Resident Skills Research Articles

Pelatihan dan Pendampingan Pemanfaatan Media Digital untuk Medukung Peningkatan Pemasaran Produk UKM di Desa Uteunkot Kota Lhokseumawe

The use of digital media by MSMEs, which is increasingly competitive and growing rapidly, requires Small and Medium Enterprises (SMEs) to implement effective and efficient marketing strategies. The use of digital media is very important in marketing SME products in the digital era. However, the problem faced is the lack of knowledge and skills of Uteunkot village residents in utilizing digital media as a marketing tool. Meanwhile, training and mentoring are effective solutions for increasing the use of digital media to support the growth and success of SMEs. This service aims to empower SMEs in Uteunkot Village through digital media to support increased marketing of SME products. The training material covers the use of social media, both content creation and online advertising strategies. The results of the Digital Media Utilization Training and Assistance service showed that 88% and 12% of respondents were satisfied with implementing the service activities. Then, the results of the solution's suitability are expected by partners to increase their productivity and market access using digital technology and be able to compete better in an increasingly competitive market.

Objective improvement in dexterity for trainees undergoing a video-assisted thoracoscopic surgery simulation program, a prospective single center study.

Video-assisted thoracoscopic surgery (VATS) is the recommended approach for the management of early-stage operable non-small cell lung carcinoma as well as for other pathologies of the thoracic cavity. Although VATS approaches have been largely adopted in Europe and North America, teaching the technique to novice thoracic surgery trainees remains challenging and non-standardized. Our objective was to assess the impact of a VATS simulation training program on the dexterity of thoracic surgery residents in a prospective single institution study. We developed a 6-month VATS simulation training program on two different dry-lab simulators (Johnson & Johnson Ethicon Stupnik® lobectomy model; CK Surgical Simulation® Crabtree perfused lobectomy model) and assessed the skills of first year thoracic surgery residents (study group, n=7) before and after this program using three standardized exercises on the Surgical Science Simball® Box (peg placement on a board, rope insertion in loops, precision circle cutting). The results were compared to those of last-year medical students who performed the same Simball® Box exercises at a 6-month interval without undergoing a training program (control group, n=5). For each participant, the travel distances of instruments, operation time and absences of periods of extreme motion were assessed for each exercise by the use of the computer-based evaluation of the Simball® Box. After the 6-month VATS training program, all residents revealed a significant increase of their performance status with respect to instrument travel distances operation times and absence of periods of extreme motion in all three exercises performed. The performance of the control group was not different from the study group prior to the training program and remained unchanged 6 months later, for all exercises and parameters assessed. Our results suggest that the implementation of a VATS simulation training program objectively increases the dexterity of thoracic surgery residents and could be an interesting training tool for their surgical education.

Assessment of Basic Laparoscopic Skills for Surgical Residents on Simulation Based Endotrainer

INTRODUCTION Minimal invasive surgery revolution has bestowed surgeons the power to gain maximum access in surgical area of interest while inflicting minimal trauma. Simulator based training develops cognitive and psychomotor skills which identifies the limitations and strength of learner. AIM To assess the role of endotrainer for development of laparoscopic skills amongst surgical residents. MATERIALS AND METHODS A structured endotrainer program was conducted among 18 surgical residents for a period of 2 months from May – July22 in the department of general surgery in RRMCH, Bangalore, consisting of various tasks which each resident performed regularly for 2 months. The tasks performed were evaluated by a mentor on the basis of Global Rating Scale and the time taken to perform each task and feedback was taken from the subjects. RESULTS T test for 2 dependent mean using SPSS version23 with P value of <0.05 was considered significant. Significant improvement observed in the performance of each participant from DAY1 to DAY30 and further to DAY60 both with respect to time taken as well as GRS score. Day 1, Day 30 and Day 60 GRS mean percentage growth exhibits 45% to 75% to 80% respectively. CONCLUSION Short term training not only proved to show significant improvement in the cognitive performance alongside exploring feedbacks, limitations and building perseverance. We conclude that simulation based training is the need of the hour in this laparoscopy era and should be incorporated as a compulsory module in the curriculum of postgraduate training.

