Objective Structured Research Articles

Video-Based Coaching for Laparoscopic Salpingectomy: A Randomized Controlled Trial.

To evaluate the effect of video-based coaching on the gynecology resident performance of laparoscopic salpingectomy. PGY-1 and PGY-2 residents were randomized before their gynecology rotations to standard gynecology curriculum (control group) or standard curriculum plus two video-coaching sessions by a fellowship-trained minimally invasive gynecologic surgeon (VBC group). Residents were video recorded intraoperatively performing three unilateral laparoscopic salpingectomies. Participants in the VBC group were coached between the procedures. The primary outcome was the improvement in modified GOALS (Global Operative Assessment of Laparoscopic Skills) and OSA-LS (Objective Structured Assessment of Laparoscopic Salpingectomy) scores, compared with baseline, in the VBC and control groups, with videos independently graded by three blinded minimally invasive gynecologic surgeons. A minimum sample size of 18 participants (nine per group) was needed to achieve 90% power to detect a difference of 5.0 points. From October 2021 to December 2022, 28 PGY-1 and PGY-2 residents completed the study with 14 participants per group. Baseline characteristics were similar between groups. In the VBC group, modified GOALS scores significantly improved by 3.0 points from video 1 to video 2 ( P =.04) and by 3.2 points from video 1 to video 3 ( P =.02). Modified OSA-LS scores also increased significantly in the VBC group, by 6.1 points from video 1 to video 3 ( P =.02). In the control group, modified GOALS and OSA-LS scores improved from baseline but were not significant ( P =.2, P =.5). Video-based coaching also enhanced resident comfort and confidence in performing laparoscopic surgery. Video-based coaching improves resident performance of laparoscopic salpingectomy and can be used as an adjunct to resident surgical training. ClinicalTrials.gov , NCT05103449.

52991 Objective Structured Assessment of Technical Skills (OSATS) for layered repair, adjacent tissue transfer, and full-thickness skin graft

52991 Objective Structured Assessment of Technical Skills (OSATS) for layered repair, adjacent tissue transfer, and full-thickness skin graft

The Relationship between Anxiety Level and Cognitive Function of Students Class of 2022 Medical Faculty of Universitas Palangka Raya in Dealing with OSCE

Anxiety is a feeling that is often felt in dealing with various life situations that occur to a person. This can also happen to new students taking the Objective Structured Clinical Examination (OSCE). Anxiety that is continuously experienced by students will disrupt their sleep patterns, and lack of sleep results in poor sleep quality which can affect the cognitive and psychomotor aspects of medical students. This study aims to determine the relationship between anxiety levels and students' cognitive function in dealing with OSCE. This research is a cross-sectional study, where the research subjects are students from the class of 2022 who meet the exclusion and inclusion criteria. The research was conducted in June 2023 at the Faculty of Medicine, University of Palangka Raya. This research was conducted on 135 subjects consisting of 41 men and 94 women with an average age of 19(17-21) years. The highest anxiety level before the OSCE exam in the study was a moderate anxiety level of 75.5%. There is no significant relationship between anxiety level (ZSAS score) and cognitive function (Moca-Ina) with p=0.680. In conclusion, there is no relationship between anxiety level and students' cognitive function in dealing with OSCE.

Investigating the usefulness of artificial intelligence-driven robots in developing empathy for English for medical purposes communication: The role-play of Asian and African students

Studies have shown that integrating Artificial Intelligence into robot-assisted language learning ushers in an immersive situation to establish empathy for communication competence and enjoyment. To investigate the usefulness of Artificial Intelligence-driven robots in learning English for Medical Purposes oral skills, this quasi-experimental study was conducted through an embedded mixed methods design in the 2024 academic year. One thousand and forty male (n = 398) and female (n = 642) students of different academic disciplines from the Isfahan University of Medical Sciences were included in the study and grouped under three categories. They were randomly assigned to control (n = 520) and experimental (n = 520) groups. In the qualitative phase, students’ communication enjoyment was debriefed through semi-structured interviews. Simultaneously, in the quantitative phase, once the participants watched simulcast lectures and joined in conversation with Artificial Intelligence-driven (non)-robots, their academic and professional oral skills were assessed. The collected data were the participants’ responses to the interviews and formative assessment of their progress and performance through Objective Structured Video Examinations and Mini-Clinical Evaluation Exercises. The interview results suggested that the participants had empathy in joining conversations with robots. The statistical analysis indicated that in performing role-play to teach oral skills to the Artificial Intelligence-driven robot, the participants achieved significantly greater communication competence than those who did role-play for virtual agents. Students of Medicine were great academic and professional achievers as they were significantly successful in establishing empathy and communication. The findings could open up further prospects for using Artificial Intelligence-driven robots in discipline-specific language learning contexts.

