Standardized Trainees Research Articles

Computer-assisted surgery navigation of pedicle screw insertion by standardized trainees

Objective: To assess the precision and efficiency computer-assisted surgery navigation of pedicle screw insertion by standardized trainees. Methods: From September 2013 to June 2016, 360 thoracic pedicle screws were inserted into 100 patients by standardized trainees (n = 30). Screws on the left side were inserted by hands (control group), while the other side were inserted under the guidance of computer-assistant navigation system (guided group). The insertion time and volume of blood lost by each screw were retrospectively analyzed. The precision ratio was assessed by computerized tomography (CT) scan after operation. Results: The time consumed in screw insertion was significantly shorter in the guided group than that in the control group. The blood lost volume was lesser in the guided group. Post-operation CT scan revealed higher precision in the guided group than that in the control group. Conclusion: Computer-assistant navigation system facilitates the learning of standardized trainees, and reduces the time-consuming and bleeding in thoracic pedicle screw insertion.

Creation of nurse-specific integrated interprofessional collaboration and team-efficiency scenario/video improves trainees' attitudes and performances.

It is importance to train the interprofessional collaboration (IPC) and team-efficiency (TE) of medical trainees. This prospective study evaluates whether implementation of scenario/video-created workshops in integrated IPC and TE (IIT) program provides additional benefits for IPC-TE skills of nursing trainees. Mock simulation with two IIT scenarios was held as preintervention IPC-TE assessment. Basic and advanced workshops were arranged for teams of intervention groups for creation of discipline-specific scenario and video. Thirty-six nursing trainees were randomized into teams of five members (three nursing students, one standardized medical student, and one standardized trainees of other profession) in either intervention (scenario plus video and scenario) or control groups. After intervention, all groups received the formal simulation-based assessment using another two IIT scenario. In addition to instructors-based assessment of team' performance in mock and formal IIT simulation using interprofessional team collaboration scale (AITCS), self-assessment of attitudes and program-value score were completed by each trainee, using attitudes toward interprofessional health care teams scale (ATIHCTS) at all stages. Nursing trainees in intervention group gave high satisfaction score to this IIT intervention. In comparison with control group, greater increase in instructor-assessed team performance in the "partnership," "cooperation," and "shared decision making" domains of AITCS and the self-assessed "quality of care delivery" and TE domains of ATIHCTS were noted in the intervention groups. The overall improvement was greater in the scenario plus video group than those in the scenario group. Further, these improvements among nursing trainees persisted until follow-up stage at 4-weeks later. For nursing trainees, our study suggested that implementation of a scenario creation-based training resulted in additional improvement in trainee' IPC and TE behaviors and attitudes. Additionally, making video of newly created nurse-specific scenario enhances partnership and cooperation among nursing trainees and their interprofessional team members.

Computer-assisted surgery navigation of pedicle screw insertion by standardized trainees

<p><strong>Objective:</strong> To assess the precision and efficiency computer-assisted surgery navigation of pedicle screw insertion by standardized trainees. <strong>Methods</strong> From September 2013 to June 2016, 360 thoracic pedicle screws were inserted into 100 patients by standardized trainees (n = 30). Screws on the left side were inserted by hands (control group), while the other side were inserted under the guidance of computer-assistant navigation system (guided group). The insertion time and volume of blood lost by each screw were retrospectively analyzed. The precision ratio was assessed by computerized tomography (CT) scan after operation. <strong>Results</strong> The time consumed in screw insertion was significantly shorter in the guided group than that in the control group. The blood lost volume was lesser in the guided group. Post-operation CT scan revealed higher precision in the guided group than that in the control group.<strong> Conclusion</strong> Computer-assistant navigation system facilitates the learning of standardized trainees, and reduces the time-consuming and bleeding in thoracic pedicle screw insertion. Orthodontics training is the most important low-grade physician training in the orthopedic department1,2. Due to the complexity of spinal anatomy, professional required and high risk of spinal surgery, thoracic pedicle screw implantation has become a very demanding technique. Furthermore, the spine surgery learning is not conducive to the trainees. Since 2013, our department started to use the computer-assisted three-dimensional navigation technology to guide the implantation of screws3. We found that the computer-assisted navigation technology has greater advantage when compared with the traditional hand-implanted technology.</p>

Applied Research on Laparoscopic Simulator in the Resident Surgical Laparoscopic Operation Technical Training.

The purpose of this study was to estimate the effects of surgical laparoscopic operation course on laparoscopic operation skills after the simulated training for medical students with relatively objective results via data gained before and after the practice course of laparoscopic simulator of the resident standardized trainees. Experiment 1: 20 resident standardized trainees with no experience in laparoscopic surgery were included in the inexperienced group and finished simulated cholecystectomy according to simulator videos. Simulator data was collected (total operation time, path length, average speed of instrument movement, movement efficiency, number of perforations, the time cautery is applied without appropriate contact with adhesions, number of serious complications). Ten attending doctors were included in the experienced group and conducted the operation of simulated cholecystectomy directly. Data was collected with simulator. Data of two groups was compared. Experiment 2: Participants in inexperienced group were assigned to basic group (receiving 8 items of basic operation training) and special group (receiving 8 items of basic operation training and 4 items of specialized training), and 10 persons for each group. They received training course designed by us respectively. After training level had reached the expected target, simulated cholecystectomy was performed, and data was collected. Experimental data between basic group and special group was compared and then data between special group and experienced group was compared. Results of experiment 1 showed that there is significant difference between data in inexperienced group in which participants operated simulated cholecystectomy only according to instructors' teaching and operation video and data in experienced group. Result of experiment 2 suggested that, total operation time, number of perforations, number of serious complications, number of non-cauterized bleeding and the time cautery is applied without appropriate contact with adhesions in special group were all superior to those in basic group. There was no statistical difference on other data between special group and basic group. Comparing special group with experienced group, data of total operation time and the time cautery is applied without appropriate contact with adhesions in experienced group was superior to that in special group. There was no statistical difference on other data between special group and experienced group. Laparoscopic simulators are effective for surgical skills training. Basic courses could mainly improve operator's hand-eye coordination and perception of sense of the insertion depth for instruments. Specialized training courses could not only improve operator's familiarity with surgeries, but also reduce operation time and risk, and improve safety.