PD30-06 A NOVEL SYSTEM FOR TEACHING INTRAOPERATIVE LAPAROSCOPIC SKILLS USING STANDARDIZED COMMUNICATION AND AN ENDOSCOPIC MONITOR FRAME OF REFERENCE TOOL
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Résumé
You have accessJournal of UrologyCME1 Apr 2023PD30-06 A NOVEL SYSTEM FOR TEACHING INTRAOPERATIVE LAPAROSCOPIC SKILLS USING STANDARDIZED COMMUNICATION AND AN ENDOSCOPIC MONITOR FRAME OF REFERENCE TOOL Kikachukwu Otiono, Jennifer Hoogenes, Kevin Kim, Bobby Shayegan, Anil Kapoor, Kevin Piercey, and Edward D. Matsumoto Kikachukwu OtionoKikachukwu Otiono More articles by this author , Jennifer HoogenesJennifer Hoogenes More articles by this author , Kevin KimKevin Kim More articles by this author , Bobby ShayeganBobby Shayegan More articles by this author , Anil KapoorAnil Kapoor More articles by this author , Kevin PierceyKevin Piercey More articles by this author , and Edward D. MatsumotoEdward D. Matsumoto More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003316.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Directional terminology in the operating room (OR) during laparoscopic surgery is a common source of confusion for trainees, as the spatial orientation of the on-screen operative field differs depending on the viewer’s perspective and frame of reference. We developed and evaluated the utility and feasibility of 2 endoscopic monitor screen overlays designed to standardize directional instruction. METHODS: For a baseline perspective on laparoscopic instruction, we video-recorded and qualitatively analyzed 20 teaching cases. We then designed and printed 2 transparent endoscopic monitor overlays: an alphanumeric grid (AG) and a clock. In a laparoscopic simulation lab, 63 medical students were randomized into 3 groups of 21: control, AG, and clock. AG and clock groups were given overlay-specific instructions. All groups completed 3 trials of 6 transfer tasks. Completion and error rates were recorded. We then trialed the overlays in 44 teaching cases in urology and general surgery (30 AG and 14 clock). All cases were video recorded, transcribed, and qualitatively analyzed. Participants completed follow-up experiential surveys with 6-point Likert scales of agreement and space for comments. RESULTS: In the baseline cases, instructors often used directional terms (e.g., screen left/right; up/down) and pointed to the screen during instruction. In the simulation study, the AG group demonstrated the lowest error rates which became significant by trial 3 (p=0.01). 6 instructors and 21 residents from urology (n=14) and general surgery (n=7) participated in the intraoperative evaluation of the overlays. Instructors rated the AG higher than the clock in improving efficiency and hand-eye coordination (p’s<0.001) and agreed that it should be used in the residency program. Trainees rated the AG higher in improving operative technique and confidence in the OR (p’s<0.001). Instructors were more likely to recommend use of the AG over the clock (p=0.004). CONCLUSIONS: We showed that an AG overlay used with standardized commands significantly improved instruction and learning during simulated and live laparoscopic cases. Further work will involve the evaluation of the economy of motion and errors while using the overlay. This could lead to the use of a heads-up display for laparoscopic and robotic training. Further exploration of instructor-trainee discourse is necessary when considering the development and implementation of new methods to improve intraoperative teaching in the era of competency-based medical education. Source of Funding: McMaster Surgical Associates, McMaster University, Hamilton, Ontario, Canada © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e833 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kikachukwu Otiono More articles by this author Jennifer Hoogenes More articles by this author Kevin Kim More articles by this author Bobby Shayegan More articles by this author Anil Kapoor More articles by this author Kevin Piercey More articles by this author Edward D. Matsumoto More articles by this author Expand All Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,047 | 0,011 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».