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Surgical Training (surgical + training)
Selected AbstractsTEMPLATE FOR SURGICAL TRAINING IN RESOURCE-POOR COUNTRIESANZ JOURNAL OF SURGERY, Issue 10 2006FRACS, Russell L Gruen MB BS No abstract is available for this article. [source] The Importance of Core Surgical Training for Dermatologists and Dermatologic SurgeonsDERMATOLOGIC SURGERY, Issue 2 2002Robert L. Hewitt MD No abstract is available for this article. [source] Ensuring a graduated integrated progression of learning in a changing environmentANZ JOURNAL OF SURGERY, Issue 3 2009W. E. G. Thomas Abstract Surgical training is under threat in the changing environment of today. In the past, training consisted of an apprenticeship, which is no longer feasible or practical within the time limitation imposed on trainees currently, and so a new and innovative approach is required to train the surgeons of tomorrow. There is therefore a need for an explicit curriculum that ensures a graduated and integrated progression of learning in which both trainees and trainers are aware of what is required for each stage in training and for each surgical specialty. Such a curriculum has now been developed in the UK. [source] Surgical training: a change for the betterANZ JOURNAL OF SURGERY, Issue 7 2006BMedSci, PGDipSurgAnat, Warren M. Rozen MB BS No abstract is available for this article. [source] Surgical training in gastrointestinal procedures within a UK gynaecological oncology subspecialty programmeBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 10 2010J Williams No abstract is available for this article. [source] Surgical training in gastrointestinal procedures within a UK gynaecological oncology subspecialty programmeBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 10 2010R Naik No abstract is available for this article. [source] Surgical training in gastrointestinal procedures within a UK gynaecological oncology subspecialty programmeBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 1 2010R Naik Objective, An analysis of surgical experience in gastrointestinal procedures within a UK-based gynaecological oncology centre to which subspecialty fellows within the subject are exposed. Design, Retrospective study. Setting, Northern Gynaecological Oncology Centre, Gateshead, UK. Population, All women undergoing bowel surgery over a six-year period, 1 January 2000 to 31 December 2005. Methods, Cases were analysed by specialty and grade of surgeon performing the procedure. Main outcome measure, Proportion of cases to which subspecialty fellows were exposed. Results, Two hundred and sixty-two women (11.5%) underwent bowel surgery out of 2280 women undergoing major surgery for gynaecological cancer. This included ovarian/primary peritoneal cancer in 186 women (71%). Of these 262 cases, 238 operations (91%) were performed by a gynaecological oncologist, 20 (7.5%) were performed jointly with the gastrointestinal surgeons and four (1.5%) were performed solely by the gastrointestinal surgeons. A gynaecological oncology subspecialty fellow performed 21 (8%) and assisted in an additional 204 operations (78%). Perioperative morbidity and mortality statistics in addition to overall survival outcomes were comparable to the published literature. Conclusions, A significant proportion of major surgical operations performed within a gynaecological oncology centre require gastrointestinal procedures. The majority of these procedures can be performed by gynaecological oncologists with an acceptable perioperative morbidity and mortality rate. Subspecialty training has the potential to allow trainees significant exposure to these procedures. An accredited post-Fellowship Training Programme can provide the opportunity for hands-on experience to allow gynaecological oncologists the confidence and credibility to perform these procedures independently. [source] Surgical training and working time restrictionBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 4 2009T. B. Glomsaker Team,patient, not doctor,patient, relationship [source] Structured training of ENT Specialist Registrars in the out-patient clinic and theatreCLINICAL OTOLARYNGOLOGY, Issue 5 2002A. Drake-Lee The aims of this paper are to evaluate the training in out-patients and in theatre after the recent changes in SpR training. A postal questionnaire was sent to 191 Specialist Registrars (SpRs) in England and Wales and 57 were returned (30%). There were temporal bone facilities within the hospital for 53 SpRs but only three used them because there were no temporal bones. Surgical training was more satisfactory than out-patient training. Fewer general clinics and more specialized clinics are required, and consultant supervision is still patchy and needs attention. [source] Porcine Sebaceous Cyst Model: An Inexpensive, Reproducible Skin Surgery SimulatorDERMATOLOGIC SURGERY, Issue 8 2005Jonathan Bowling MBChB background. Surgical