Senior Trainees Research Articles

633 Are Laparoscopic Skills Transferable to Robotic Assisted Surgery? A Systematic Review

Abstract Aim Surgical education programs are being developed to incorporate robotic technical skills training into pre-existing curricula. With limited availability of robotic training platforms, the aim of this paper was to determine if laparoscopic training can facilitate the acquisition of robotic surgical skills. Method A search was conducted using PubMed, MEDLINE, Embase and Cochrane databases according to PRISMA guidelines. Original articles evaluating the transferability of laparoscopic skills into robotic surgery were included across multiple surgical specialities. Non-peer reviewed papers, conference s, and single surgeon’s experience were excluded. The primary outcome was skills transfer, secondary outcomes included; the level of participant experience, tasks performed and assessment tools used. Results 17 papers were included. 9 (53%) showed good evidence for skill transfer from laparoscopic to robotic surgery, 7 (41%) reported no significant difference. 1 (6%) paper demonstrated prior laparoscopic training had a positive impact on robotic skill but this was diminished for senior trainees. The majority of studies compared residents at different stages of training. All papers assessed simulator surgical specific tasks. There was limited standardisation of assessment processes. No papers assessed tasks in real-life surgical practice. Conclusions Evidence exists to suggest that laparoscopic skills are transferable to robotic surgery in a simulation environment. This is particularly evident for surgical novices and less so for experienced laparoscopists. This could potentially enable the use of established laparoscopic training as a means of reducing the robotic learning curve. Further work is needed to assess laparoscopic to robotic skills transfer in a real-world setting.

Surgical experience and identification of errors in laparoscopic cholecystectomy.

Surgical errors are acts or omissions resulting in negative consequences and/or increased operating time. This study describes surgeon-reported errors in laparoscopic cholecystectomy. Intraoperative videos were uploaded and annotated on Touch SurgeryTM Enterprise. Participants evaluated videos for severity using a 10-point intraoperative cholecystitis grading score, and errors using Observational Clinical Human Reliability Assessment, which includes skill, consequence, and mechanism classifications. Nine videos were assessed by 8 participants (3 junior (specialist trainee (ST) 3-5), 2 senior trainees (ST6-8), and 3 consultants). Participants identified 550 errors. Positive relationships were seen between total operating time and error count (r2 = 0.284, P < 0.001), intraoperative grade score and error count (r2 = 0.578, P = 0.001), and intraoperative grade score and total operating time (r2 = 0.157, P < 0.001). Error counts differed significantly across intraoperative phases (H(6) = 47.06, P < 0.001), most frequently at dissection of the hepatocystic triangle (total 282; median 33.5 (i.q.r. 23.5-47.8, range 15-63)), ligation/division of cystic structures (total 124; median 13.5 (i.q.r. 12-19.3, range 10-26)), and gallbladder dissection (total 117; median 14.5 (i.q.r. 10.3-18.8, range 6-26)). There were no significant differences in error counts between juniors, seniors, and consultants (H(2) = 0.03, P = 0.987). Errors were classified differently. For dissection of the hepatocystic triangle, thermal injuries (50 in total) were frequently classified as executional, consequential errors; trainees classified thermal injuries as step done with excessive force, speed, depth, distance, time or rotation (29 out of 50), whereas consultants classified them as incorrect orientation (6 out of 50). For ligation/division of cystic structures, inappropriate clipping (60 errors in total), procedural errors were reported by junior trainees (6 out of 60), but not consultants. For gallbladder dissection, inappropriate dissection (20 errors in total) was reported in incorrect planes by consultants and seniors (6 out of 20), but not by juniors. Poor economy of movement (11 errors in total) was reported more by consultants (8 out of 11) than trainees (3 out of 11). This study suggests that surgical experience influences error interpretation, but the benefits for surgical training are currently unclear.