Tetrahedral grids in Monte Carlo radiative transfer

Context. To understand the structures of complex astrophysical objects, 3D numerical simulations of radiative transfer processes are invaluable. For Monte Carlo radiative transfer, the most common radiative transfer method in 3D, the design of a spatial grid is important and non-trivial. Common choices include hierarchical octree and unstructured Voronoi grids, each of which has advantages and limitations. Tetrahedral grids, commonly used in ray-tracing computer graphics, can be an interesting alternative option. Aims. We aim to investigate the possibilities, advantages, and limitations of tetrahedral grids in the context of Monte Carlo radiative transfer. In particular, we want to compare the performance of tetrahedral grids to other commonly used grid structures. Methods. We implemented a tetrahedral grid structure, based on the open-source library TetGen, in the generic Monte Carlo radiative transfer code SKIRT. Tetrahedral grids can be imported from external applications or they can be constructed and adaptively refined within SKIRT. We implemented an efficient grid traversal method based on Plücker coordinates and Plücker products. Results. The correct implementation of the tetrahedral grid construction and the grid traversal algorithm in SKIRT were validated using 2D radiative transfer benchmark problems. Using a simple 3D model, we compared the performance of tetrahedral, octree, and Voronoi grids. With a constant cell count, the octree grid outperforms the tetrahedral and Voronoi grids in terms of traversal speed, whereas the tetrahedral grid is poorer than the other grids in terms of grid quality. All told, we find that the performance of tetrahedral grids is relatively poor compared to octree and Voronoi grids. Conclusions. Although the adaptively constructed tetrahedral grids might not be favourable in most media representative of astrophysical simulation models, they still form an interesting unstructured alternative to Voronoi grids for specific applications. In particular, they might prove useful for radiative transfer post-processing of hydrodynamical simulations run on tetrahedral or unstructured grids.

The objectively structured clinical examination for safe nursing care: a scoping review

Introduction: The Objective Structured Clinical Examination (OSCE) has been utilized as an educational strategy in the training of health professionals. Its application in this context can enhance the development of both technical and non-technical skills, as well as safety in care.Objective: To map the patient safety skills developed by nursing professionals through the Objective Structured Clinical Examination as found in the literature.Method: This is a scoping review structured according to the JBI framework and guided by the Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. The review is registered in the Open Science Framework with the DOI number 10.17605/OSF.IO/MESC3. A search was conducted in the following databases: PubMed, Scopus, Web of Science, Cumulative Index of Nursing and Allied Health Literature (CINAHL), the CAPES Catalog of Theses and Dissertations, and Google Scholar, between February and April 2023.Results: Twenty-five studies were selected, demonstrating that the OSCE is used to train nursing teams with a focus on safety skills such as communication, teamwork, decision-making, clinical care, and situational safety awareness.Conclusion: The OSCE has been used as an educational strategy to improve the quality and safety of care. It is applied from primary care to high-complexity settings to evaluate professional skills that are technical, attitudinal, or behavioral in nature. The use of OSCE aids in the development of professional skills related to patient safety.

