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Rhode Island Medical Journal (2013) Oct 2023Robotic surgery continues to revolutionize the field of urologic surgery, and thus it is crucial that graduating urologic surgery residents demonstrate proficiency with...
Robotic surgery continues to revolutionize the field of urologic surgery, and thus it is crucial that graduating urologic surgery residents demonstrate proficiency with this technology. The large learning curve of utilizing robotic technology limits resident immediate participation in real-life robotic surgery, and skill acquisition is further challenged by variable case volume. Robotic simulation offers an invaluable opportunity for urologic trainees to cultivate strong foundational skills in a non-clinical setting, ultimately leading to both competence and operative confidence. Several different simulation technologies and robotic assessment protocols have been developed and demonstrate validity in several domains. However, despite their demonstrable utility, there is no formal robotic curricula within US urologic surgery residencies. In this article, we will review the current state of robotic simulation training in urologic surgery and highlight the importance of its widespread utilization in urologic surgery residency training programs.
Topics: Humans; Robotic Surgical Procedures; Clinical Competence; Robotics; Urologic Surgical Procedures; Computer Simulation; Internship and Residency; Curriculum; Simulation Training
PubMed: 37768162
DOI: No ID Found -
Advances in Physiology Education Dec 2023Inquiry-based learning (IBL) is a promising educational framework that is understudied in graduate medical education. To determine participant satisfaction and...
Inquiry-based learning (IBL) is a promising educational framework that is understudied in graduate medical education. To determine participant satisfaction and engagement with phases of an IBL postgraduate education program, a mixed-methods study collected data via survey statements and open-ended responses. The authors included participants attending an intensive care medicine (ICM) IBL program from May to November 2020. Quantitative outcomes included participants' satisfaction with the IBL format and impact of engagement with IBL on the learning experience. Qualitative outcomes explored determinants of engagement with IBL phases and the impact on the learning experience. Of 378 attendees, 167 submitted survey responses (44.2%). There was strong agreement relating to overall satisfaction (93.4%). Responses indicated engagement with "orientation" (94.6%), "conceptualization" (97.3%), "discussion" (91.1%), and "conclusion" (91.0%) but limited engagement with the "investigation" phase (48.1%). Greater engagement with IBL phases had positive impacts, with repeat attenders having clearer learning objectives (79.1% vs. 56.6%, < 0.05) and enhanced learning through collaborative discussion (65.9% vs. 48.7%, < 0.05). Qualitative analysis showed that ICM learners value active learning principles, clear objectives, and a safe environment to expand their "knowledge base." Sessions facilitated "clinically relevant learning," with application of theoretical knowledge. Learners transformed and "reframed their understanding," using the input of others' experiences. ICM learners were highly satisfied with the IBL format and reported valuable learning. Participants engaged strongly with all IBL phases except the investigation phase during the sessions. IBL facilitated learners' active construction of meaning, facilitating a constructivist approach to learning. An inquiry-based learning (IBL) program was launched as part of a novel binational intensive care medicine education program. Postgraduate intensive care medicine practitioners participated in this education intervention, where facilitated group discussions explored core intensive care medicine concepts. Survey responses indicated overall satisfaction, engagement with the IBL format, and a constructivist approach to learning. This study provided new insights into the benefits and challenges of an IBL program in the context of practicing clinicians.
Topics: Humans; Problem-Based Learning; Education, Medical, Graduate; Educational Status; Personal Satisfaction
PubMed: 37823188
DOI: 10.1152/advan.00050.2023 -
BMC Medical Education Jul 2023Video-assisted thoracic surgery (VATS) has become the standard for lung cancer diagnosis and treatment. However, this surgical technique requires specific and dedicated... (Review)
Review
BACKGROUND
Video-assisted thoracic surgery (VATS) has become the standard for lung cancer diagnosis and treatment. However, this surgical technique requires specific and dedicated training. In the past 20 years, several simulator systems have been developed to promote VATS training. Advances in virtual reality may facilitate its integration into the VATS training curriculum. The present review aims to first provide a comprehensive overview of the simulators for thoracoscopic surgery, focused especially on simulators for lung lobectomy; second, it explores the role and highlights the possible efficacy of these simulators in the surgical trainee curriculum.