SP11.16 Development and Validation of a Novel Simulation-Based Assessment of Operative Skill for Higher Specialist Trainees in General Surgery

Abstract Introduction Simulation is an established training modality, though its use in high-stakes assessment is under-explored. This study sought to develop and validate a novel assessment of operative competence for higher specialist trainees in general surgery. Methods Content validity was derived from a previously conducted Delphi consensus study of trainers. Eight stations were created using a combination of virtual reality and bio-hybrid models. The assessment was designed to assess performance at the end of ‘phase 2’ of training. Performance was scored using an equally weighted Objective Structured Assessment of Technical Skills (OSATS) tool and a modified Procedure Based Assessment (PBA) tool. Validity evidence was analysed in accordance with Messick's validity framework. Both ‘junior’ (ST2 - ST4) and ‘senior’ trainees (ST 5 - ST8) were included to allow for comparative analysis. Results Thirteen trainees (six ‘junior’ trainees and seven ‘senior’ trainees) were observed and scored by a total of ten assessors across eight stations. Inter-station reliability was high (Cronbach's alpha 0.81). Inter-rater reliability was acceptable (inter-class correlation coefficient 0.77). A significant difference in mean station score was observed between junior and senior trainees (44.82 vs 58.18, p = .004). Mean scores were moderately correlated with increasing training year (rs = .74, p = .004, Kendall’s tau-b .57, p = 0.009). A pass-fail score generated using borderline regression methodology resulted in all ‘senior’ trainees passing and 4/6 (66.66%) of junior trainees failing the assessment. Conclusion This study demonstrates the validity, reliability and feasibility of a novel simulation-based assessment, designed to assess the operative competence of higher specialist trainees in general surgery.

EVALUATING BASIC KNEE ARTHROSCOPY SKILLS IN ORTHOPAEDIC TRAINEES IN A LIMITED RESOURCE SETTING

AbstractBackgroundOrthopaedic training in Southern Africa is largely focused on trauma, although elective procedures, such as knee arthroscopy are increasing. This is especially true in the private sector where most trainees will practice. The primary aim of this study was to assess the arthroscopic competency of orthopaedic trainees in a setting of limited resources.MethodsA prospective observational cohort study was carried out. Orthopaedic trainees of a Southern African university hospital performed basic arthroscopy on a knee model. Their surgical competency was assessed by two surgeons proficient in arthroscopy using the modified Basic Knee Arthroscopy Skill Scoring System (mBAKSSS).ResultsA total of 16 trainees (12 male) were included (6 junior and 10 senior trainees). The median age of participants was 36 (34.8, 37). The median mBAKSSS was 28.0 (20.3, 32.5) but showed a large variability (12.0–42.5). The overall reliability was excellent with Cronbach's Alpha of 0.91 and interclass correlation of 0.91 [95% CI 0.75, 0.97].ConclusionsThe average knee arthroscopy proficiency of our trainees is comparable to those of international training programs, but there was great variability with inconsistent skills amongst the trainees. This calls for improved and reproducible arthroscopy training and skills transfer, exposure to procedures and ongoing assessment.

Implementation of an Online Intraoperative Assessment of Technical Performance for Surgical Trainees

