in the Russian Federation mentoring is not only one of the most important areas of personnel policy of many industrial and commercial enterprises, but also represents one of the key vectors of state policy in the field of modernization and development of the domestic education system. The article describes mentoring not only as a certain system of professional corporate training of a new employee (trainee) by transferring knowledge, skills, principles of corporate culture, but also defined as a specific non-professional pedagogical activity. In this regard, the importance of training effective mentors is emphasized as one of the basic tasks of corporate training aimed both at training a novice trainee and at self-development and personal and professional growth of the mentor himself. The author, within the framework of the described program of psychological and pedagogical training of mentors, identifies the functions of a modern mentor and describes possible forms of formation of his psychological and pedagogical competence. The stages of the development of the content part of the program and its thematic sections are shown. At the end, brief results of the implementation of the mentor training system and further plans are given.

Culturally Responsive Chemistry Teaching (CRCT) of College Students as A Novice Teacher: Does It Matter?

Culture is an essential part of human life; cultural involvement in learning can train students to find the meaning of life, including the contribution of chemistry in the cultural context of society. Teachers reported that they struggle to meet students' needs relevant to differences in culture and ability. The study aimed to investigate college students' understanding of chemistry by involving their culture with various methods, including transformative teaching and problem-solving. The research method used descriptive with a qualitative approach. The data collection techniques were projects, interviews, observation, and questionnaires. The findings revealed that the learning process involving cultural aspects could show the contribution of chemical elements in society, especially the formation of scientific cognition. Culturally responsive chemistry teaching is an innovative learning approach to training college students' understanding (novice teachers). The research concludes that a good chemistry teacher can understand the needs of students, especially knowing their cultural background. To effectively teach from diverse backgrounds, schools need teachers who understand the impact of student's home and community cultures on their educational experience. This research can also develop an instructional design, train novice chemistry teachers’ teaching skills, and develop curriculum.

The Effect of Mindfulness Training on the Self-Regulation of Socio-Moral Thoughts.

The change in moral attitude due to discrimination of the degree of reality of thought is an unexplored potential effect of mindfulness training. In this article we examine whether the mindfulness training of novices reduces the defensive reaction to normative transgressions when the threatening thought is salient, that is, a thought that stands out regardless of the objective reality that threatens self-survival. To test the study hypotheses, we used a bifactorial design mindfulness training (pre vs. post) x threatened thought salience (low vs high) in a sample of 115 participants. The dependent variable (punishment of social norm transgression) was measured on two different occasions: (1) pre-training (T1), (2) after training (T2). One group receives training in mindfulness in the threatened thought salience low condition (N = 47), and a second group receives the same training in the threatened thought salience high condition (N = 38). A third group did not receive training in threatening thought salience high condition (N = 30). The results show that training mindfulness reduces moral punishment with high threatening thought salience and reduces moral judgment with low threatening thought salience. The shift in reactivity (punishment) is more representative of a MT effect than the shift in moral judgment (seriousness). Implications of the results and limitations of the study are also explored.

Preoperative Simulation of Retropubic Midurethral Sling to Decrease Bladder Perforation Rate Among Obstetrics and Gynecology Residents.

Bladder perforation is an often avoidable complication of retropubic midurethral sling procedures. Bladder injury rates decrease with surgeon experience, but literature on techniques to train novice surgeons is limited. Our objective was to decrease the bladder perforation rate among obstetrics and gynecology residents during retropubic midurethral sling procedures through implementation of an instructional video and low-fidelity simulation. A baseline bladder perforation rate was determined by retrospective chart review. A prospective educational intervention, consisting of a 10-minute instructional video with preoperative simulation using a simple bony pelvis model, was then implemented among residents on the urogynecology service from December 2017 through March 2020. The primary outcome was the change in the bladder perforation rate. Compliance with the intervention protocol was a secondary outcome. Categorical data were evaluated using the χ 2 or Fisher exact test. Continuous variables were assessed using the Student t test or Mann-Whitney U test as appropriate. Two hundred fifteen retropubic midurethral sling cases were included in analysis. There were no significant demographic differences between the patients undergoing surgery preintervention and postintervention. Resident surgeons were in their second (47.4%) and third (52.6%) years of training. The postintervention bladder perforation rate was 6.5%, which is a 35% reduction from the preintervention perforation rate of 10% ( P = 0.19). The instructional video and preoperative simulation were successfully implemented in 193 of 215 (89.8%) eligible cases. Despite high compliance, the combination of the instructional video and preoperative low-fidelity bony pelvis simulation was not effective in reducing tension-free vaginal tape-associated bladder perforations among residents.