A Proficiency-Based Progression Training Curriculum Coupled With a Model Simulator Results in the Acquisition of a Superior Arthroscopic Bankart Skill Set

Angelo, Richard L.; Ryu, Richard K.N.; Pedowitz, Robert A.; Beach, William R.; Burns, Joseph P.; Dodds, Julie; Field, Larry D.; Getelman, Mark H.; McIntyre, Louis F.; Gallagher, Anthony G.

doi:10.1016/j.arthro.2015.07.001

Cited by 166 publications

(170 citation statements)

References 38 publications

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“…(41,(55)(56)(57) Our learner-centred model also incorporated the spirit of newer models of surgical training based on task deconstruction, detailed steps and identifi cation of potential errors, which represents a superior system of training to traditional apprenticeship, and to which low complication rates and initial success have been attributed. (58,59) Our model allowed the team to focus on rapid service provision while simultaneously acquiring technical capability and benefitting from instant feedback from the proctor, and the team training together allowed us to adopt a singular practice tailored to suit our hospital's infrastructure. (38)(39)(40)(41)59,60) At the same time, we are well aware of the technical complexities in the surgical management of an important but infrequent condition and intend to extend the duration of proctorship to build the team's confi dence.…”

Section: Discussionmentioning

confidence: 99%

“…(58,59) Our model allowed the team to focus on rapid service provision while simultaneously acquiring technical capability and benefitting from instant feedback from the proctor, and the team training together allowed us to adopt a singular practice tailored to suit our hospital's infrastructure. (38)(39)(40)(41)59,60) At the same time, we are well aware of the technical complexities in the surgical management of an important but infrequent condition and intend to extend the duration of proctorship to build the team's confi dence.…”

Section: Discussionmentioning

confidence: 99%

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Rapid initiation of fetal therapy services with a system of learner-centred training under proctorship: the National University Hospital (Singapore) experience

Gosavi

Vijayakumar

et al. 2017

smedj

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INTRODUCTION Management of complicated monochorionic twins and certain intrauterine structural anomalies is a pressing challenge in communities that still lack advanced fetal therapy. We describe our efforts to rapidly initiate selective feticide using radiofrequency ablation (RFA) and selective fetoscopic laser photocoagulation (SFLP) for twin-to-twin transfusion syndrome (TTTS), and present the latter as a potential model for aspiring fetal therapy units. METHODSFive pregnancies with fetal complications were identifi ed for RFA. Three pregnancies with Stage II TTTS were selected for SFLP. While RFA techniques utilising ultrasonography skills were quickly mastered, SFLP required stepwise technical learning with an overseas-based proctor, who provided real-time hands-off supervision.RESULTS All co-twins were live-born following selective feticide; one singleton pregnancy was lost. Fetoscopy techniques were learned in a stepwise manner and procedures were performed by a novice team of surgeons under proctorship. Dichorionisation was completed in only one patient. Five of six twins were live-born near term. One pregnancy developed twin anaemia-polycythaemia sequence, while another was complicated by co-twin demise.DISCUSSION Proctor-supervised directed learning facilitated the rapid provision of basic fetal therapy services by our unit. While traditional apprenticeship is important for building individual expertise, this system is complementary and may benefi t other small units committed to providing these services.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Rapid initiation of fetal therapy services with a system of learner-centred training under proctorship: the National University Hospital (Singapore) experience

Gosavi

Vijayakumar

et al. 2017

smedj

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“…Arthroscopic surgery is an area where orthopaedic simulation is more advanced and that simulation-based training can be very effective in improving skills of orthopaedic trainees[5-7]. During the past few decades, there have been dramatic improvements in arthroscopic surgery of the knee, shoulder, hip, elbow, wrist and ankle joints.…”

Section: Current Obstacles To Simulation-based Education In Orthopaedicsmentioning

confidence: 99%

Orthopaedic education in the era of surgical simulation: Still at the crawling stage

Ateşok

MacDonald

Leiter

et al. 2017

WJO

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Surgical skills education is in the process of a crucial transformation from a master-apprenticeship model to simulation-based training. Orthopaedic surgery is one of the surgical specialties where simulation-based skills training needs to be integrated into the curriculum efficiently and urgently. The reason for this strong and pressing need is that orthopaedic surgery covers broad human anatomy and pathologies and requires learning enormously diverse surgical procedures including basic and advanced skills. Although the need for a simulation-based curriculum in orthopaedic surgery is clear, several obstacles need to be overcome for a smooth transformation. The main issues to be addressed can be summarized as defining the skills and procedures so that simulation-based training will be most effective; choosing the right time period during the course of orthopaedic training for exposure to simulators; the right amount of such exposure; using objective, valid and reliable metrics to measure the impact of simulation-based training on the development and progress of surgical skills; and standardization of the simulation-based curriculum nationwide and internationally. In the new era of surgical education, successful integration of simulation-based surgical skills training into the orthopaedic curriculum will depend on efficacious solutions to these obstacles in moving forward.

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“…Gallagher and colleagues have described PBP for training in procedural skills. This approach consistently achieves greatly superior training effect—including clinical performance—compared with other methods of competency assessment approaches3 but requires the development of unambiguously defined and detailed procedure-specific metrics and errors, so-called ‘procedure characterisation’ 1. The success of PBP is dependent on the definition and recognition of specific observable behaviours.…”

Section: A Potential Synergymentioning

confidence: 99%

Synergy of wearable technologies and proficiency-based progression for effecting improvement in procedural skill training

Srinivasan

Dempsey

O’Leary

et al. 2016

BMJ Simul Technol Enhanc Learn

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A Proficiency-Based Progression Training Curriculum Coupled With a Model Simulator Results in the Acquisition of a Superior Arthroscopic Bankart Skill Set

Cited by 166 publications

References 38 publications

Rapid initiation of fetal therapy services with a system of learner-centred training under proctorship: the National University Hospital (Singapore) experience

Rapid initiation of fetal therapy services with a system of learner-centred training under proctorship: the National University Hospital (Singapore) experience

Orthopaedic education in the era of surgical simulation: Still at the crawling stage

Synergy of wearable technologies and proficiency-based progression for effecting improvement in procedural skill training

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