Self-estimation of surgical skills and competencies based on the learning curve theory in medical residents and fellows

Borracci, Raúl A.; Gallesio, José M. Álvarez; Ciambrone, Graciana; Mezzadri, Norberto A

doi:10.24875/ciru.18000664

Cited by 9 publications

(7 citation statements)

References 35 publications

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“…31 Once they are confident in performing cases with well-dilated pupils and a moderate grade of cataract, then they can start operating on complicated cases. 32 In our study, we observed that residents often struggled in creating a perfect tunnel; nevertheless, with experience they were more comfortable. A well-formed tunnel reduces surgical time and the risk of intraoperative complications.…”

Section: Resultsmentioning

confidence: 61%

Resident Performed Sutureless Manual Small Incision Cataract Surgery (MSICS): Outcomes

Subudhi¹,

Patro²,

Subudhi³

et al. 2021

OPTH

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Purpose: To show the surgical and visual outcomes of a resident-performed manual small incision cataract surgery. Study Type: Retrospective observational case series. Study Setting: Ruby Eye Hospital. Materials and Methods: Manual small incision cataract surgery was performed on 339 uncomplicated cataract cases by three in-house residents. Preoperative visual acuity and vision with a pinhole were meticulously noted in the record sheets. All patients underwent thorough preoperative evaluation with the help of a slit lamp. Eyes with corneal guttae, undilated pupils, pseudo-exfoliation, raised intraocular pressure and posterior segment abnormalities were excluded from the study. The mean patient age was 59 years (min: 47 years and max: 85 years). Forty-seven percent were males, and the rest were females. The mean uncorrected preoperative visual acuity recorded was 1.3 logMAR units (max: 1 and min: 1.6, Std dev: 0.4). Forty-two percent of the eyes had dense nuclear cataracts (≥ Nuclear Sclerosis grade III from LOCS II). Results: The mean postoperative visual acuity recorded was 0.4 logMAR units [standard deviation 0.3 logMAR units (max: 1 and min: 0.1 p-value <0.001)]. Forty-three cases (12.6%) had tunnel-related complications (premature entry/button hole). Thirty-six cases (10.6%) had iatrogenic prolapse of the iris tissue. Eight cases (2.3%) had a runaway capsulorhexis, while 18 cases (5.3%) had iatrogenic posterior capsular rupture. Two cases (0.58%) had a large zonular dialysis. Ten cases (2.9%) were retaken to the operating room again for repeat intervention. Conclusion:The ophthalmic resident learning curve for manual small incision cataract surgery is steep, unlike what is reported in the literature. A good training program with a special emphasis on wound construction is of paramount importance for future residents.

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Section: Resultsmentioning

confidence: 61%

Resident Performed Sutureless Manual Small Incision Cataract Surgery (MSICS): Outcomes

Subudhi¹,

Patro²,

Subudhi³

et al. 2021

OPTH

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“…As this was a prospective study conceived after the COVID‐19 outbreak, prospective collection of such pre‐pandemic data was unfeasible and as the participation of this study is voluntary, artificial retrospective data on all trainees was unlikely to be a reliable source for comparison due to the likelihood of recall biases. Additionally, there are complexities associated with the value of self‐report measures of efficacy and what it means for clinical practice and competence 19–21 . As self‐report efficacy and self‐reported number of procedures are subjective, these need to be considered with caution.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, there are complexities associated with the value of self‐report measures of efficacy and what it means for clinical practice and competence. 19 , 20 , 21 As self‐report efficacy and self‐reported number of procedures are subjective, these need to be considered with caution.…”

Section: Discussionmentioning

confidence: 99%

Endoscopy training in Australia during COVID‐19: Efficacy and knowledge assessment of gastroenterology and general surgery trainees

