Article

Surgical instruction for general practitioners: How, who and how often?

Department of Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland.
Journal of Plastic Reconstructive & Aesthetic Surgery (Impact Factor: 1.47). 06/2009; 63(7):1156-62. DOI: 10.1016/j.bjps.2009.05.023
Source: PubMed

ABSTRACT Educational programmes, designed to meet the training needs of General Practitioners (GPs) performing minor surgical procedures, have previously been shown to increase their surgical workload. The change in the level of competence following these programmes has not been assessed. The aims of this study were two-fold: to evaluate the vertical mattress suture for construct validity and to assess the impact of plastic surgery training on the surgical skill of GPs. Thirty non-consultant hospital doctors and 27 self-selected GPs were included. Using a modified objective structured assessment of technical skills (OSATS) scoring system, construct validity of the vertical mattress suture was confirmed. The median total OSATS score was 16 points (26.7%) in the novice group (medical registrars), 38.5 points (64.2%) in the intermediate group (surgical SHOs) and 59 points (98.3%) in the expert group (surgical registrars, p<0.001, Kruskal-Wallis test). Objective assessment in the GP group immediately following practical instruction revealed a median overall improvement of 31.7% (19 points) in total OSATS scores (p<0.001, Friedman non-parametric test, F). At six months follow-up all course participants had improved compared to their baseline. A median overall improvement of 13 points (21.7%) was noted (p<0.001, F). However, the majority (80%, n=20) had deteriorated from the standard set immediately after the course with a median overall reduction in total OSATS scores of six points (10%, p=0.001, F). Plastic surgery training is immediately efficacious in improving the technical proficiency of GPs. Through objective assessment of a standardised suture task we demonstrated a low rate of educational decay of 10% over a six-month period.

0 Followers
 · 
81 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Due to ethical and medical-legal drawbacks, high costs, and difficulties of accessibility that are inherent to the practice of basic surgical skills on living patients, fresh human cadaver, and live animals, the search for alternative forms of training is needed. In this study, the teaching and learning process of basic surgical skills pertinent to plastic surgery during medical education on different inanimate bench models as a form of alternative and complementary training to the teaching programs already established is proposed.
    01/2012; 2012:651863. DOI:10.1155/2012/651863
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We propose a collaborative knowledge network that we call omniscient spaces in the attempt to generate sophisticated robotic behavior with minimal programming effort. New products are manufactured and brought into our daily life everyday. Robots should need a way to easily integrate new products into their existing recognizable environments. Radio frequency identification gains increasing attention to support context and ambient awareness in dynamically changing environments. To solve robot programming difficulties in our environments, the collaborative knowledge network connects heterogeneous knowledge resources to collectively build up the robot's knowledge required to accomplish a task. Specifically, a decentralized knowledge acquisition and task specific integration model is proposed, where the proposed knowledge integrator merges specific knowledge with existing knowledge into a task requiring knowledge. For this, manufacturers put their product data tailored to plan robot motions online and robots may access the data without authorization. In this work, the best possible scenario under current technological limitations is proposed for real world robot applications. A detailed analysis of the knowledge flow model is described. To verify the validity of the proposed model, a test bed is built and table clearing task is performed according to the distributed knowledge management framework.
    Intelligent Robots and Systems, 2004. (IROS 2004). Proceedings. 2004 IEEE/RSJ International Conference on; 01/2004
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To develop a written practical examination and scoring system for assessing trainee skills in basic soft-tissue techniques. A brief written practical examination was developed to assess the ability of trainees to sketch preoperative plans and postoperative results for common soft-tissue techniques: simple-excision, M-plasty, geometric broken line closure, Z-plasty, V-to-Y flap, and rhombic flap. A scoring system was developed to assign 0 to 5 points to each of 10 items on the examination for a total score of 0-50. The 15-minute examination was administered as a pretest, posttest, and 3-month posttest assessment as part of a soft-tissue course at our institution. University of Minnesota, Otolaryngology Department. Three raters reviewed all examination answer sheets independently. The pretest scores of examinees correlated strongly with their level of training; the average pretest for junior residents (PGY 1-2) compared with senior residents (PGY 4-5) was 17.3 (of 50) versus 26.0 (p < 0.01). The scoring system showed a high intrarater reliability and high interrater reliability with correlation coefficients of r = 0.99 and r = 0.95, respectively and agreement coefficients of κ = 0.82 and κ = 0.77, respectively. This written practical examination and scoring system may be used to assess the skills of trainees accurately in basic soft tissue techniques and to expose areas of deficiency that can be addressed in future training sessions.
    Journal of Surgical Education 05/2011; 68(3):178-84. DOI:10.1016/j.jsurg.2010.12.006 · 1.39 Impact Factor