Increasing Knowledge of Residents in Pinang Griya Permai Housing in Waste Management through Training of Organic and Anorganic Waste Recycling by the Teratai Waste Bank

Garbage is currently still a problem for the community where there is a lack of knowledge of waste management properly. The waste bank is present as a solution to assist the government in reducing the accumulation of waste and helping to improve the economy of housewives, especially residents affected by the COVID-19 pandemic. Bank Sampah Teratai (BST) is one of the social group organizations engaged in environmental economics, especially in managing household waste for residents of RW. 05 Pinang Griya Permai, Pinang - Tangerang. Bank Sampah Teratai located in Pinang Griya Permai Tangerang is a partner in this activity. Observation results show that Bank Sampah Teratai does not yet have adequate knowledge in waste management, both organic and inorganic. Based on the above problems, a community partnership program was formed with the academic community (lecturers and students) of Universitas Budi Luhur to help solve problems at the Bank Sampah Teratai. Based on these conditions, training on organic and inorganic waste management was carried out for residents of the Pinang Griya Permai housing. This training provides understanding, and appropriate skills, which help residents to carry out organic and inorganic waste management. Based on the results of the questionnaire after the training was carried out, 100% of participants stated that the material presented was in accordance with their needs, and the material presented was also considered good by 100% of the participants. The long-term result of this training is an increase in the understanding and skills of the residents to manage organic and inorganic waste. This training has been a useful contribution to improving skills for members of the Bank Sampah Teratai in particular, and skills for residents of Pinang Griya Permai housing in general.

Initial validation of the powered mobility device autonomy residential screen (PoMoDARS)

Background The Powered Mobility Device Autonomy Residential Screen (PoMoDARS) is a new tool to enable clinicians to screen resident capacity and performance skills for powered mobility device (PMD) use in residential aged care settings. The PoMoDARS is context specific, time efficient and promotes resident autonomy and safety. Aims To (i) undertake initial face and content validation of the PoMoDARS, and (ii) use the research findings to make any modifications. Methods A mixed-methods study design, underpinned by Classical Test Theory. Eight clinicians completed 20 PoMoDARS screens and provided both quantitative and qualitative feedback on item importance and ease of use within a formal interview. Results Initial face and content validity of the PoMoDARS were supported, with small modifications made to item descriptors and instructions. Conclusions The PoMoDARS has been developed for use in residential aged care settings to screen resident PMD use. While initial validation has been undertaken, further studies to determine the reliability of the tool and continue the validation process are required. Significance Older adults in residential aged care facilities benefit greatly from the autonomy gained through PMD use. The PoMoDARS promotes collaboration between occupational therapists, nurses, and the wider team to support residents and safe PMD use.

Assessment of suturing and scaling skills of periodontology and oral medicine residents by OSATS method: a pilot study

IntroductionUpdating the method for evaluating suturing and scaling skills in dental education has attracted relatively little attention and there is no consensus to what should be assessed and how. The purpose of this study was to investigate the applicability of the Objective Structured Assessment of Technical Skill (OSATS) method for these two basic skills, the possible association between the scores and demographic factors, and the level of satisfaction of residents with this method.MethodsAll six periodontics and three oral medicine residents were recruited by census method and video-recorded while performing a simple interrupted suture, a figure eight suture and scaling on a model. Then, the videos were evaluated independently via a checklist and a global rating scale (GRS) by two expert raters. Agreement between raters and residents’ satisfaction were evaluated. Correlation between demographic factors of participants and scores was also assessed. T-test and linear regression analysis were used.ResultsThere was no significant difference between the scores based on the views of the two raters for each of the checklist (ICC = 0.99, CI = 0.96–0.99, P < 0.001) and GRS (ICC = 0.97, CI = 0.86–0.99, P < 0.001). Linear regression showed no correlation between gender and scores but periodontics major and higher year of education showed correlation with higher scores.ConclusionConsidering the excellent agreement between raters in using both the checklist and GRS components of OSATS, and satisfaction of 88% the residents with this method, it seems to be able to provide a reliable assessment.