METHODS
A literature search was conducted in the PubMed, EMBASE, Science Direct, Scopus and Web of Science databases using the following keywords combined with Boolean operators "AND" and "OR": virtual reality, VR, augmented reality, virtual simulation, mixed reality, extended reality, thoracic surgery, thoracoscopy, VATS, video-assisted thoracoscopic surgery, simulation, simulator, simulators, training, and education. Reference lists of the identified articles were hand-searched for additional relevant articles to be included in this review.
RESULTS
Different types of simulators have been used for VATS training: synthetic lung models (dry simulators); live animals or animal tissues (wet simulators); and simulators based on virtual or augmented reality. Their role in surgical training has been generally defined as useful. However, not enough data are available to ascertain which type is the most appropriate.
CONCLUSIONS
Simulator application in the field of medical education could revolutionize the regular surgical training curriculum. Further studies are required to better define their impact on surgeons' training programs and, finally, on patients' quality of care.
Topics: Animals; Thoracic Surgery, Video-Assisted; Computer Simulation; Virtual Reality; Augmented Reality; Robotic Surgical Procedures; Simulation Training; Clinical Competence
PubMed: 37501111
DOI: 10.1186/s12909-023-04482-z -
BMC Medical Informatics and Decision... Dec 2023Given that patients' medication adherence is regarded as the major part of disease control and improving health literacy can be effective in promoting adherence to... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Given that patients' medication adherence is regarded as the major part of disease control and improving health literacy can be effective in promoting adherence to healthy behaviors, the present study aimed to investigate the effect of health literacy intervention based on the medication adherence among uncontrolled hypertensive patients using mobile health (M-health).
METHODS
An interventional study with a quasi-experimental design, was conducted on 118 uncontrolled hypertensive patients. Participants were randomly divided into the intervention (n = 59) and control (n = 59) groups using blocked randomization. In the intervention group, a mobile health (M-health) program was designed using programmed instruction to improve patients' health literacy over a period of 3 months. Data was collected by administering health literacy and medication adherence questionnaires to participants before and after the intervention. The analysis involved using the independent sample t-test to compare the variables before and after the study.
RESULTS
Before the intervention, the total score of health literacy was 33.34 and 33.14 in the intervention and control groups, respectively. After the intervention, it increased to 40.36 and 34.20 in the intervention and control groups, respectively, which was statistically significant in the intervention group (p = 0.01). Moreover, the medication adherence score of the intervention group significantly increased after the intervention. Both systolic and diastolic blood pressure decreased in the intervention group. However, it should be noted that the decrease in systolic blood pressure by 148.98 was statistically significant, while the decrease observed in diastolic blood pressure in the intervention group was not statistically significant (p = 0.08).
CONCLUSION
The application of programmed instruction through M-Health has shown a positive effect on the health literacy of uncontrolled hypertensive patients. In addition to detecting and treating patients, it is important to prioritize the improvement of health literacy in terms of medication adherence and the adoption of healthy behaviors.
Topics: Humans; Health Literacy; Hypertension; Blood Pressure; Medication Adherence; Telemedicine
PubMed: 38102648
DOI: 10.1186/s12911-023-02393-z -
Medical Education Online Dec 2023The goal of this systematic review was to examine self-directed learning (SDL) assessment practices in undergraduate health professions education. (Review)
Review
PURPOSE
The goal of this systematic review was to examine self-directed learning (SDL) assessment practices in undergraduate health professions education.
METHODS
Seven electronic databases were searched (PubMed, Embase, PsycINFO, ERIC, CINAHL, Scopus, and Web of Science) to retrieve English-language articles published between 2015 and July of 2022, investigating assessment of SDL learning outcomes. Extracted data included the sample size, field of study, study design, SDL activity type, SDL assessment method, number of SDL assessments used, study quality, number of SDL components present utilising the framework the authors developed, and SDL activity outcomes. We also assessed relationships between SDL assessment method and number of SDL components, study quality, field of study, and study outcomes.
RESULTS
Of the 141 studies included, the majority of study participants were medical (51.8%) or nursing (34.8%) students. The most common SDL assessment method used was internally-developed perception surveys (49.6%). When evaluating outcomes for SDL activities, most studies reported a positive or mixed/neutral outcome (58.2% and 34.8%, respectively). There was a statistically significant relationship between both number and type of assessments used, and study quality, with knowledge assessments (median-IQR 11.5) being associated with higher study quality ( < 0.001). Less than half (48.9%) of the studies used more than one assessment method to evaluate the effectiveness of SDL activities. Having more than one assessment (mean 9.49) was associated with higher quality study ( < 0.001).
