American journal of surgery
-
This study was performed to determine the impact of an endovascular program (EVP) on open and endovascular abdominal aortic aneurysm (AAA) operations in a residency training institution. ⋯ An endovascular program has a positive impact on the aortic aneurysm practice in an academic institution, as evidenced by the significant increase in annual endovascular AAA cases despite a decrease in open AAA operations. Although vascular fellows continued to maintain sufficient experience in both open and endovascular AAA operations, general surgery chief residents suffered a significant decrease in their open AAA experience. Further evaluation of the residency system is warranted to better optimize the training paradigm of both vascular fellowship and general surgery residency.
-
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.
-
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.
-
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.
-
Performance review using videotapes is a strategy employed to improve future performance. We postulated that videotape review of trauma resuscitations would improve compliance with a treatment algorithm. ⋯ Videotape review can be an important learning tool as it was more effective than verbal feedback in achieving behavioral changes and algorithm compliance. Videotape review can be an important quality assurance adjunct, as improved algorithm compliance should be associated with improved patient care.