simulators are an established part of surgical training and are regularly used as part of the objective structured assessment of technical skills. Specific artificial skin models representing cutaneous pathology are available, although they are expensive when compared with pigskin. The limitations of artificial skin models include their difficulty in representing lifelike cutaneous pathology. objective. Our aim was to devise an inexpensive, reproducible surgical simulator that provides the most lifelike representation of the sebaceous cyst. materials and methods. Pigskin, either pig's feet/trotters or pork belly, was incised, and a paintball was inserted subcutaneously and fixed with cyanoacrylic glue. results. This model has regularly been used in cutaneous surgical courses that we have organized. Either adding more cyanoacrylic glue or allowing more time for the paint ball to absorb fluid from surrounding tissue can also adjust the degree of difficulty. conclusions. The degree of correlation with lifelike cutaneous pathology is such that we recommend that all courses involved in basic skin surgery should consider using the porcine sebaceous cyst model when teaching excision of sebaceous cysts. [source] Policy related to abdominoplasty in publicly funded elective surgery programs: a systematic reviewINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 2 2009Alan Pearson RN, DipNEd Abstract Objectives, This systematic review set out to establish best practice in relation to policy for the inclusion/exclusion of abdominoplasty procedures within public health systems. Inclusion criteria, The review considered any studies relating to abdominoplasty that addressed issues of inclusion/exclusion from public funded health systems including criteria for clinical need, contraindications, fit/ready for surgery, policy compliance and issues in relation to surgical training. Search strategy, The search strategy sought to find published and unpublished studies and papers limited to English. An initial search of Medline and CINAHL was undertaken, followed by an analysis of keywords contained in the title, abstract and index terms. A second comprehensive search was then undertaken using Medline, CINAHL, EMBASE, AUSTROM, Health Business, and FullTEXT Elite and PsycINFO. The search was restricted to the period 1995,2005. Methodological quality, Each paper identified was assessed by two independent reviewers for methodological quality before inclusion in the review using an appropriate critical appraisal instrument from the Joanna Briggs Institute System for the Unified Management and Assessment Review Instrument package. Results, A total of 19 papers were included in the review. Owing to the diverse nature of the papers no meta-analysis or meta-synthesis was able to be used to pool studies. The results are therefore presented in a narrative form. The papers identified were mainly retrospective audits and discussion/opinion papers. The main issues addressed were criteria to establish clinical need, contraindications and policy compliance. Conclusion, There are clinical indicators, mainly in relation to physical symptoms/dysfunction, to support exemption of some cases of abdominoplasty. For abdominoplasty to be conducted clinical need must be assessed and formally documented. Where clinical need is primarily based on psychological distress/dysfunction a formal psychiatric assessment should be used to justify surgery. [source] The value of microsurgery in liver researchLIVER INTERNATIONAL, Issue 8 2009Maria-Angeles Aller Abstract The use of an operating microscope in rat liver surgery makes it possible to obtain new experimental models and improve the already existing macrosurgical models. Thus, microsurgery could be a very valuable technique to improve experimental models of hepatic insufficiency. In the current review, we present the microsurgical techniques most frequently used in the rat, such as the portacaval shunt, the extrahepatic biliary tract resection, partial and total hepatectomies and heterotopic and orthotopic liver transplantation. Hence, reducing surgical complications allows for perfecting the resulting experimental models. Thus, liver atrophy related to portacaval shunt, prehepatic portal hypertension secondary to partial portal vein ligation, cholestasis by resection of the extrahepatic biliary tract, hepatic regeneration after partial hepatectomies, acute liver failure associated with subtotal or total hepatectomy and finally complications derived from preservation or rejection in orthotopic and heterotopic liver transplantation can be studied in more standardized experimental models. The results obtained are therefore more reliable and facilitates the flow of knowledge from the bench to the bedside. Some of these microsurgical techniques, because of their simplicity, can be performed by researchers without any prior surgical training. Other more complex microsurgical techniques