American journal of surgery
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Resident work hours may impact patient care. We hypothesized that "call-associated" acute sleep deprivation has no effect on technical dexterity as measured on a minimally invasive surgery trainer, virtual reality (MIST VR) surgical simulator. ⋯ Resident work schedules lead to sleep deprivation and fatigue. Call-associated sleep deprivation and fatigue are associated with increased technical errors in the performance of simulated laparoscopic surgical skills.
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To evaluate the usefulness of routine radiologic control after the insertion of a central venous catheter as a tool that might modify treatment of patients. ⋯ The results suggest that routine chest radiology after the insertion of a central venous catheter is not always necessary and that it should be ordered selectively, according to the findings made during the procedure and the subjective degree of difficulty.
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Comparative Study
Intravenous catheter training system: computer-based education versus traditional learning methods.
Virtual reality simulators allow trainees to practice techniques without consequences, reduce potential risk associated with training, minimize animal use, and help to develop standards and optimize procedures. Current intravenous (IV) catheter placement training methods utilize plastic arms, however, the lack of variability can diminish the educational stimulus for the student. This study compares the effectiveness of an interactive, multimedia, virtual reality computer IV catheter simulator with a traditional laboratory experience of teaching IV venipuncture skills to both nursing and medical students. ⋯ The pretest scores were similar between the computer and the traditional laboratory group. There was a significant improvement in cognitive gains, student satisfaction, and documentation of the procedure with the traditional laboratory group compared with the computer catheter simulator group. Both groups were similar in their ability to demonstrate the skill correctly. CONCLUSIONS; This evaluation and assessment was an initial effort to assess new teaching methodologies related to intravenous catheter placement and their effects on student learning outcomes and behaviors. Technology alone is not a solution for stand alone IV catheter placement education. A traditional learning method was preferred by students. The combination of these two methods of education may further enhance the trainee's satisfaction and skill acquisition level.
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The Edinburgh Basic Surgical Trainee Assessment Form (EBSTAF) is a feasible, reliable and construct valid tool for assessment of surgical trainees. Our aim was to determine its acceptability as a formative training tool. ⋯ There was total agreement in 44 skills (63%, kappa = 0.34). Trainees assigned greater importance to 24 (34%). For individual skills domains, trainees assigned significantly greater value: communication, 86% versus 78%; application of knowledge, 75% versus 67%; team-working, 84% versus 77%; clinical skills, 86% versus 83%; and technical skills, 84% versus 79%. Responses were internally consistent (alpha = 0.74 to 0.93). CONCLUSIONS; Trainees attach greater value than consultants to the qualities assessed by EBSTAF. Trainees therefore agree with consultant opinion on what is important in a surgical trainee, supporting use of this form as a formative training tool.
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With the introduction of effective antituberculous chemotherapy, the clinical outcome of tuberculous peritonitis depends much on the diagnostic accuracy of this disease entity. This review summarizes the current state-of-the-art thinking regarding the protean manifestation and diagnostic modalities of this major infectious disease. ⋯ We believe an aggressive diagnostic approach, particularly with peritoneal biopsy, is warranted for the diagnosis and timely treatment of tuberculous peritonitis.