Pelatihan Budidaya Larva Lalat Buah Sebagai Pakan Alternatif Produksi Tambak Ikan di Kabupaten Pangkep

This service activity aims to increase the knowledge and skills of fish farming residents regarding cultivating fruit fly larvae (BSF maggots) as an alternative feed for fish pond production in Pangkep Regency. Implementing this service used training and assistance in making alternative feed products. The evaluation instrument for this activity was an interview guide and practice, then analyzed descriptively. This activity showed that training activities on cultivating fruit larvae as alternative feed provided benefits and positive impacts for fish farmers, where farmers could make an alternative feed from fruit fly larvae that was cheaper and had high nutritional value.

Pemberdayaan Masyarakat Berbasis Teknologi Tepat Guna Melalui Instalasi Pengolahan Air Bersih Skala Rumah Tangga di Dusun Kulim Jaya Kabupaten Rokan Hulu

This community service aims to increase the knowledge and skills of Kulim Jaya Village residents in making simple clean water filters on a household scale so that they can get access to clean water more easily. The method of implementing this service used participatory training. The service evaluation instrument was an observation sheet and was analyzed descriptively. The results of this service showed that this simple household-scale clean water filter was able to overcome clean water problems, and there was an increase in residents' knowledge and skills in making clean water filter equipment to overcome clean water difficulties. This simple, clean water filter tool makes it easier for the people of Kulim Jaya Village residents to obtain and increase clean water for their daily needs.

Factors Affecting Learning Essential Procedural Skills in Pediatric Residents: A Cross-sectional Study

Background: Clinical education is a vital component of physician education, where medical students learn by attending to patients and applying their knowledge and reasoning to solve their problems. However, many medical students struggle to acquire procedural skills, the ultimate goal of clinical education. Procedural skills are expected to be learned by the residents according to their academic year and are essential for providing better health services to children and families. Objectives: This study evaluates the status of the training provided and the level of learning the necessary procedural skills in pediatric residents based on standards. Methods: This research was a descriptive cross-sectional method from 1998 to 99. In the first part of the researcher-made questionnaire, the implementation of the educational program on all pediatric residents (115) of Mofid Children's Hospital was evaluated. In the second part, the residents' views on the current state of their learning of essential procedural skills were determined. Results: All residents from years one to four participated in the study. After assessing the status of skills acquired by residents with a questionnaire and comparing the average of each skill acquisition procedure with the desired standards, the average of all skills in all three methods was under the standards approved by the Ministry of Health, except for independent subcutaneous, intramuscular and intravenous injection skills and the skill of working with a ventilator. Also, according to the Friedman test, the lowest score for gaining skills in performing procedures was related to NG tube placement skills and subcutaneous, intramuscular, and intravenous injection skills. According to the statistical results obtained from the Spearman coefficient in all procedures, the level of subcutaneous, intramuscular, and intravenous injection skills had a significant correlation with independent skills. Conclusions: According to the specialized assistants of children participating in this study, the current training program of essential procedural skills implemented at Shahid Beheshti University of Medical Sciences was generally useful and effective. But there were also obstacles and limitations. Therefore, it is recommended to review the implementation of the training programs and implement effective measures, including providing more exposure conditions for independent procedures.

Improving the Procedure of Delivering Serious News: Impact of a Six-Month Curriculum for Second Year Pediatric Residents.

Objective: We implemented and studied a novel curriculum that combined role play, didactic education, and the use of a procedure card for asynchronous learning to improve second-year pediatric residents' skills in delivering serious news. Design: Phase 1 established baseline performance with a self-efficacy survey and observed simulation delivering serious news. Phase 2 included directed education of participants with a validated communication skills training framework. During Phase 3, participants were instructed to review the communication procedure card as a just-in-time reference prior to delivering serious news to patients and their families over 6months. Following this period, participants completed a second self-efficacy survey and engaged in another observed simulation session delivering serious news. Pre and post intervention performance and self-efficacy were compared. Results: A total of 21 out of 26 (81%) participants completed all phases of this study. Participants had a statistically significant increase (p < .001) in self-efficacy scores post-intervention compared to pre-intervention for each of the skills to effectively deliver serious news: assess understanding, communicate news clearly, allow for silence, respond to emotion, and equip for next steps. Additionally, investigator assessments of participants showed an overall statistically significant improvement (p < .001) in all five communication skills post intervention compared to pre intervention. Conclusions: This curriculum resulted in significantly improved self-efficacy and observed ratings of communication skills in second-year pediatric residents over a 6-month period.