require in-depth surgical training. These techniques are ideal for achieving a complete surgical training and more select microsurgical models for hepatology research. [source] Should plastic surgery experience be an integral part of orthopaedic and trauma surgical training?MEDICAL EDUCATION, Issue 3 2005Mark S Gaston No abstract is available for this article. [source] Graphic and haptic modelling of the oesophagus for VR-based medical simulationTHE INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY, Issue 3 2009Changmok Choi Abstract Background Medical simulators with vision and haptic feedback have been applied to many medical procedures in recent years, due to their safe and repetitive nature for training. Among the many technical components of the simulators, realistic and interactive organ modelling stands out as a key issue for judging the fidelity of the simulation. This paper describes the modelling of an oesophagus for a real-time laparoscopic surgical simulator. Methods For realistic simulation, organ deformation and tissue cutting in the oesophagus are implemented with geometric organ models segmented from the Visible Human Dataset. The tissue mechanical parameters were obtained from in vivo animal experiments and integrated with graphic and haptic devices into the laparoscopic surgical simulation system inside an abdominal mannequin. Results This platform can be used to demonstrate deformation and incision of the oesophagus by surgical instruments, where the user can haptically interact with the virtual soft tissues and simultaneously see the corresponding organ deformation on the visual display. Conclusions Current laparoscopic surgical training has been transformed from the traditional apprenticeship model to simulation-based methods. The outcome of the model could replace conventional training systems and could be useful in effectively transferring surgical skills to novice surgeons. Copyright © 2009 John Wiley & Sons, Ltd. [source] New Alternative Methods to Teach Surgical Techniques for Veterinary Medicine Students despite the Absence of Living Animals.ANATOMIA, HISTOLOGIA, EMBRYOLOGIA, Issue 3 2007Is that an Academic Paradox? Summary Due to a raised ethical mentality, veterinary schools are pursuing methods to preserve animal corpses used for surgical technique classes in an attempt to reduce the use of living animals for teaching. Generally speaking, animal and human bodies are usually preserved with 10% aqueous formalin solution especially for descriptive anatomy classes. Other possibilities include the use of glycerol, alcohol and phenol. At present, new fixatives have been developed to allow a better and longer preservation of animal corpses in order to maintain organoleptic characteristics, i.e. colour, texture, as close as possible to what students will deal with living animals. From 2004, in our college, surgical technique classes no longer use living animals for students' training. Instead, canine corpses chemically preserved with modified Larssen (MLS) and Laskowski (LS) solutions are preferred. The purpose of this study was to investigate comparatively the biological quality of preservation of these two solutions and to evaluate students' learning and acceptance of this new teaching method. Although these fixatives maintain body flexibility, LS solution failed to keep an ordinary tissue colouration (cadavers were intensely red) and tissue preservation was not adequate. By contrast, MLS solution, however, did not alter the colouration of cadavers which was fairly similar to that normally found in living animals. A remarkable characteristic was a very strong and unpleasant sugary odour in LS-preserved animals and therefore the MLS solution was the elected method to preserve cadavers for surgical technique classes. The students' feedback to the use of Larssen-preserved cadavers was very satisfactory, i.e. 96.6% of students were in favour of the use of cadavers for surgical training and on average 91.8% (2002,2003) of students preferred the MLS solution as the chemical preserver, whereas only 8.2% elected LS solution for teaching purposes. From the students' point of view (95.1%) the ideal class would be an initial training in MLS cadavers followed by classes with animals admitted to the Veterinary Hospital. [source] Nurturing of surgical careers by the wellington surgical interest clubANZ JOURNAL OF SURGERY, Issue 4 2009Sanket Srinivasa The Royal Australasian College of Surgeons (RACS) has recently introduced the new Surgical Education and Training programme. The purpose of this was, in part, to help address the anticipated shortage of surgeons in the future, by streamlining the surgical training programme. The formation of the Wellington Surgical Interest Club (WSIC), a student-led initiative, had several complementary goals. These included the desire to identify potential candidates for a career in surgery, promote a surgical career to students