Cox

et al. 2022

JGH Open

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Background and Aim During COVID‐19, restrictions to elective endoscopy were introduced worldwide. A reduction in procedures may impact trainees' endoscopy learning. This study aims to assess Australian advanced gastroenterology and general surgery trainees' self‐perceived efficacy and knowledge in endoscopy during the pandemic. Methods All Australian gastroenterology and general surgery trainees in their last 2 years of accredited training were invited to participate through email (2020–2021 and 2021–2022 training cycles). The primary outcome was to assess trainees' self‐efficacy and knowledge regarding gastrointestinal endoscopy. Secondary outcomes included subgroup analysis between gastroenterology and general surgery trainees. Self‐perceived efficacy was assessed with Likert‐scale questions on 20 endoscopy procedures and knowledge was assessed through 21 endoscopy‐related multiple choice questions. Results Eighty‐one trainees responded to a self‐efficacy questionnaire and 77 responded to the knowledge questionnaire. Over 90% of the trainees were confident or extremely confident in diagnostic endoscopy, but only half demonstrated similar efficacy for therapeutic endoscopy. The efficacy for basic endoscopy procedures was higher for gastroenterology trainees (64.0% vs 51.1%, P < 0.001). Last‐year trainee achievement of conjoint committee requirements for upper gastrointestinal endoscopy was achieved in 95.8% of gastroenterology trainees versus 22.2% of surgical trainees (P < 0.001). The median score on the knowledge questionnaire was also higher for the gastroenterology subset (90.5% vs 71.4%, P < 0.001). Conclusion During COVID‐19, endoscopy trainees' self‐efficacy in endoscopic diagnostic procedures was achieved for most trainees. The differences in self‐perceived efficacy and knowledge between gastroenterology and surgical trainees may be reflective of the different opportunities for learning between the two groups.

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“…No other factor, such as professional experience or experience in minimally invasive surgery showed such a strong correlation. The curve generated for this purpose approximated a classical learning curve [ 26 ]. As described in the introduction, uniform definitions do not exist for experts and novices in surgical disciplines.…”

Section: Discussionmentioning

confidence: 99%

“…However, we lack a common definition for the terms “expert” and “beginner.” As a result, different methods of classification have been used. Distinctions have been made on the basis of professional experience in years, number of operations, or even self-assessment [ 22 , 23 , 24 , 25 , 26 , 27 ]. Specific conditions and the numbers of subgroups in the individual studies vary widely.…”

Section: Introductionmentioning

confidence: 99%

Impact of Acoustic and Interactive Disruptive Factors during Robot-Assisted Surgery—A Virtual Surgical Training Model

Krüger

Ackermann

Bauerschlag

et al. 2020

Sensors

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The use of virtual reality trainers for teaching minimally invasive surgical techniques has been established for a long time in conventional laparoscopy as well as robotic surgery. The aim of the present study was to evaluate the impact of reproducible disruptive factors on the surgeon’s work. In a cross-sectional investigation, surgeons were tested with regard to the impact of different disruptive factors when doing exercises on a robotic-surgery simulator (Mimic Flex VRTM). Additionally, we collected data about the participants’ professional experience, gender, age, expertise in playing an instrument, and expertise in playing video games. The data were collected during DRUS 2019 (Symposium of the German Society for Robot-assisted Urology). Forty-two surgeons attending DRUS 2019 were asked to participate in a virtual robotic stress training unit. The surgeons worked in various specialties (visceral surgery, gynecology, and urology) and had different levels of expertise. The time taken to complete the exercise (TTCE), the final score (FSC), and blood loss (BL) were measured. In the basic exercise with an interactive disruption, TTCE was significantly longer (p < 0.01) and FSC significantly lower (p < 0.05). No significant difference in TTCE, FSC, or BL was noted in the advanced exercise with acoustic disruption. Performance during disruption was not dependent on the level of surgical experience, gender, age, expertise in playing an instrument, or playing video games. A positive correlation was registered between self-estimation and surgical experience. Interactive disruptions have a greater impact on the performance of a surgeon than acoustic ones. Disruption affects the performance of experienced as well as inexperienced surgeons. Disruption in daily surgery should be evaluated and minimized in the interest of the patient’s safety.

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Self-estimation of surgical skills and competencies based on the learning curve theory in medical residents and fellows

Cited by 9 publications

References 35 publications

Resident Performed Sutureless Manual Small Incision Cataract Surgery (MSICS): Outcomes

Resident Performed Sutureless Manual Small Incision Cataract Surgery (MSICS): Outcomes

Endoscopy training in Australia during COVID‐19: Efficacy and knowledge assessment of gastroenterology and general surgery trainees

Impact of Acoustic and Interactive Disruptive Factors during Robot-Assisted Surgery—A Virtual Surgical Training Model

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