Utilizing nano-computed tomography to characterize the structural nature of industrial minerals

Abstract X-ray computed tomography (XRT) is a nondestructive and thus reproducible examination method allowing the three-dimensional (3D) investigation of the internal and external structures of objects regardless of their material and geometry. In the present study, XRT was used to investigate the influence of hydrochloric acid leaching on the composition and constitution of iron-rich bauxite grains. Reducing the iron content in raw bauxites by acid leaching is a promising method for the beneficiation of iron-rich bauxites for subsequent use in the refractory industry. Not only the effect of the leaching process on the chemical composition of the bauxites, but also aspects such as the acid’s influence on the mineralogical composition and the resulting porosity of the individual grains have hardly been taken into account so far. To address these issues, various bauxites were examined before and after acid leaching using XRT analysis and specifically characterized with regard to their constitution.

Designing, Implementing, and Evaluating a Basic Surgical Skills Bootcamp: An Effective Approach to Enhance Competency in Surgical Residency Training

IntroductionRecent technological advances have facilitated the development of new educational methods, such as simulation-based learning, in specialized bootcamps to enhance the learning of surgical residents. This study aimed to design, implement, and evaluate a basic surgical skills bootcamp for residents in general surgery, orthopedics, neurosurgery, and gynecology based on the learning gap in the current educational program. MethodsThis intervention study focused on the design, implementation, and evaluation of a basic surgical skills bootcamp in a simulated operating room for first-year surgical residents in general surgery, orthopedics, neurosurgery, and gynecology. ResultsThe study resulted in the creation of a comprehensive course plan and the execution of a 6-day training program. Evaluation of educational outcomes confirmed high learner satisfaction, improvement in Multiple Choice Questions (MCQ) exam scores, and acceptable scores in the Objective Structured Clinical Examination (OSCE). ConclusionThe findings of this study suggest that surgical bootcamps, when designed based on needs assessment and in line with scientific bootcamp design principles, play a crucial role in enhancing the satisfaction, knowledge, and skills of surgical residents.

Knowledge Retention of Undergraduate Medical Students in Regional Anatomy Following a One-Month Gross Anatomy Course Setting

Background: In the achievement of optimal learning outcomes, knowledge retention presents a major concern for medical students and educators. Practical dissection courses facilitate the consolidation of knowledge of anatomy. Previously, it was shown that a regional anatomy dissection course is more beneficial over a 3-month than a 1-month duration for gathering pre examination knowledge. This study aimed to assess if follow-up anatomy interventions help consolidate regional anatomy knowledge and facilitate knowledge retention of undergraduate medical students. It was hypothesized that knowledge retention could be enhanced using post-dissection teaching interventions. Methods: Upon completion of the dissection course, Objective Structured Practical Examinations (OSPEs) were performed for the neck, thorax, and abdomen immediately before the start of the oral examinations, with follow-ups at 6 and 12 months. Between each of the examinations, virtual and in-person lectures and seminars on (radiologic) anatomy and pathology were held, including Cinematic Rendering, but without additional teaching on human tissues. Results: Significant improvements were observed for knowledge of the neck and abdomen regions in the 6- and 12-month follow-up OSPEs. The effects of knowledge gain were less marked in ethanol-glycerin- than in Thiel-embalmed tissues. Student perceptions regarding tissue quality correlated positively with their assessment of tissue suitability for examination preparation. In conclusion, even anatomy teaching interventions not utilizing human tissues may help consolidate and improve regional anatomy knowledge over a one-year term. Conclusion: Knowledge retention can be enhanced by accompanying virtual with physical teaching interventions.

Characterization of corrosion mechanism and traditional soldering treatment of a composite bronze lamp from the Greco-Roman period of Egypt

This paper presents a study of treatment by soldering for a unique bronze oil lamp combined with Eros and dog figurines. In this object, there are two types of soldering; the first is ancient, used to join the three pieces together, and the other is used in conservation treatments to stop the degradation of the object. Soft solders have been a modern method of repair, with its historical use as the original joining technique demonstrating its general durability and effectiveness. Optical microscopy, portable X-ray fluorescence, and micro-Raman spectroscopy were used to identify the soldering treatment, the chemical composition of the alloy, and the corrosion products. Investigation techniques showed the use of a modern tin-lead alloy as soft soldering in past interventions to treat cracks and fill losses. Cracks propagated due to soil pressures and ongoing corrosion processes, as well as the combined action of tensile forces and the surface-active molten solder. The ancient solder used to attach the dog and Eros to the lamp was a hard solder. The three pieces were made of high-leaded tin bronze, with Pb contents ranging from 10.5 to 13 wt%. The chloride and sulfate corrosion products detected by µ-RS were more aggressive in the object structure. The corrosion products of the soft solder consisted mostly of lead and tin oxides, basic carbonates, and sulfates.