IntroductionAssessment of surgical resident technical performance is an integral component of any surgical training program. Timely assessment delivered in a structured format is a critical step to enhance technical skills, but residents often report that the quality and quantity of timely feedback received is lacking. Moreover, the absence of written feedback with specificity can allow residents to seemingly progress in their operative milestones as a junior resident, but struggle as they progress into their postgraduate year 3 and above. We therefore designed and implemented a web-based intraoperative assessment tool and corresponding summary "dashboard" to facilitate real-time assessment and documentation of technical performance. Materials and methodsA web form was designed leveraging a cloud computing platform and implementing a modified Ottawa Surgical Competency Operating Room Evaluation instrument; this included additional, procedure-specific criteria for select operations. A link to this was provided to residents via email and to all surgical faculty as a Quick Response code. Residents open and complete a portion of the form on a smartphone, then relinquish the device to an attending surgeon who then completes and submits the assessment. The data are then transferred to a secure web-based reporting interface; each resident (together with a faculty advisor) can then access and review all completed assessments. ResultsThe Assessment form was activated in June 2021 and formally introduced to all residents in July 2021, with residents required to complete at least one assessment per month. Residents with less predictable access to operative procedures (night float or Intensive Care Unit) were exempted from the requirement on those months. To date a total of 559 assessments have been completed for operations performed by 56 trainees, supervised by 122 surgical faculty and senior trainees. The mean number of procedures assessed per resident was 10.0 and the mean number per assessor was 4.6. Resident initiation of Intraoperative Assessments has increased since the tool was introduced and scores for technical and nontechnical performance reliably differentiate residents by seniority. ConclusionsThis novel system demonstrates that an online, resident-initiated technical assessment tool is feasible to implement and scale. This model's requirement that the attending enter performance ratings into the trainee's electronic device ensures that feedback is delivered directly to the trainee. Whether this aspect of our assessment ensures more direct and specific (and therefore potentially actionable) feedback is a focus for future study. Our use of commercial cloud computing services should permit cost-effective adoption of similar systems at other training programs.

Evaluation of Surgical Requirements and Competencies of the Saudi Ophthalmology Training Program in a Tertiary Eye Specialist Hospital- A Cross-Sectional Study.

To evaluate the adequacy of a Saudi ophthalmology training programs in achieving the competencies outlined by the Saudi Commission for Health Specialties (SCFHS) and the Accreditation Council for Graduate Medical Education (ACGME) and to assess resident satisfaction with their training. A cross-sectional survey was sent electronically to all trainees (n=50) enrolled in the King Khaled Eye Specialist Hospital (KKESH) ophthalmology training program by email and messaging app (Whatsapp). The survey was sent between January 20, 2021, and January 30, 2021. It evaluated the level of satisfaction with surgical training and skills. The surgical logbooks of all trainees were extracted, and identifiers were removed. Then they were compared with SCFHS and ACGME curriculums for ophthalmology training. Out of 50 invitees, 47 returned the questionnaire. All trainees were confident they could meet surgical requirements by the end of their training. Most trainees were satisfied (n=29, 61.7%) with their performance in core competency requirements. There was no difference between female and male trainees' comfort levels when performing surgical steps in core competency requirements (P=0.2). Senior trainees seem more satisfied with their performance, especially in core competency requirements (P=0.087). All trainees practice at the wet lab and a virtual reality simulator to improve their skills. Obstacles faced during training were highlighted, including low exposure in the operating theater (n=18, 37.50%), competition on cases (n=5, 10.42%), attending surgeons not willing to teach (n=5, 10.42%), COVID-19 pandemic (n=5, 10.42%), and complex cases (n=4, 8.33%). The outcomes of the current study indicate that trainees at KKESH were adequately satisfied with their surgical training in general. Also, competencies outlined by both the SCFHS and the ACGME were adequately fulfilled.

The consequences of limited training in disorders of gut-brain interaction: Results from a national survey of gastroenterology trainees in the United Kingdom.