especially women, help students acquire basic surgical skills early, inform students about surgical careers, promote student involvement in surgical research and to create an effective mentorship model during undergraduate and junior surgical training. The strengths of WSIC are its goals, which are similar to those of the RACS with regard to promoting surgery as a career option; its easy reproducibility at other medical institutions; its ability to focus on issues of relevance to both students and junior doctors; and being a bridging solution at a time when early exposure to surgical specialties is both desired and necessary. [source] Workplace-based assessment: assessing technical skill throughout the continuum of surgical trainingANZ JOURNAL OF SURGERY, Issue 3 2009Jonathan Beard Abstract The Royal Colleges of Surgeons and Surgical Specialty Associations in the UK have introduced competence-based syllabi and curricula for surgical training. The syllabi of the Intercollegiate Surgical Curriculum Programme (ISCP) and Orthopaedic Curriculum and Assessment Programme (OCAP) define the core competencies, that is, the observable and measureable behaviours required of a surgical trainee. The curricula define when, where and how these will be assessed. Procedure-based assessment (PBA) has been adopted as the principal method of assessing surgical skills. It combines competencies specific to the procedure with generic competencies such as safe handling of instruments. It covers the entire procedure, including preoperative and postoperative planning. A global summary of the level at which the trainee performed the assessed elements of the procedure is also included. The form has been designed to be completed quickly by the assessor (clinical supervisor) and fed-back to the trainee between operations. PBA forms have been developed for all index procedures in all surgical specialties. The forms are intended to be used as frequently as possible when performing index procedures, as their primary aim is to aid learning. At the end of a training placement the aggregated PBA forms, together with the logbook, enable the Educational Supervisor and/or Programme Director to make a summary judgement about the competence of a trainee to perform index procedures to a given standard. [source] Rural surgical training in Australia and update: rural and remote surgeryANZ JOURNAL OF SURGERY, Issue 7 2008Andrew J. A. Holland BSc (Hons), FRACS (Paed), PhD (Syd) No abstract is available for this article. [source] Virtual reality simulators: Current status in acquisition and assessment of surgical skillsANZ JOURNAL OF SURGERY, Issue 1 2002Peter H. Cosman Medical technology is currently evolving so rapidly that its impact cannot be analysed. Robotics and telesurgery loom on the horizon, and the technology used to drive these advances has serendipitous side-effects for the education and training arena. The graphical and haptic interfaces used to provide remote feedback to the operator , by passing control to a computer , may be used to generate simulations of the operative environment that are useful for training candidates in surgical procedures. One additional advantage is that the metrics calculated inherently in the controlling software in order to run the simulation may be used to provide performance feedback to individual trainees and mentors. New interfaces will be required to undergo evaluation of the simulation fidelity before being deemed acceptable. The potential benefits fall into one of two general categories: those benefits related to skill acquisition, and those related to skill assessment. The educational value of the simulation will require assessment, and comparison to currently available methods of training in any given procedure. It is also necessary to determine , by repeated trials , whether a given simulation actually measures the performance parameters it purports to measure. This trains the spotlight on what constitutes good surgical skill, and how it is to be objectively measured. Early results suggest that virtual reality simulators have an important role to play in this aspect of surgical training. [source] Gynaecological surgery from art and craft to science?AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 2 2009Neil Philip JOHNSON Randomised controlled trials are applied more readily to medical than surgical interventions. There are even more barriers to randomised trials of surgical interventions than to other randomised trials. These include reluctance among surgeons to undertake trials (owing to concern over expressing equipoise, surgical training and surgical learning curve issues, restrictions of funding and time for research, even financial conflict of interest), reluctance of patients to participate in surgical trials owing to fears over ,experimental surgery', failure of randomised trials to detect rare surgical complications and the almost universal failure of those