‘Having skin in the game’: guiding principles for incorporating moulage into OSCEs

BackgroundDermatological conditions are a common reason for patients to seek healthcare advice. However, they are often under-represented in Objective Structured Clinical Examinations (OSCEs). Given the visual nature of skin conditions, simulation is suited to recreate such skin conditions in assessments such as OSCEs. One such technique often used in simulation is moulage—the art and science of using special effects make-up techniques to replicate a wide range of conditions on Simulated Participants or manikins. However, the contextual nature of OSCEs places additional challenges compared to using moulage in more general forms of simulated-based education.Main bodyOSCEs are high-stakes assessments and require standardisation across multiple OSCE circuits. In addition, OSCEs tend to have large numbers of candidates, so moulage needs to be durable in this context. Given the need to expand the use of moulage in OSCE stations and the unique challenges that occur in OSCEs, there is a requirement to have guiding principles to inform their use and development.ConclusionInformed by evidence, and grounded in experience, this article aims to provide practical tips for health profession education faculty on how best to optimise the use of moulage in OSCEs. We will describe the process of designing an OSCE station, with a focus on including moulage. Secondly, we will provide a series of important practice points to use moulage in OSCEs—and encourage readers to integrate them into their day-to-day practice.

A Novel Simulation Model and Training Program for Minimally Invasive Surgery of Hallux Valgus.

Minimally invasive surgery (MIS) for hallux valgus (HV) has gained popularity. However, adopting this technique faces the challenges of a pronounced learning curve. This study aimed to address these challenges by developing and validating an innovative simulation model and training program, targeting enhanced proficiency in HV MIS. A training program and a high-fidelity simulation model for HV MIS were designed based on experts' recommendations. Four foot and ankle surgeons without experience in MIS formed the novice group and took the program that encompassed six-session instructional lessons, hands-on practice on simulated models, and immediate feedback. The program concluded with a cadaveric surgery. Four foot and ankle experienced MIS surgeons formed the expert group and underwent the same procedure with one simulated model. Participants underwent blind assessment, including Objective Structured Assessment of Technical Skills (OSATS), surgical time, and radiograph usage. Expert evaluation of the simulation model indicated high satisfaction with anatomical representation, handling properties, and utility as a training tool. The expert group consistently outperformed novices at the initial assessment across all outcomes, demonstrating OSATS scores of 24 points (range, 23 to 25) versus 15.5 (range, 12 to 17), median surgical time of 22.75 minutes (range, 12 to 27) versus 48.75 minutes (range, 38 to 60), and median radiograph usage of 70 (range, 53 to 102) versus 232.5 (range, 112 to 280). Novices exhibited a significant improvement in OSATS scores from the fifth session onward (P = 0.01), reaching the desired performance of 20 points. Performance at the final training with the simulated model did not differ from cadaveric surgery outcomes for all parameters. This study validated a simulation model and training program, allowing nonexperienced HV MIS foot and ankle surgeons to enhance their surgical proficiency and effectively complete a substantial portion of the learning curve at the fifth session, and this performance was successfully transferred to a cadaver model. III.