Despite their high prevalence and burden, disorders of gut-brain interaction (DGBI) are undertaught and underrepresented in medical curricula. We evaluated the exposure of UK gastroenterology trainees to DGBI and their comfort managing these conditions. An electronic survey was distributed to trainees via UK training program directors. The survey included questions on stage of training; subspecialty interest; access to DGBI training opportunities, and comfort levels with DGBI diagnosis and management. Responses were compared between junior and senior trainees, by subspecialty interest (luminal and non-luminal), by geographical region, and training program size. One hundred twelve trainees from across the UK participated (21.4% of national training post holders). Exposure to DGBI lectures (32.8% junior vs. 73.3% senior trainees, p = 0.00003) and clinics (9.0% junior vs. 42.2% senior trainees, p = 0.00003), increased with seniority. Regardless of seniority, most trainees were rarely comfortable making a DGBI diagnosis (39.5% senior vs. 33.9% junior trainees, p = 0.69), and were not comfortable initiating neuromodulators (50% senior vs. 25.8% junior trainees, p = 0.08). Trainees without a luminal subspecialty interest (50%) accessed fewer DGBI clinics (p = 0.04), had less communication skills training (p = 0.04) and were less likely to have been observed during DGBI consultations (p = 0.002). Responses were similar across UK regions and did not differ between smaller and larger programs. DGBI training opportunities are limited in UK gastroenterology training across training grades. Most trainees lack confidence with DGBI diagnosis and management. Urgent interventions need to be targeted at all stages of training to ensure DGBI competencies for future gastroenterologists and improve patient outcomes.

Formation and Assessment of a Laryngology Pathology Video Atlas for Resident Education

Conventional reference images of laryngeal pathologies may provide educational value for Otolaryngology-Head & Neck Surgery (OHNS) residents, but observing dynamic vocal fold function is critical for diagnosis. Our aim was to develop and validate a video atlas of laryngeal pathologies for resident education in OHNS. A multi-institution, prospective case-control study. Ten videos showing 10 representative laryngeal pathologies were verified by two laryngologists. Six videos per category with kappa>0.8 were included in the video database. A collection of the videos was shown to a group of OHNS residents in a quiz fashion to determine if senior trainees would score higher than junior trainees. Another group of residents in OHNS was recruited and randomized to control or intervention. The control group was shown a quiz of 10 laryngeal videos at baseline and 24 weeks later. The intervention group was shown quizzes at baseline and every 6 weeks, ending at 24 weeks. Free-text diagnoses were scored for accuracy. Descriptive statistics, two-tailed tests, and analysis of covariance were performed. Twenty-nine residents participated, with 14 (48.3%) randomized to control, and 15 (51.7%) to the intervention. The postgraduateyear (PGY) level had a significant impact on diagnostic performance. PGY1 and 2 had a significantly lower score than PGY5 (P=0.017 and P=0.035, respectively). PGY3 and PGY4 scores were not statistically different from PGY5 scores. The mean score difference between groups decreases as the PGY level increases (mean difference between groups=0.87, P=0.153), but this was not significant. The current study has created a validated collection of videos that are representative of common laryngeal pathologies and can be easily incorporated into resident video-based learning. Future directions include larger multi-site studies to further elucidate whether repeated viewing of this video atlas can improve OHNS resident laryngology knowledge.

The role of Gender in Operative Autonomy in orthopaedic Surgical Trainees (GOAST).

Global literature suggests that female surgical trainees have lower rates of independent operating (operative autonomy) than their male counterparts. The objective of this study was to identify any association between gender and lead/independent operating in speciality orthopaedic trainees within the UK national training programme. This was a retrospective case-control study using electronic surgical logbook data from 2009 to 2021 for 274 UK orthopaedic trainees. Total operative numbers and level of supervision were compared between male and female trainees, with correction for less than full-time training (LTFT), prior experience, and time out during training (OOP). The primary outcome was the percentage of cases undertaken as lead surgeon (supervised and unsupervised) by UK orthopaedic trainees by gender. All participants gave permission for their data to be used. In total, 274 UK orthopaedic trainees submitted data (65% men (n = 177) and 33% women (n = 91)), with a total of 285,915 surgical procedures logged over 1,364 trainee-years. Males were lead surgeon (under supervision) on 3% more cases than females (61% (115,948/189,378) to 58% (50,285/86,375), respectively; p < 0.001), and independent operator (unsupervised) on 1% more cases. A similar trend of higher operative numbers in male trainees was seen for senior (ST6 to 8) trainees (+5% and +1%; p < 0.001), those with no time OOP (+6% and +8%; p < 0.001), and those with orthopaedic experience prior to orthopaedic specialty training (+7% and +3% for lead surgeon and independent operator, respectively; p < 0.001). The gender difference was less marked for those on LTFT training, those who took time OOP, and those with no prior orthopaedic experience. This study showed that males perform 3% more cases as the lead surgeon than females during UK orthopaedic training (p < 0.001). This may be due to differences in how cases are recorded, but must engender further research to ensure that all surgeons are treated equitably during their training.

