Study Design: Retrospective cohort study. Objectives: The aim of this study was to compare the results of cervical laminectomy (CL) performed with ultrasonic bone scalpel (UBS) or conventional method (CM). Method: This study comprised 311 CL performed by a single surgeon between January 2004 and December 2017. Group A (GpA) comprised 124 cases of CL performed using UBS, while Group B (GpB) comprised 187 cases of CL performed using CM. These 2 groups were compared in terms of demographic characteristics of patients, duration of surgery, estimated blood loss, and surgical complications. Results: GpA included 112 males and 12 females, mean age being 61.18 years. GpB comprised 166 males and 21 females, mean age being 62.04 years. Mean duration of surgery, estimated blood loss, and length of hospital stay was 65.52/70.87 minutes, 90.24/98.40 mL, and 4.80/4.87 days in GpA and GpB, respectively. Six patients were reported to have dural injuries in each group. In GpA, 2 cases of C5 palsy and 1 nerve root injury was observed, while in GpB, 3 cases of C5 palsy and no nerve root injury was reported. One patient had developed transient neurological deterioration postsurgery in GpA as against 11 patients in GpB. Conclusion: Neurological complications observed in CM leads to intensive care unit admission, additional morbidity, and additional expenditure, whereas UBS provides a safe, rapid, and effective means of performing CL, thereby decreasing the rate of surgical complications and postoperative morbidity.
Background:
Medical education aims at providing quality health care to community, which evidently needs professionally competent physicians. Mini-CEX tool can be employed to assess the core competencies of trainees during their routine clinical practice. This assessment tool offers a reliable measure of trainee's performance through being observed a number of brief encounters over a period, with a number of different assessors and in different clinical settings. So the study was carried out to test utility of Mini-CEX to test competence in postgraduate s in Orthopedics at a rural medical college in central India.
Method and Material:
Eighteen Orthopedics postgraduates underwent this assessment at an interval of 1 month to a total of 5 encounters. All were examined for seven skills. The timing of these assessments was mostly opportunistic, but the interval was maintained. Various said clinical test / skill was performed on real patient and rated them on the prevalidated checklist and provided feedback. Every skill was observed five times in similar case scenario. Nine point Likert scale was used for assessment.
Results:
Among the trainees the level of satisfaction was less varied than the supervisors and majority have shown interest with high level of satisfaction with the mean for Mini-CEX ranging from 7.94 to 8.27. And Pair wise analysis between 1st and 5th intervention, 3rd and 4th intervention and 3rd and 5th intervention was found to be significant. Conclusion: Mini-CEX is a method of assessing the clinical skills, which is task focused and quick to perform in a broader set of routine clinical practice administered as multiple encounters with variable patient problems and different examiners. Mini-CEX is a workplace-based assessment of performance, which has been reported to be reasonably reliable and valid to confer structured clinical skills learning in medical education.
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