Effectiveness of a pediatric critical care pilot preceptor program: Improved confidence and competency outcomes among a cohort of professional nurses in Blantyre, Malawi

BackgroundAvailability of high-level pediatric training for nurses in Malawi is limited. To address this gap, a novel pediatric critical care nurse preceptor program was developed and implemented by pediatric nurse specialists. AimEvaluate the effectiveness of a pediatric critical care nurse preceptor program, via change in nurses' knowledge, skills, confidence, and precepting competence. DesignA 12-month pediatric critical care nurse preceptor program with assessments at baseline, end of intensive (3 months), and end of program (6 months). SettingBlantyre, Malawi. ParticipantsNurses with two or more years of pediatric nursing experience (N = 20) nominated by unit managers. MethodsQuantitative data were collected throughout program implementation. Assessments included: (1) multiple choice knowledge test, (2) Objective Structured Clinical Examinations in two areas (vital signs and airway, breathing, circulation, disability, exposure assessments; and blood gas and electrolyte analysis), (3) group simulations (cardiopulmonary resuscitation or respiratory distress), (4) Likert-scale clinical confidence survey, and (5) Likert-scale precepting competence survey. Data were analyzed using repeated measures ANOVA with pairwise comparisons. For Likert-scale surveys, median confidence scores were compared using a Friedman test with post hoc pairwise comparisons using Wilcoxon signed-rank tests. ResultsParticipants demonstrated significant improvement in clinical knowledge (p < .001), vital signs and airway, breathing, circulation, disability, exposure assessment (p = .001), blood gas and electrolyte analysis (p = .001), CPR (p < .001) and respiratory distress (p < .001) simulations, clinical confidence (p = .002), and precepting competence (p = .041). ConclusionThis pediatric critical care nurse preceptor program was effective in improving participants' confidence and competence (knowledge and skills) in pediatric critical care nursing and precepting. Results suggest the program's potential to address the shortage of highly trained pediatric critical care nurses in Malawi. This lays groundwork for refining and expanding preceptorship, ultimately improving pediatric critical care nursing education in resource-limited settings.

Development and Integration of Models for Teaching Ram Breeding Soundness Examinations in Veterinary Education

Proficiency with ram breeding soundness examinations requires competency with palpation, a skill that can be difficult to teach and assess. There are limited small ruminant clinical skills models available, despite the advantages they offer in veterinary education. We developed reusable models for teaching ram breeding soundness examinations, focusing on scrotal assessment and palpation. Then we integrated these models into a practical session where multiple clinical aspects were included. We created anatomically normal (“sound”) testes using 3D modeling software before editing these to display common abnormalities (“unsound” testes). Then, we 3D printed two-part molds and cast the silicone testes. Testes were inserted into siliconized, lubricated stockings facilitating free movement during palpation. Scrotal sacs were sewn from polar fleece and suspended to mimic natural orientation in a live, standing ram. As well as for scheduled classes, we used the models as a station in our course's Objective Structured Clinical Examination (OSCE) assessment. Our models offer advantages in the veterinary education context. Their relatively low cost and durability facilitates their classification as “open access” within our skills lab for student deliberate practice outside scheduled classes. They provide a uniform student learning experience that does not rely on live animals or clinical case load and aligns with best-practice recommendations from accrediting bodies. Student engagement and OSCE outcomes were good, but going forward it would be ideal to collaborate with a program that uses live rams for teaching and assessing this skill to directly examine the impact of our models on confidence and competence.

Low-Stakes, Growth-Oriented Testing in Large-Enrollment General Chemistry 1: Formulation, Implementation, and Statistical Analysis.

We formulate an alternative to high-stakes examinations that is designed to help students grow, and we describe its implementation in a large-enrollment General Chemistry 1 class. In our alternative grading approach, students complete weekly assessments. Each assessment has four items that are aligned to explicit learning objectives and a level in Marzano's taxonomy, retrieval, comprehension, analysis, and knowledge utilization, which can be used by students and instructors to gauge the progression of student learning. Proficiency-based grading and multiple attempts reduce the stakes of the assessments. Unique assessments are generated through a computational infrastructure that draws question stems from an item bank and further randomizes quantities, elements, compounds, reactions, spectra, Lewis structures, orbitals, etc. in the questions. Nearly all assessment items require student-generated responses and cover a complete General Chemistry 1 curriculum. We interpret Marzano's taxonomy in the General Chemistry context and outline the structure of the learning objectives, cognitive levels, assessment schedule, and grading scheme. Item response theory (Rasch analysis) validates the theoretical framework and indicates that assessment items are high quality. Students demonstrate improvement through assessment retakes, and they report that the system motivates them to study and learn.