CONCLUSIONS
The results of our systematic review suggest that SDL assessment practices within undergraduate health professions education vary greatly, as different aspects of SDL were leveraged and implemented by diverse groups of learners to meet different learning needs and professional accreditation requirements. Evidence-based best practices for the assessment of SDL across undergraduate healthcare professions education should include the use of multiple assessments, with direct and indirect measures, to more accurately assess student performance.
Topics: Humans; Health Occupations; Learning; Motivation; Qualitative Research; Program Evaluation; Self-Directed Learning as Topic; Students, Medical; Students, Nursing; Students, Health Occupations
PubMed: 36919556
DOI: 10.1080/10872981.2023.2189553 -
Advances in Physiology Education Dec 2023Application-of-knowledge skills are highly valued in clinical medicine, as indicated by recent changes to licensure and entrance exams for nursing and physician programs...
Application-of-knowledge skills are highly valued in clinical medicine, as indicated by recent changes to licensure and entrance exams for nursing and physician programs (i.e., the NCLEX and MCAT). Such emphasis should be both welcomed and supported by approaches to teaching human anatomy and physiology that emphasize critical thinking skills built upon logic, reasoning, and judgment. The argument for development of these skills is not simply philosophical. Rather, such emphasis is strongly supported by a 2016 Johns Hopkins study (Makary MA, Daniel M. 353: i2139, 2016) that estimates that medical errors are now the third leading cause of death in the United States! Active learning techniques known to require critical thinking skills are often supplemental to standard expository lecturing or other avenues of imparting content knowledge (reading, videos, etc.). We propose that all content dissemination can and should provide for the development of critical thinking skills, preparing students for active learning techniques requiring this ability. This can be accomplished by establishing an intellectual framework for understanding the adaptive benefits of anatomical or physiological traits. Additionally, explanations conveying the causality of mechanistic sequences result in learning content within intuitive functional groups rather than as isolated phenomena, the latter often accomplished mainly through memorization as opposed to real understanding. Here, we provide a template for lecture development based upon these principles as well as a specific example from human anatomy and physiology. Our hope is to provide a model for how students should think about all physiology, making comprehensive coverage of content (an impossible task!) much less important. Critical thinking skills are essential to the effective performance of many careers, particularly those involving health care. To aid the development of these skills in physiology, the formation of logical cognitive frameworks needs to be supported via instruction that emphasizes the context of physiological functions (the "why") as well as the causality of their sequential actions. Within such frameworks, students become capable of cognitive reasoning required to reach intuitive conclusions after system perturbations.
Topics: Humans; Thinking; Problem-Based Learning; Problem Solving; Judgment; Curriculum
PubMed: 37732369
DOI: 10.1152/advan.00131.2023 -
One Health Outlook Apr 2024The One Health (OH) approach recognises that humans, animals, plants, and the environment are interrelated, and therefore seeks to facilitate collaboration,...
BACKGROUND
The One Health (OH) approach recognises that humans, animals, plants, and the environment are interrelated, and therefore seeks to facilitate collaboration, communication, coordination, and capacity building between relevant stakeholders to achieve a healthier ecosystem. This calls for integrating OH into established governance, policy, health, education, and community structures, and requires OH professionals equipped with the necessary inter and trans-disciplinary skillset. Therefore, numerous OH training programmes are currently being offered globally. However, the coordination and contents of some of these trainings have been criticised as inconsistent and inadequately standardised, and therefore could serve as a barrier to OH implementation. In this study, an up-to-date repository of a subset of OH academic programmes offered globally was provided, and their curricula contents was critically assessed.
METHODS
Between December 2022 and April 2023, an online search for key terms 'ONE HEALTH MASTERS COURSES', and 'ONE HEALTH MASTERS PROGRAMMES' together with variations of 'AFRICA', 'NORTH AMERICA', 'ASIA', 'AUSTRALIA', 'EUROPE', 'GLOBAL' was conducted. Details about course title, delivery mode, joint administration status, curricula contents, language of instruction, years to completion, host university, country, and continent were collected.