Self-assessment of residents in breaking bad news; skills and barriers

IntroductionBreaking bad news (BBN) is inevitable in medicine and is one of the most important and difficult professional tasks of physicians. The main aims of this study are to evaluate residents’ practice of BBN and identify perceived barriers to its implementation.MethodsIn this cross-sectional study in 2021, 240 residents from medical, surgical, and emergency medicine departments completed the demographic questionnaire, the Persian SPIKES questionnaire (P-SPIKES), and the researchers-made questionnaire of Barriers to Breaking Bad News (BBBN). In addition, they were asked about their previous experience, previous training, and their perceived level of competence in BBN.Results46.5% and 36.84% of residents rated their perceived competence in BBN and managing the patient’s emotions during BBN as good or very good, respectively. The most difficult aspects of BBN for residents were expressing upsetting information (78.1%) and not disappointing the patient while being honest (58.3%). The mean and standard deviation of the score of the P- SPIKES was 55.92 ± 6.84. The most common SPIKES item was not giving bad news by phone (98.9%). The SPIKES total score was only related to age (positive relationship). The most commonly reported barriers to BBN were concerns about controlling the patient’s emotions (61%) and the aggressiveness of the patient or companions (52.6%). A significant proportion of participants identified lack of training (28%) and insufficient skills (21.9%) as significant barriers to BBN.ConclusionsThe skill of residents in BBN is insufficient in some aspects and points to the need for BBN training courses during residency. BBN is difficult for residents in some aspects and residents may perceive barriers. To overcome the existing barriers and increase residents’ confidence in BBN, strategies such as incorporating BBN training into residency educational curricula and communication skills are recommended.

Simulating aortic root replacement for a surgical wet laboratory in a resource-limited setting: an economical innovation.

Traditional cardiac surgery residency programs rely mainly on teaching surgical skills in the operating room. The increasing complexity of cardiac surgical operations on high-risk patients and the time constraints placed on residents in this surgical discipline negatively impact the learning opportunities for those residents. Simulation models, though efficient, are very expensive. In Third World Countries, they are unavailable for trainees due to financial constraints. We have introduced an innovative and cost-effective way of simulating aortic root replacement in a wet laboratory by applying a hand-made valve conduit or 'pencil conduit' to a bovine heart. It is reproducible, easy to assemble, cost-effective and simple to use. It can help develop and enhance the surgical skills of residents and junior surgeons for this advanced operation, which requires a meticulous surgical technique performed within a limited time frame.

Impact of cornea recovery training and certification on ophthalmology residents

BackgroundIn Asian countries, such as Taiwan, social taboos regarding organ and tissue donation decreases the prevalence of organ and tissue transplants. This also applies to cornea recovery, which is a skill that requires precision and practice to perform well. In Taiwan, to ensure the maintenance of high-quality corneas, a comprehensive training program and certified examination has been implemented. This study aims to investigate the impact of these programs and examinations on cornea recovery. MethodsResearchers evaluated the efficiency of the training and certified examination process by comparing the corneoscleral rim width, Descemet's membrane folds, endothelial layer stress lines, and endothelial cell density performed by ophthalmology residents in 2018 and 2019. ResultsAfter training and certification, the Descemet's membrane folds rate decreased from 14.3 % to 2.0 % and endothelial layer stress lines rate decreased from 22.5 % to 5.0 %. The endothelial cell density of donor grafts significantly improved from 2681.9 cells/mm2 to 2869.7 cells/mm2 (p < 0.001). ConclusionsThis study used objective data to evaluate cornea recovery quality after training and certification. The training and certified examination significantly improved the surgical skills of ophthalmology residents and could be applied in other tissue or organ recovery procedures to maintain and improve quality.