Senior trainee as endoscopy teacher: impact on trainee learning and attending experience

ObjectiveTraining in how to effectively teach endoscopy is not included in most gastroenterology (GI) training programme curricula, yet many gastroenterologists are expected to teach endoscopy in their careers. Near-peer teaching...

Time to VENT: a weekly, voluntary peer support initiative to improve colleague wellbeing and promote reflective practice

Background: Anaesthesia trainees are particularly susceptible to burnout and depression.1 2 The Association of Anaesthetists of Great Britain and Ireland suggest that wellbeing interventions warrant further research, leading to campaigns such as ‘#CoffeeAndAGas’. A pre-intervention survey showed, within our department, that being on call causes stress that negatively impacts trainees’ wellbeing beyond shifts and there is not always someone who understands their job role to talk to. Trainees do not want to speak to consultants or supervisors about these wellbeing issues but are more willing to speak to colleagues of a similar grade. Therefore, weekly VENT sessions were designed and implemented in our department. Methods: Weekly, voluntary, 30-min VENT sessions were organised for all junior anaesthetists. Ground rules were displayed at the beginning of every session. Core principles included: voluntary engagement, mutual respect, no consultant presence, complete confidentiality, and non-judgmental discussion. The aims were to promote wellbeing through offloading, developing reflective practice, and stimulating culture change. Sessions were structured the same way to promote a comfortable, empathetic, and open environment. The sessions included Vocalising how you really feel, Empathising with colleagues (sharing similar feelings, experiences, and advice), learning a New wellbeing theory or mindfulness technique each session, and finally, Talking about cases and experiences. Anonymous surveys were sent to attendees after four sessions to assess impact and gain feedback. Results: Voluntary attendance was sustained at 95% of all available trainees. Ten (90%) responded to the post session survey. All respondents believed the sessions were helpful for wellbeing and were valuable for learning, with most (80%) seeing value in learning wellbeing theory. All felt the sessions will promote ‘cultural change’ and have a positive impact on overall wellbeing. All respondents believed VENT should be offered by other hospitals and should continue in our hospital. Free text feedback included comments expressing relief and reassurance gained from speaking to more senior trainees, relieving stress, and improving confidence. Trainees also found it helpful to talk through scenarios which aided their own reflection and processing of difficult situations. Conclusion: Junior anaesthetists feel more comfortable speaking to their peers about wellbeing issues than to consultants. The ability to talk to colleagues about things that have happened whilst working is beneficial. Promoting an open environment with a familiar structure exceeded expectations of colleague engagement with most colleagues attending regularly. VENT allows learning from each other’s experiences, and revisiting of personal experiences allows improved reflective practice. VENT is also beneficial in teaching colleagues how to look after their own wellbeing. Overall, regular VENT sessions have had a positive impact on personal wellbeing of our trainees and should become embedded into practice, and be adopted by other hospitals. 1.Looseley A, Wainwright E, Cook TM, et al. Anaesthesia 2019; 74: 1231–92.Nyssen AS, Hansez I, Baele P, Lamy M, De Keyser V. Br J Anaesth 2003; 90: 333–7

Rapid Prototyping Techniques for the Development of a Take-Home Surgical Anastomosis Simulation Model