RESULTS
Forty-three programmes met inclusion criteria of the study, and almost all (n = 36, 83.7%) were tailored towards infectious diseases and population/global health, compared to the environmental and conservation perspectives. Compiled curricula contents clustered into one of these 12 sub-headings: 'principles and concepts of OH', 'epidemiology and biostatistics', 'major branches of OH', 'internship/externship/research project', 'infectious diseases, zoonoses, and surveillance', 'risk analysis and crises management', 'food safety, microbiology, immunology, and allied', 'communication', 'ethics', 'economics, policy, and management' and 'others. Of these, infectious disease themes were the most common. Regarding geography and organising institutions, North America and Europe, and veterinary institutions, respectively, were the most represented.
CONCLUSION
Despite the multi-level diversity observed, uniformity still exists across the programmes which favours interdisciplinary cross-talks. Future pedagogical studies that objectively assess the alignment of module contents with the OH core competencies and the impacts of these OH programmes is recommended. With this study, a critical information gap that has existed for long in the OH field has been bridged.
PubMed: 38600594
DOI: 10.1186/s42522-024-00097-6 -
PeerJ. Computer Science 2024There are a large number of professions in the world today. Some professions are disappearing, and some new ones are emerging. However, they all have something in...
There are a large number of professions in the world today. Some professions are disappearing, and some new ones are emerging. However, they all have something in common: the need to manage them. Throughout its history, humanity has developed several constantly changing forms of management. For this reason, school absolvents must enter the labour market with skills already sufficiently developed, such as communication, cooperation, teamwork, responsibility, and the ability to plan their work. The article focuses on the issue of teaching programming through mobile applications and basic robotics through the innovative form of teaching-EduScrum. The EduScrum methodology is based on the agile software development method Scrum, which develops soft skills. The article describes our experience with this teaching in computer science classes. We established several hypotheses evaluated using descriptive statistics on a sample of 251 students. The main objective of the research is to verify whether teaching computer science in primary and secondary schools using the eduScrum methodology is more suitable than the classical-frontal teaching of computer science. The research showed that secondary school students preferred the eduScrum methodology more than traditional frontal teaching and the primary school students preferred traditional frontal teaching.
PubMed: 38435552
DOI: 10.7717/peerj-cs.1822 -
BMC Medical Education Aug 2023Fellowship programs offer training in a subspecialty focusing on distinct and advanced clinical/academic skills. This advanced postgraduate training allows physicians,... (Review)
Review
BACKGROUND
Fellowship programs offer training in a subspecialty focusing on distinct and advanced clinical/academic skills. This advanced postgraduate training allows physicians, who desire a more specialized practice, to further develop clinical, academic, research, and leadership/administrative skills. The Aga Khan University (AKU) is one of the few institutes offering paediatric sub-specialty training in Pakistan. We aimed to evaluate the current Paediatric fellowship programs at AKU.
METHODS
Process evaluation of six paediatric fellowship programs (cardiology, neurology, endocrinology, critical care medicine, neonatology, and infectious disease) was conducted from September 2020 to April 2021 by senior clinicians and medical educationists. Evidence was collected through document review (using existing postgraduate medical education program information form), observation of teaching and learning support, and focused group discussions/interviews with program faculty and fellows were conducted. A review of the evaluation report was done as part of this study. This study received an exemption from the ethical review committee. The quantitative data were analyzed using SPSS (22.0) while the reports of discussion with fellows and friends underwent content analysis.
RESULTS
All fellowship programs met the criteria for having a robust competency-based fellowship curriculum as per the institutional and national guidelines. Formative assessment in the form of continuous evaluation was found to be integrated into all the fellowship programs, however, most of the programs were found to lack a summative assessment plan. Fellows in training and program faculty were satisfied with the opportunities for mentorship, teaching, and learning. Thematic analysis of the discussion reports with faculty and fellows revealed three key themes including, program aspects translating into strengthening the training, gaps in the training program in delivering the expectations, and making ways to reach par excellence.
CONCLUSIONS
The process evaluation of paediatric fellowship programs provided an opportunity to holistically review the current strengths and quality of the training in individual programs along with the unmet needs of the trainees. This will help the program stakeholders to prioritize, align and allocate the resources to further enhance the quality of training and outcome of individual fellowship programs to ensure wider impacts at a regional, national, and international health system level.
Topics: Humans; Child; Pakistan; Fellowships and Scholarships; Curriculum; Learning; Hospitals, University
PubMed: 37641130
DOI: 10.1186/s12909-023-04501-z