Performance of Vascular Exposure and Fasciotomy Among Surgical Residents Before and After Training Compared With Experts

Mackenzie, Colin F.; Garofalo, Evan; Puché, Adam C.; Chen, Hegang; Pugh, Kristy; Shackelford, Stacy; Tisherman, Samuel A.; Henry, Sharon M.; Bowyer, Mark W.

doi:10.1001/jamasurg.2017.0092

Cited by 35 publications

(30 citation statements)

References 27 publications

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“…Fifty‐one studies were included in the review, of which 47 were full‐text original research articles and four were conference posters. The main characteristics of studies, including OCEBM and mean MERSQI scores are shown in Tables S2 – S5 (supporting information).…”

Section: Resultsmentioning

confidence: 99%

“…Various score‐based methods were also used, including procedure scores, global rating scale (GRS), OSATS (Objective Structured Assessment of Technical Skills in Surgery) and the GOALS (Global Operative Assessment of Laparoscopic Skills) scale. Seven of the 23 studies were RCTs and 16 were cohort studies. Of the seven RCTs, three compared cadaveric simulation with no simulation training, and four compared cadaveric simulation with low‐fidelity simulation.…”

Section: Resultsmentioning

confidence: 99%

“…Of the 16 cohort studies measuring change in learner behaviour, five were comparative in design. Three studies compared inexperienced versus experienced performance, one compared behaviour change in cadaveric simulation‐trained versus low‐fidelity simulation‐trained cohorts, and one compared within‐subject performance change after cadaveric simulation training. Eleven were non‐comparative descriptive studies.…”

Section: Resultsmentioning

confidence: 99%

“…Mednick and co‐workers also found that, when performing corneal rust ring removal, FPA did not correlate with trainee experience, although procedure time did. Mackenzie et al . compared preintervention, immediately after (less than 4 weeks) and delayed (12–18 months) intervention scores for cadaveric‐trained, inexperienced learners with experienced ‘expert’ performance when undertaking lower‐extremity vascular exposure, repair and fasciotomy.…”

Section: Resultsmentioning

confidence: 99%

“…Fresh cadavers were used in 12 of the reviewed studies. These offer the most authentic tissue‐handling fidelity, but have the significant disadvantage of rapid deterioration, and therefore a short time‐window for their potential use.…”

Section: Resultsmentioning

confidence: 99%

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Systematic review of the current status of cadaveric simulation for surgical training

James

Chapman

Pattison

et al. 2019

British Journal of Surgery

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BackgroundThere is growing interest in and provision of cadaveric simulation courses for surgical trainees. This is being driven by the need to modernize and improve the efficiency of surgical training within the current challenging training climate. The objective of this systematic review is to describe and evaluate the evidence for cadaveric simulation in postgraduate surgical training.MethodsA PRISMA‐compliant systematic literature review of studies that prospectively evaluated a cadaveric simulation training intervention for surgical trainees was undertaken. All relevant databases and trial registries were searched to January 2019. Methodological rigour was assessed using the widely validated Medical Education Research Quality Index (MERSQI) tool.ResultsA total of 51 studies were included, involving 2002 surgical trainees across 69 cadaveric training interventions. Of these, 22 assessed the impact of the cadaveric training intervention using only subjective measures, five measured impact by change in learner knowledge, and 23 used objective tools to assess change in learner behaviour after training. Only one study assessed patient outcome and demonstrated transfer of skill from the simulated environment to the workplace. Of the included studies, 67 per cent had weak methodology (MERSQI score less than 10·7).ConclusionThere is an abundance of relatively low‐quality evidence showing that cadaveric simulation induces short‐term skill acquisition as measured by objective means. There is currently a lack of evidence of skill retention, and of transfer of skills following training into the live operating theatre.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Systematic review of the current status of cadaveric simulation for surgical training

James

Chapman

Pattison

et al. 2019

British Journal of Surgery

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Surgical Training to Proficiency

Lipsett

2017

JAMA Surg

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A Novel Paradigm for Surgical Skills Training and Assessment of Competency

et al. 2021

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Sustainment of comprehensive procedural skills in trauma surgery is a particular problem for surgeons in rural, global, and combat settings. Trauma care often requires open surgical procedures for low-frequency/high-risk injuries at a time when open surgical experience is declining in general and trauma surgery training.OBJECTIVE To determine whether general surgeons participating in a 2-day standardized trauma skills course demonstrate measurable improvement in accuracy and independent performance of specific trauma skills.DESIGN, SETTING, AND PARTICIPANTS General surgeons in active surgical practice were enrolled from a simulation center with anatomic laboratory from October 2019 to October 2020. Differences in pretraining/training and posttraining performance outcomes were examined using (1) pretraining/posttraining surveys, (2) pretraining/posttraining knowledge assessment, and (3) training/posttraining faculty assessment. Analysis took place in November 2020.INTERVENTIONS A 2-day standardized, immersive, cadaver-based skills course, developed with best practices in instructional design, that teaches and assesses 24 trauma surgical procedures was used. MAIN OUTCOMES AND MEASURESTrauma surgery capability, as measured by confidence, knowledge, abilities, and independent performance of specific trauma surgical procedures; 3-month posttraining skill transfer. RESULTSThe study cohort included 65 active-duty general surgeons, of which 16 (25%) were women and 49 (75%) were men. The mean (SD) age was 38.5 (4.2) years. Before and during training, 1 of 65 participants (1%) were able to accurately perform all 24 procedures without guidance. After course training, 64 participants (99%) met the benchmark performance requirements for the 24 trauma procedures, and 51 (78%) were able to perform them without guidance. Procedural confidence and knowledge increased significantly from before to after the course. At 3 months after training, 37 participants (56%) reported skill transfer to trauma or other procedures. CONCLUSIONS AND RELEVANCEIn this study, direct measurement of procedural performance following standardized training demonstrated significant improvement in skill performance in a broad array of trauma procedures. This model may be useful for assessment of procedural competence in other specialties.

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Performance of Vascular Exposure and Fasciotomy Among Surgical Residents Before and After Training Compared With Experts

Cited by 35 publications

References 27 publications

Systematic review of the current status of cadaveric simulation for surgical training

Systematic review of the current status of cadaveric simulation for surgical training

Surgical Training to Proficiency

A Novel Paradigm for Surgical Skills Training and Assessment of Competency

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