The objective of this paper is to describe the techniques and process of developing and testing a take-home surgical anastomosis simulation model. Through an iterative process, a simulation model was customized and designed to target specific skill development and performance objectives that focused on anastomotic techniques in thoracic surgery and consist of 3D printed and silicone molded components. Various manufacturing techniques such as silicone dip spin coating and injection molding have been described in this paper and explored as part of the research and development process. The final prototype is a low-cost, take-home model with reusable and replaceable components. The study took place at a single-center quaternary care university-affiliated hospital. The participants included in the model testing were 10 senior thoracic surgery trainees who completed an in-person training session held during an annual hands- on thoracic surgery simulation course. Feedback was then collected in the form of an evaluation of the model from participants. All 10 participants had an opportunity to test the model and complete at least 1 pulmonary artery and bronchial anastomosis. The overall experience was rated highly, with minor feedback provided regarding the set- up and fidelity of the materials used for the anastomoses. Overall, the trainees agreed that the model was suitable for teaching advanced anastomotic techniques and expressed an interest in being able to use this model to practice skill development. Developed simulation model can be easily reduced, with customized components that accurately simulate real-life vascular and bronchial components suitable for training of anastomoses technique amongst senior thoracic surgery trainees.

Current update on multimodal analgesia and nonopiate surgical pain management

Based on the Competency Assessment Tool, herein we developed an assessment instrument suitable to evaluate the implantation of central intravenous devices.Surgical assessment is based mainly on the subjective impressions of the teacher. Based on the “Competency Assessment Tool” (CAT) developed for the evaluation of technical surgical skills in minimally invasive colorectal resection, we designed an assessment tool suitable to evaluate the implantation of central venous access devices performed by junior surgical trainees.Four major assessments during the different steps of the intervention were used in this evaluation. Each of these tasks was divided into four sub-domains according to surgical skill. In addition to the CAT score, the apprentices’ skills were evaluated using a visual assessment that was quantified using an analogue scale (value from 1 to 10). The candidates were classified into junior and senior trainees depending on the number of procedures they had already performed and on their surgical experience.71 procedures were evaluated during the study period. Seven senior trainees conducted 43 procedures and five junior trainees performed 28 interventions. The senior trainees had significantly higher CAT scores than junior candidates, and the scores fluctuated according to surgical experience, usually reaching their peak after 10 procedures.The CAT model is well suited for the assessment of surgical trainees during central venous access device implantation. It enables a close assessment of the learning process and the technical skills of trainees, which helps them improving in a safe, standardized manner.

Evaluation of Technical Performance of Ultrasound-Guided Procedures through Hand Motion Analysis: An Exploration of Motion Metrics

PurposeTo evaluate the ability of hand motion analysis using conventional and new motion metrics to differentiate between operators of varying levels of experience for central venous access (CVA) and liver biopsy (LB). Materials and MethodsIn the CVA task, 7 interventional radiologists (experts), 10 senior trainees, and 5 junior trainees performed ultrasound-guided CVA on a standardized manikin; 5 trainees were retested after 1 year. In the LB task, 4 radiologists (experts) and 7 trainees biopsied a lesion on a manikin. Conventional motion metrics (path length and task time), a refined metric (translational movements), and new metrics (rotational sum and rotational movements) were calculated. ResultsIn the CVA task, experts outperformed trainees on all metrics (P < .02). Senior trainees required fewer rotational movements (P = .02), translational movements (P = .045), and time (P = .001) than junior trainees. Similarly, on 1-year follow-up, trainees had fewer translational (P = .02) and rotational (P = .003) movements with less task time (P = .003). The path length and rotational sum were not different between junior and senior trainees or for trainees on follow-up. Rotational and translational movements had greater area under the curve values (0.91 and 0.86, respectively) than the rotational sum (0.73) and path length (0.61). In the LB task, experts performed the task with a shorter path length (P = .04), fewer translational (P = .04) and rotational (P = .02) movements, and less time (P < .001) relative to the trainees. ConclusionsHand motion analysis using translational and rotational movements was better at differentiating levels of experience and improvement with training than the conventional metric of path length.