Rôle des médecins hospitalo-universitaires de médecine interne dans la formation aux métiers de la santé et au sein des institutions en France : enquête du Collège National des Enseignants de Médecine Interne (CEMI)

RationaleOn the occasion of the General stage meeting of Internal Medicine, the National College of Internal Medicine Teachers (CEMI) conducted a survey on teaching activity among all French university hospital (HU) internal medicine specialists. MethodThe survey was carried out in September 2023 by sending an email to 101 hospital practitioners university professors (PU–PH) and 18 hospital practitioners assistant professors (MCU–PH) of internal medicine in subsection 53-01 of the National council of universities (CNU), as well as to the 11 HU internists working in immunology (subsection 47-01) or therapeutics (subsection 48-04). ResultsSeventy-three HUs (56.1%) responded to the survey, including 65 PU–PH, 7 MCU–PH and 1 university hospital practitioner (PHU). Internal medicine HUs participate in faculty teaching: 80% are responsible for teaching, 30% are responsible for the year or cycle or lead committees and 40% have had or have an elected mandate at the faculty or at university. Internal medicine HU are involved in the teaching of semiology during the first cycle of medical studies, but also in pharmaceutical sciences, dentistry, midwifery and in paramedical training. They are very invested in the implementation of the second cycle reform and 80% are involved in the preparation of Objective Structured Clinical Examinations (ECOS), mainly as examiners (90%). They also participate in teaching using simulation (60%), teaching advanced practice nurses (IPA) (25%), and writing CEMI books (75%). For ECOS, 90% participate as examiners, 60% participate in teaching using simulation, 25% are involved in teaching advanced practice nurses (IPA), 75% participated in the writing of CEMI works. Eight (12%) internal medicine HUs co-facilitate training with patients and 26 (38%) participate in master's courses at the Faculty of Sciences. Finally, 94% are affiliated with a research unit and 48% supervise university theses students. ConclusionInternal medicine universities teachers have a strong educational commitment, particularly in semiology and in the reform of the second cycle of medical studies with ECOS and simulation.

A new controllable weak recycling inflow turbulence generator for evaluating wind effects on building in LES

The weak recycling method, known as the “rescaling-recycling” method, has been extended to simulate micro-scale turbulent atmospheric boundary layers (ABL) by employing staggered blocks in the developing section, replicating physical ABL wind tunnel setups. However, this method faces challenges, such as the need to re-evaluate the sizes and configurations of roughness elements when addressing different objective structures, computational domain sizes, or ground exposures. To address these issues, we propose a controllable weak recycling (CWR) method for generating turbulent ABL flows over rough surfaces in large eddy simulation (LES). This method can directly produce a turbulent boundary layer with arbitrary target characteristics in a single simulation, significantly enhancing generation efficiency and reducing computational resource consumption. Our refinement method incorporates a feedback proportional control algorithm into the “rescaling” procedure to minimize errors between simulated and targeted turbulence intensities. Besides, an existing drag model is utilized in the near-ground region to maintain horizontal homogeneous ABL flows over rough surfaces. The proposed CWR method is validated by simulating three turbulent ABL flows over various rough terrains using LES. Results confirm that the generated inflow turbulence adheres to prescribed mean velocities and turbulence intensities, demonstrating consistent self-sustainability along the flow direction. Furthermore, the generated wind spectra closely align with the anisotropic von-Kármán spectrum. When applying the extracted wind time histories at the main domain’s inlet, we find that the mean and fluctuating wind pressures on a high-rise building closely match specified wind tunnel test results.

