Learning Laparoscopic Skills: Observation or Practice?

Schmitt, Françoise; Mariani, Aurora; Eyssartier, E.; Granry, J.C.; Podevin, Guillaume

doi:10.1089/lap.2017.0254

Cited by 11 publications

(8 citation statements)

References 28 publications

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“…In our literature review we found no evidence for learning curves regarding the number of prior seen chest tube insertions. Nevertheless, the assumption that observation of surgical procedures leads to an improvement of surgical ability is in accordance with results of Schmitt et al, who showed skills improvement after observation of surgical procedures [39, 40]. Therefore, the cut-off for the ‘advanced’ group was set to ≥3 seen chest tube insertions as we expected that there were also learning effects concerning knowledge and precise conception of the intervention after several instances of seeing a chest tube insertion.…”

Section: Discussionsupporting

confidence: 70%

Development and validation of an objective assessment scale for chest tube insertion under ‘direct’ and ‘indirect’ rating

et al. 2018

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BackgroundThere is an increasing need for objective and validated educational concepts. This holds especially true for surgical procedures like chest tube insertion (CTI). Thus, we developed an instrument for objectification of learning successes: the assessment scale based on Objective Structured Assessment of Technical Skill (OSATS) for chest tube insertion, which is evaluated in this study. Primary endpoint was the evaluation of intermethod reliability (IM). Secondary endpoints are ‘indirect’ interrater reliability (IR) and construct validity of the scale (CV).MethodsEvery participant (N = 59) performed a CTI on a porcine thorax. Participants received three ratings (one ‘direct’ on site, two ‘indirect’ via video rating). IM compares ‘direct’ with ‘indirect’ ratings. IR was assessed between ‘indirect’ ratings. CV was investigated by subgroup analysis based on prior experience in CTI for ‘direct’ and ‘indirect’ rating.ResultsWe included 59 medical students to our study. IM showed moderate conformity (‘direct’ vs. ‘indirect 1’ ICC = 0.735, 95% CI: 0.554–0.843; ‘direct’ vs. ‘indirect 2’ ICC = 0.722, 95% CI 0.533–0.835) and good conformity between ‘direct’ vs. ‘average indirect’ rating (ICC = 0.764, 95% CI: 0.6–0.86). IR showed good conformity (ICC = 0.84, 95% CI: 0.707–0.91). CV was proven between subgroups in ‘direct’ (p = 0.037) and ‘indirect’ rating (p = 0.013).ConclusionResults for IM suggest equivalence for ‘direct’ and ‘indirect’ ratings, while both IR and CV was demonstrated in both rating methods. Thus, the assessment scale seems a reliable method for rating trainees’ performances ‘directly’ as well as ‘indirectly’. It may help to objectify and facilitate the assessment of training of chest tube insertion.

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Section: Discussionsupporting

confidence: 70%

Development and validation of an objective assessment scale for chest tube insertion under ‘direct’ and ‘indirect’ rating

et al. 2018

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“…Training and simulation are seen today as an essential element in medical education and are increasingly appearing in the teaching of students and residents, ensuring more excellent patient safety [6]. It is also necessary to emphasise a higher value of the practical training over the observation itself [7]. However, as Panek et al reported, not only manual skills influence the learning curve of an individual but also their experience with regard to the entire therapeutic process, including choice of the optimal surgical method [8].…”

Section: Discussionmentioning

confidence: 99%

Assessment of training and selected factors on speed and quality of performing different tasks on the endoscopic simulator.

Kasprzyk¹,

Łuczak²,

Kaczmarek³

et al. 2020

Videosurgery and Other Miniinvasive Techniques

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Introduction: One of the most significant challenges nowadays is to educate and predict the predispositions of young surgeons taking into consideration that every ability has its own learning curve. Aim: To determine the influence of selected factors and examine the shape and the length of the learning curve in performing simple tasks on an endoscopic simulator. Material and methods: Twenty students took part in 4 training sessions with a one-week break between sessions. They were training 12 minutes and performed three tasks at every session on the endoscopic simulator. To identify whether selected factors influence the time of completing tasks, the participants were asked to fill in questionnaires. All participants also completed the Minnesota Manual Dexterity Test (MMDT) to assess hand-eye coordination. Results: Our research reveals that regardless of activities performed in free time, the shape of the learning curve was logarithmic. Improvement after the fourth session ranged from 50% to 75%. Performing specific activities in the free time did not influence the results achieved on the simulator. No statistically significant correlation between MMDT results and the time to accomplish each task was found. Conclusions: This study has shown that the length of the learning curve of performing simple tasks is quite short and the shape is logarithmic. It suggests that more complex exercises should be included in the training programme.

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“…The role of observational and simulation-based learning has been evaluated in different fields of medicine and different stages of the training process. [9][10][11] Harris et all reported the effect on the acquisition of surgical skills on a robotic platform, 9 and Torricelli et al on laparoscopic surgical training. 8 In the field of endoscopy, Draganov reported that observation of experts performing endoscopic submucosal dissection not only shortened the learning curve and procedure times, but also decreased the number of unsuccessful procedures.…”

Section: Observational and Simulation Based Learningmentioning

confidence: 99%

Single Day Observational Experience at High Volume Ablation Programs: What is the Impact to Practicing Electrophysiologists?

Osorio

Bubien

Ruff³

et al. 2018

Journal of Atrial Fibrillation

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Background: Significant improvements in catheter technology, electro-anatomic (EA) mapping and techniques to reduce fluoroscopy during radiofrequency ablation (RFA) of atrial fibrillation (AF) are ongoing. However, few educational opportunities are available post fellowship for Electrophysiologists (EPs) to understand and integrate them into their practice, preventing widespread adoption. The impact of observational learning for adoption of new technologies and techniques in the field of cardiac electrophysiology has not been studied. We sought to report the impact of a visit to a high-volume center with experience in new technologies and fluoroscopy reduction to the clinical practice of EPs. Methods: Between 8/2014 and 10/2017 a total of 150 EPs visited 3 hospitals that perform a high volume of AF RFAs. EPs observed a minimum of 4 RFAs, primarily AF. AF RFAs were performed without fluoroscopy, using Carto 3 Version 4 (Biosense Webster) and intracardiac Echocardiography. There was ample interaction and discussion between hosting and visiting EP. Results: 73 EPs (48.6% of visitors) completed an electronic survey after the visit. The majority reported a significant reduction in fluoroscopy (>50%) and procedure (>20%) times. 68% adopted a rigorous workflow and reported an increase in their confidence level with intracardiac echo (79%), continuous mapping (52%) and the Visitag module (61%). Conclusions: Observational experience can have an immense impact on the clinical practice of EPs. Further effort should be devoted to such programs and to study in a more systematic way their ultimate impact on patient care.

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Learning Laparoscopic Skills: Observation or Practice?

Abstract: Although simple observation of laparoscopic skills improved further performance, direct practice on the virtual reality trainer ensured more effective training. This work therefore advocates incorporating personal training on simulators into residents' surgical curricula.

Cited by 11 publications

References 28 publications

Development and validation of an objective assessment scale for chest tube insertion under ‘direct’ and ‘indirect’ rating

Development and validation of an objective assessment scale for chest tube insertion under ‘direct’ and ‘indirect’ rating

Assessment of training and selected factors on speed and quality of performing different tasks on the endoscopic simulator.

Single Day Observational Experience at High Volume Ablation Programs: What is the Impact to Practicing Electrophysiologists?

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