MP66-12 SENIOR VS. JUNIOR UROLOGY TRAINEES: FACTORS ASSOCIATED WITH BURNOUT

You have accessJournal of UrologyCME1 Apr 2023MP66-12 SENIOR VS. JUNIOR UROLOGY TRAINEES: FACTORS ASSOCIATED WITH BURNOUT Katelyn Klimowich, Young Son, Shawon Akanda, Raeann Dalton, Dayna Devincentz, Kim Lince, Emma Troyer, and Thomas Mueller Katelyn KlimowichKatelyn Klimowich More articles by this author , Young SonYoung Son More articles by this author , Shawon AkandaShawon Akanda More articles by this author , Raeann DaltonRaeann Dalton More articles by this author , Dayna DevincentzDayna Devincentz More articles by this author , Kim LinceKim Lince More articles by this author , Emma TroyerEmma Troyer More articles by this author , and Thomas MuellerThomas Mueller More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003329.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Burnout is one of the many challenges physicians may face in their careers. While there are studies focusing on burnout among surgical specialties, there are limited studies focusing on burn out at different levels of training. The aim of this study is to measure and compare rates of burnout between junior and senior trainees in urological surgery as well as to identify changes in training that could be made to improve work-life balance. METHODS: To assess professional burnout, respondents completed the 22-item Maslach Burnout Inventory Human Services Survey as part of the 2019 AUA census. Respondents were categorized into junior trainees (PGY1, PGY2, PGY3) and senior trainees (PGY4, PGY5, and fellow). RESULTS: A total of 512 respondents were included. Senior trainees represented 57% while junior trainees represented 43% of the total cohort. The prevalence of burnout (p=0.005) and high levels of depersonalization (p=0.018) were 50% in junior trainees and 38% in senior trainees. High levels of emotional exhaustion were 9% for junior and 5% for senior trainees (p=0.053) (Table 1). The top changes to improve work life balance for urology trainees were access to meal plans, on-call rooms, and time to attend health appointments (Figure 1). CONCLUSIONS: Juniors experience higher levels of burnout, depersonalization, and emotional exhaustion when compared to seniors. Providing meal plans, on-call quarters, and time to attend health appointments are the top changes to improve work-life balance among urology trainees. These changes may have a dramatic impact on the well-being of our trainees, especially in this post-COVID era. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e937 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Katelyn Klimowich More articles by this author Young Son More articles by this author Shawon Akanda More articles by this author Raeann Dalton More articles by this author Dayna Devincentz More articles by this author Kim Lince More articles by this author Emma Troyer More articles by this author Thomas Mueller More articles by this author Expand All Advertisement PDF downloadLoading ...

UK national trainee survey of hepatology training, research and the future workforce

ObjectiveThe increasing prevalence of liver disease in the UK means there is a pressing need to expand the hepatology workforce. This survey aims to evaluate current hepatology training provision, and...

A comparative analysis of lecturers' satisfaction with Anatomage and Pirogov virtual dissection tables during clinical and topographic anatomy courses in Russian universities.

Anatomy is increasingly taught using computer-assisted learning tools, including electronic interactive anatomy dissection tables. Anatomage was he first virtual anatomy dissection table introduced in Russian medical universities and gained popularity among lecturers and students. The Pirogov interactive anatomy table was recently released, but the strengths and weakness of each platform is currently unknown. The objective of this article is to survey lecturers in anatomy to understand their perspectives on the Pirogov versus Anatomage virtual dissection tables' application to teaching in medical universities. A total of 80 anatomy educators from 12 Russian universities, using Anatomage (n=40) and Pirogov (n=40) tables were surveyed regarding their satisfaction with the application of the respective tables. Using a five-point Likert scale, both tables were assessed, and responses were statistically analyzed. In addition, qualitative analysis was performed on free response comments provided by survey respondents. There was no significant difference in overall satisfaction ratings between Pirogov (4.38 ± 0.53) and Anatomage (3.94 ± 0.60) interactive tables (p > 0.05). The Anatomage table ranked significantly higher on the accuracy of displayed anatomical details, resolution of the images, and its suitability for teaching senior medical and postgraduate students. Pirogov table performed significantly better on survey items measuring ergonomics, ability to assess students' performance, and teaching basic anatomy to junior first- and second-year medical students. Thus, in summary, anatomists' responses indicated that while both tables are suitable for teaching anatomy, the Pirogov table was superior in undergraduate medical education and the Anatomage table was more beneficial for teaching more senior trainees.