The Development of an Innovative Crowdsourced Resident Procedure Team Model to Improve Bedside Procedural Proficiency in the Inpatient Setting.

Background Bedside procedures are a necessary skill for many residents. Practice changes, including the discontinuation of a minimum number of procedures required by the American Board of Internal Medicine, may have resulted in decreased incentive for residents to seek procedural opportunities. Objective To improve residents' procedural output and confidence in abdominal paracentesis, arterial and central venous line placement, nasogastric intubation, and ultrasound-guided peripheral intravenous catheter insertions (USPIV). Methods A novel Resident Procedure Team (RPT) model was created using crowdsourced proficient (having completed ≥5 procedures) near-peers in combination with peer-led USPIV simulation workshops to increase the number of supervising residents available. Procedure logs and the number of residents who became qualified to perform and supervise procedures were tracked from July 2018 to June 2022 and compared before and after the implementation of the RPT in July 2020. Results Implementing the novel RPT model significantly increased the number of procedures performed (1875 procedures post-RPT vs 1292 pre-RPT; P=.02). Abdominal paracentesis increased from 411 to 482 (17.3%), central venous line placement increased from 344 to 401 (16.6%), USPIV increased from 318 to 389 (22.3%), arterial line placement increased from 189 to 360 (90.5%), and nasogastric intubation increased from 30 to 243 (710.0%). Resident confidence levels increased significantly after RPT-led USPIV workshops (P<.05 for all). Conclusions Implementation of a novel, crowdsourced, resident-led procedure team and peer-led USPIV workshops helped increase the number of procedures performed by residents.

Teaching Trainees to be Effective Mentors: A Needs-Based Assessment in Radiation Oncology

Mentorship plays a critical role in the training and career development of medical trainees. Teaching-the-teacher workshops for residents translate to higher long-term job satisfaction and improved patient communication skills. Further, near-peer mentorship has been associated with increased job satisfaction and patient care experience. Resident-as-mentors can add benefit to the mentorship networks of students, particularly in resource-limited environments, while benefiting residents' own mentorship relations and career satisfaction. We hypothesized that residents would desire to be a mentor, but would lack specific skills needed for effective mentoring of students in radiation oncology. A multi-institution, cross-sectional study was conducted among residents in the Radiation Oncology Education Collaborative Study Group (ROECSG) Graduate Medical Education working group from 06/2022-10/2022. Participants completed the Mentorship Competency Assessment (MCA), a validated 26-item questionnaire, scored on a Likert scale from 0-7 (0: most unprepared with mentorship skill, 7: most prepared with mentorship skill). The primary endpoint was the average score in individual mentorship skills among participants. Kruskal-Wallis test assessed associations between total MCA score (range 0-182) and demographics. A total of 36 of 39 participants (92% response rate) responded. A majority were male (58%), from a residency size >10 (75%), and P Gy-2/3 (52%). Most had no formal training in teaching (86%) or mentorship (89%). Many believed they would be a good mentor to students on a rotation (89%), but most felt they would benefit from a formal mentorship program (92%). From the MCA, the mentorship skills residents felt most unprepared for were: coordinating effectively with other mentors (3.4/7), helping mentees acquire resources (3.6/7), negotiating a path to professional independence with mentees (3.6/7), helping mentees network effectively (3.7/7), and working with mentees to set clear expectations of the mentoring relationship (3.9/7). The mentorship skills residents felt most prepared for were: acknowledging mentees' professional contributions (5.6/7), establishing a relationship based on trust (5.6/7), active listening (5.5/7), building mentees' confidence (4.9/7), and working effectively with mentees with personal backgrounds differing from one's own (4.8/7). Higher MCA scores were associated with former training in mentorship (p = 0.0143), and a trend for former training in teaching (p = 0.0525), but was not associated with sex (p = 0.5986), residency size (p = 0.1415), or P Gy-year (p = 0.9747). Residents are interested in mentorship training and report unpreparedness in several important skills. Future work should focus on formal training and assessment of mentoring skills for residents.

Narrative Medicine: Teaching Emotional Intelligence and Interpersonal Communication Skills in Plastic Surgery Residency.