conducting surgical trials to examine important long-term outcomes. Rapid advances in surgical fields mean that new surgical techniques are rapidly superseded and clinical questions surrounding new techniques may linger only until the next new technique becomes available. Nonetheless randomised controlled trials remain the cornerstone of evaluating the effectiveness of surgical interventions. Genuine progress has been made in this field. However, large multicentre collaborative randomised trials that have been prospectively defined in trial registries will be required in the future to answer the important clinical questions regarding gynaecological surgical interventions. [source] Survey of surgical skills of RANZCOG traineesAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2009Andreas OBERMAIR Background: In Australia, the Integrated Training Program (ITP) of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) offers training in obstetrics and gynaecology. There is anecdotal concern among trainees and Fellows that the surgical component of training is inadequate, with new specialists lacking the confidence and competence to perform many ,standard' surgical procedures. These concerns have not previously been quantified in Australia and New Zealand. Aim: To determine trainees' subjective competence and confidence with surgical procedures and trainees' satisfaction with their surgical training. Methods: All 430 active RANZCOG trainees and 108 Fellows elevated within the previous two years were invited to complete a self-administered questionnaire (65% response rate), which assessed details of procedures performed and confidence to perform them; satisfaction with the surgical training; and perceived teaching ability of the supervising consultants. Results: Those in ITP year 6 rated their confidence high (, 4 of 5) for procedures performed very frequently, but lower for other procedures. No procedure regarding the management of complications reached a confidence score of , 4. Teaching abilities were rated best for obstetric procedures, with 54% rating their consultants' teaching ability as ,excellent'; but for laparoscopic procedures and procedures dealing with complications, 21.2% and 23.4% of respondents rated their consultants' teaching ability as ,poor', respectively. Conclusions: Advanced trainees lacked confidence in a range of surgical procedures; and possible weaker areas were identified in the teaching experience of trainers. These limitations must be addressed by medical educators and training program coordinators. [source] Assessment of surgical competence at carotid endarterectomy under local anaesthesia in a simulated operating theatre,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 4 2010S. A. Black Background: Methods of surgical training that do not put patients at risk are desirable. A high-fidelity simulation of carotid endarterectomy under local anaesthesia was tested as a tool for assessment of vascular surgical competence, as an adjunct to training. Methods: Sixty procedures were performed by 30 vascular surgeons (ten junior trainees, ten senior trainees and ten consultants) in a simulated operating theatre. Each performed in a non-crisis scenario followed by a crisis scenario. Performance was assessed live by means of rating scales for technical and non-technical skills. Results: There was a significant difference in technical skills with ascending grade for both generic and procedure-specific technical skill scores in both scenarios (P < 0·001 for all comparisons). Similarly, there was also a significant difference in non-technical skill with ascending grade for both scenarios (P < 0·001). There was a highly significant correlation between technical and non-technical performance in both scenarios (non-crisis: rs = 0·80, P < 0·001; crisis: rs = 0·85, P < 0·001). Inter-rater reliability was high (,, 0·80 for all scales). Conclusion: High-fidelity simulation offers competency-based assessment for all grades and may provide a useful training environment for junior trainees and more experienced surgeons. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Selection, teaching and training in ophthalmologyCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 5 2005Larry Benjamin FRCOphth Abstract This article examines the training requirements for ophthalmic surgical training, and the selection, assessment and training methodologies used for trainees, and also comments on the role of the surgical trainers. As an introduction to the article, a brief description of the current scheme in the UK is given. [source] Anatomy in basic surgical trainingCLINICAL ANATOMY, Issue 6 2005Stuart W. McDonald No abstract is available for this article. [source] Reduced undergraduate medical science teaching is detrimental for basic surgical trainingCLINICAL ANATOMY, Issue 6 2005Stephen J. Hanna No abstract is available for this article. [source] | ||||||||||||||||||||||||||||