How are senior citizens capable to cope with the world of digital natives?

This study discusses the continuously growing threat to the senior citizens*), later called seniors, who can be isolated from the society if their digital competences and experiences are too poor in today’s digital world. It has been noted that to cope with one’s pursuits seniors need to actively construct and maintain their capabilities in ways that are flexible in the world of the digital devices, in response to the changing vicissitudes of life. Thus, the claim above illuminates the issue that the ability to learn from experiences is highly valued in the digital world. The seniors are obliged to closely take into consideration the changes in the environment and also flexibly respond to them as we live in the world of constantly unexpected incidents and changes. In future, the seniors are more and more expected to accept the modernized and renewed digital systems to be able to survive in everyday life. The results of this study indicate that the readiness, willingness and ability to develop oneself digitally are influenced partly by the knowledge and skills resulting from the studies and work experience, and also partly by the necessity and force of the digital world. The global challenges call seniors for new directions in education and training. The final outcome of this study helps digital trainers and specialists to educate on the curriculum basis senior trainees in the subjects which require their digital skills. Consequently, the seniors want to be regarded as good citizens also in this digital field.

Evaluating Basic Knee Arthroscopy Skills in Orthopaedic Trainees in a Limited-Resource Setting.

A prospective observational cohort study was conducted. Orthopaedic trainees of a Southern African university hospital performed basic arthroscopy on a knee model. Their surgical competency was assessed by 2 surgeons proficient in arthroscopy using the modified Basic Knee Arthroscopy Skill Scoring System (mBAKSSS). A total of 16 trainees (12 male) were included (6 junior and 10 senior trainees). The median age of participants was 36 (34.8-37) years. The median mBAKSSS was 28.0 (20.3-32.5) but showed a large variability (12.0-42.5). The overall reliability was excellent with Cronbach's alpha of 0.91 and interclass correlation of 0.91 (95% confidence interval 0.75-0.97). The average knee arthroscopy proficiency of our trainees is comparable with that of international training programs, but there was great variability with inconsistent skills among the trainees. This calls for improved and reproducible arthroscopy training and skills transfer, exposure to procedures, and ongoing assessment. II (prospective observational cohort study).

Using electroencephalography to explore neurocognitive correlates of procedural proficiency: A pilot study to compare experts and novices during simulated endotracheal intubation

The objective of this study was to explore the use of EEG as a measure of neurocognitive engagement during a procedural task. In this observational study, self-reported cognitive load, observed performance, and EEG signatures in experts and novices were compared during simulated endotracheal intubation. Twelve medical students (novices) and eight senior anesthesiology trainees (experts) were included in the study. Experts reported significantly lower cognitive load (P < 0.001) and outperformed novices based on the observational checklist (P < 0.001). EEG signatures differed significantly between the experts and novices. Experts showed a greater increase in delta and theta band amplitudes, especially in temporal and frontal locations and in right occipital areas for delta. A machine learning algorithm showed 83.3 % accuracy for expert-novice skill classification using the selected EEG features. Performance scores were positively correlated (P < 0.05) with event-related amplitudes for delta and theta bands at locations where experts and novices showed significant differences. Increased delta and frontal/midline theta oscillations on EEG suggested that experts had better attentional control than novices. This pilot study provides initial evidence that EEG may be a useful, noninvasive measure of neurocognitive engagement in operational settings and that it has the potential to complement traditional clinical skills assessment.