Narrative Medicine: Teaching Emotional Intelligence and Interpersonal Communication Skills in Plastic Surgery Residency.

Team Method for Teaching First Aid Skills in a Simulation Center

Simulation technologies are now being actively introduced at all levels of higher education in the training of qualified specialists in medicine: starting with basic general medical skills in junior courses, and ending with teamwork skills for interns and residents, as well as practicing doctors with work experience in the course of additional professional education.

TRANSFORMING RABBIT SKIN WASTE INTO A CRAFT PRODUCT

The establishment of making craft products from rabbit skin is a field that society has not previously explored. This has raised the issue of odour pollution in rabbit skin cultivation and waste disposal areas. Hence, the purpose of this study is to explore the methods of cleaning rabbit skin. Among the methods that should be highlighted is the principle of cleaning the fat inside the skin through a series of cleaning processes. Due to climate in Malaysia, some techniques have been explored and investigated that produce positive results. Initial experiments were carried out with some FELDA Besout 5 residents to determine the accuracy of the flow and cleaning processes. After some experiments, it was discovered that the best ingredients for neutralizing rabbit skin were alum, salt, and mink oil. The material used to clean rabbit skin is readily available; in fact, it is a material that individuals use at home daily. As a result, after the rabbit skin has been cleaned, it can be used to create any type of creative work. The proposed cleaning process module can be used to improve the knowledge and skills of FELDA residents who are directly involved in rabbit farming since this provides a source of revenue for their family. This can aid and mobilize the community to explore and implement the module. It is essential to keep working on involving society in these methodologies to improve their social skills and reveal more social economic lifestyle change. Craft items are an undeniably lucrative product category in tourist areas. Hopefully, rabbit fur products will catch the attention of tourists.

Adapting to a Robotic Era: The Transferability of Open and Laparoscopic Skills to Robotic Surgery

The learning curve of robotic surgical skills is poorly understood. There is a lack of data on the transferability of skills from open and laparoscopic training to robotic surgery. In this retrospective cohort study, we investigated the impact of training acquired during intern year on the development of robotic skills in general surgery residents, prior to formal robotic training. Between 2019 and 2021, novice general surgery residents underwent robotic skill assessment using 3 validated inanimate drills before starting intern year. After completing basic open and laparoscopic proficiency-based curricula, they completed an identical robotic skill assessment at the end of intern year. Pre and post intern year robotic performances were recorded and analyzed by 2 blinded graders. Video-based assessment included completion time, errors, and the modified Objective Structured Assessment of Technical Skills (mOSATS) score. The total time needed to complete all 3 robotic drills decreased from a mean of 26 to 17 minutes after intern year (p < 0.001). The number of errors decreased from a mean of 2.16 to 0.56 errors per subject (p < 0.001). The aggregated mOSATS score increased by an average of 41% (p < 0.001), with a greater increase in technical skill domains compared to the knowledge-based domain. The interrater intraclass correlation coefficient was 0.91. Baseline robotic surgical skills are limited without formal training. Our findings suggest that acquiring basic open and laparoscopic skills, such as knot tying, needle driving, and tissue handling results in improved performance on the robotic platform, prior to formal robotic training. Therefore, requiring trainees to complete fundamental open and laparoscopic training prior to robotic training may be an efficient and effective strategy within a surgical residency curriculum.

Socialization of Making Salted Eggs with Water Media to Improve the Soft Skills of the Residents of Pindrikan Lor Semarang

Eggs are an almost perfect source of animal protein. Consumption of chicken eggs is a perfect food ingredient that contains high nutrients. Increasing the consumption of salted eggs can be done by making salted eggs in a wet way. In using wet media it is very easy to use water media which can be measured with certainty in adjusting the amount of salt content added. Salt levels are very influential in the results of these eggs later. Salt will enter the egg through the pores of the eggshell to the egg white, then to the egg yolk. The salt will draw out the water contained in the egg. through socialization activities on Making Salted Eggs with Water Media to Improve the Soft Skills of Pindrikan Lor Semarang Residents resulting in an understanding of making salted eggs with water media there was a significant increase from 20% to 67%, this shows that the service activities carried out were successful