A study on the impact of open source metaverse immersive teaching method on emergency skills training for medical undergraduate students

BackgroundIn recent years, the traditional simulation-based medical teaching approach has faced challenges in meeting the requirements of practical emergency medicine education. This study utilized open-source tools and software to develop immersive panoramic videos using virtual reality technology for emergency medical teaching. It aims to investigate the efficacy of this novel teaching methodology. This transformation shifted the focus from physical simulation to virtual simulation in medical education, establishing a metaverse for emergency medical teaching.MethodsIn accordance with the curriculum guidelines, the instructors produced panoramic videos demonstrating procedures such as spinal injury management, humeral fracture with abdominal wall intestinal tube prolapse, head and chest composite injuries, cardiopulmonary resuscitation, and tracheal intubation. Using Unity software, a virtual training application for bronchoscopy was developed and integrated into the PICO4 VR all-in-one device to create a metaverse teaching environment. Fourth-year medical undergraduate students were allocated into either an experimental group (n = 26) or a control group (n = 30) based on student IDs. The experimental group received instruction through the metaverse immersive teaching method, while the control group followed the traditional simulation-based medical teaching approach. Both groups participated in theoretical and practical lessons as usual. Subsequently, all students underwent a four-station Objective Structured Clinical Examination (OSCE) to assess the effectiveness of the teaching methods based on their performance. Additionally, students in the experimental group provided subjective evaluations to assess their acceptance of the new teaching approach.ResultsBefore the training commenced, there were no significant statistical differences in the first aid test scores between the experimental and control groups. Following the training, the experimental group outperformed the control group in the four-station OSCE examination, with all P-values being less than 0.05. The satisfaction rate among the experimental group regarding the new teaching method reached 88.46%, reflecting levels of satisfaction and extreme satisfaction.ConclusionThe open-source metaverse immersive teaching method has demonstrated a positive impact on enhancing the emergency skills of medical undergraduate students, with a high level of acceptance among students. In comparison to traditional simulated medical teaching methods, this approach requires less time and space, incurring lower costs, and is deemed worthy of wider adoption.

Investigations into the Geometric Calibration and Systematic Effects of a Micro-CT System.

Micro-Computed Tomography (µCT) systems are used for examining the internal structures of various objects, such as material samples, manufactured parts, and natural objects. Resolving fine details or performing accurate geometric measurements in the voxel data critically depends on the precise calibration of the µCT systems geometry. This paper presents a calibration method for µCT systems using projections of a calibration phantom, where the coordinates of the phantom are initially unknown. The approach involves detecting and tracking steel ball bearings and adjusting the unknown system geometry parameters using non-linear least squares optimization. Multiple geometric models are tested to verify their suitability for a self-calibration approach. The implementation is tested using a calibration phantom captured at different magnifications. The results demonstrate the system's capability to determine the geometry model parameters with a remaining error on the detector between 0.27 px and 0.18 px. Systematic errors that remain after calibration, as well as changing parameters due to system instabilities, are investigated. The source code of this work is published to enable further research.

Video-Based Performance Analysis in Pituitary Surgery - Part 2: Artificial Intelligence Assisted Surgical Coaching

Superior surgical skill improves surgical outcomes in endoscopic pituitary adenoma surgery. Video-based coaching programs, pioneered in professional sports, have shown promise in surgical training. In this study, we developed and assessed a video-based coaching program using artificial intelligence (AI) assistance. An AI-assisted video-based surgical coaching was implemented over 6months with the pituitary surgery team. The program consisted of 1) monthly random video analysis and review; and 2) quarterly 2-hour educational meetings discussing these videos and learning points. Each video was annotated for surgical phases and steps using AI, which improved video interactivity and allowed the calculation of quantitative metrics. Primary outcomes were program feasibility, acceptability, and appropriateness. Surgical performance (via modified Objective Structured Assessment of Technical Skills) and early surgical outcomes were recorded for every case during the 6-month coaching period, and a preceding 6-month control period. Beta and logistic regression were used to assess the change in modified Objective Structured Assessment of Technical Skills scores and surgical outcomes after the coaching program implementation. All participants highly rated the program's feasibility, acceptability, and appropriateness. During the coaching program, 63 endoscopic pituitary adenoma cases were included, with 41 in the control group. Surgical performance across all operative phases improved during the coaching period (P < 0.001), with a reduction in new postoperative anterior pituitary hormone deficit (P= 0.01). We have developed a novel AI-assisted video surgical coaching program for endoscopic pituitary adenoma surgery - demonstrating its viability and impact on surgical performance. Early results also suggest improvement in patient outcomes. Future studies should be multicenter and longer term.