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Erschienen in: Surgical Endoscopy 3/2016

01.03.2016

Long-term knowledge retention following simulation-based training for electrosurgical safety: 1-year follow-up of a randomized controlled trial

verfasst von: Amin Madani, Yusuke Watanabe, Melina C. Vassiliou, Pascal Fuchshuber, Daniel B. Jones, Steven D. Schwaitzberg, Gerald M. Fried, Liane S. Feldman

Erschienen in: Surgical Endoscopy | Ausgabe 3/2016

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Abstract

Background

Despite the value of simulation for surgical training, it is unclear whether acquired competencies persist long term. A prior randomized trial showed that structured simulation improves knowledge of the safe use of electrosurgery (ES) amongst trainees up to 3 months after the curriculum (Madani et al. in Surg Endosc 28(10):2772–2782, 2014). We now analyse long-term knowledge retention. This study estimates the effects of a structured simulation-based curriculum to teach the safe use of ES on knowledge after 1 year.

Methods

Trainees previously participated in a 1-h didactic ES course, followed by randomization into one of two groups: an unstructured hands-on session where trainees used ES devices (control group) or a goal-directed hands-on training session (Sim group). Knowledge of pre- and post-curriculum (immediate, 3 months and 1 year) and knowledge of ES safety were assessed using different multiple-choice examinations. Data are expressed as median (interquartile range), *p < 0.05.

Results

Fifty-nine trainees participated (30 control group; 29 Sim group). Despite equal baseline examination scores, Sim group demonstrated higher scores compared to control immediately (89 % [83; 94] vs. 83 % [71; 86]*), 3 months (77 % [69; 90] vs. 60 % [51; 80]*) and 1 year after curriculum (70 % [61; 74] vs. 60 % [31; 71]*). One-year score remained significantly greater compared to baseline in the Sim group (70 % [61; 74] vs. 49 % [43; 57]*), but was similar to baseline in the control group (60 % [31; 71] vs. 45 % [34; 52]).

Conclusions

After ES simulation training, retention of competencies persists longer when the hands-on component is designed to reinforce specific learning objectives in a structured curriculum. Despite routine clinical use of ES devices, knowledge degrades overtime, suggesting the need for ongoing formal educational activities to reinforce curricular objectives.
Literatur
1.
Zurück zum Zitat Hutter MM, Kellogg KC, Ferguson CM, Abbott WM, Warshaw AL (2006) The impact of the 80-hour resident workweek on surgical residents and attending surgeons. Ann Surg 243:864–871 (discussion 871–865) PubMedCentralCrossRefPubMed Hutter MM, Kellogg KC, Ferguson CM, Abbott WM, Warshaw AL (2006) The impact of the 80-hour resident workweek on surgical residents and attending surgeons. Ann Surg 243:864–871 (discussion 871–865) PubMedCentralCrossRefPubMed
2.
Zurück zum Zitat Ahmed N, Devitt KS, Keshet I, Spicer J, Imrie K, Feldman L, Cools-Lartigue J, Kayssi A, Lipsman N, Elmi M, Kulkarni AV, Parshuram C, Mainprize T, Warren RJ, Fata P, Gorman MS, Feinberg S, Rutka J (2014) A systematic review of the effects of resident duty hour restrictions in surgery: impact on resident wellness, training, and patient outcomes. Ann Surg 259:1041–1053PubMedCentralCrossRefPubMed Ahmed N, Devitt KS, Keshet I, Spicer J, Imrie K, Feldman L, Cools-Lartigue J, Kayssi A, Lipsman N, Elmi M, Kulkarni AV, Parshuram C, Mainprize T, Warren RJ, Fata P, Gorman MS, Feinberg S, Rutka J (2014) A systematic review of the effects of resident duty hour restrictions in surgery: impact on resident wellness, training, and patient outcomes. Ann Surg 259:1041–1053PubMedCentralCrossRefPubMed
3.
Zurück zum Zitat Kasotakis G, Lakha A, Sarkar B, Kunitake H, Kissane-Lee N, Dechert T, McAneny D, Burke P, Doherty G (2014) Trainee participation is associated with adverse outcomes in emergency general surgery: an analysis of the National Surgical Quality Improvement Program database. Ann Surg 260:483–490 (discussion 490–483) CrossRefPubMed Kasotakis G, Lakha A, Sarkar B, Kunitake H, Kissane-Lee N, Dechert T, McAneny D, Burke P, Doherty G (2014) Trainee participation is associated with adverse outcomes in emergency general surgery: an analysis of the National Surgical Quality Improvement Program database. Ann Surg 260:483–490 (discussion 490–483) CrossRefPubMed
4.
Zurück zum Zitat Bridges M, Diamond DL (1999) The financial impact of teaching surgical residents in the operating room. Am J Surg 177:28–32CrossRefPubMed Bridges M, Diamond DL (1999) The financial impact of teaching surgical residents in the operating room. Am J Surg 177:28–32CrossRefPubMed
5.
Zurück zum Zitat Issenberg SB, McGaghie WC, Petrusa ER, Lee Gordon D, Scalese RJ (2005) Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach 27:10–28CrossRefPubMed Issenberg SB, McGaghie WC, Petrusa ER, Lee Gordon D, Scalese RJ (2005) Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach 27:10–28CrossRefPubMed
6.
Zurück zum Zitat Sutherland LM, Middleton PF, Anthony A, Hamdorf J, Cregan P, Scott D, Maddern GJ (2006) Surgical simulation: a systematic review. Ann Surg 243:291–300PubMedCentralCrossRefPubMed Sutherland LM, Middleton PF, Anthony A, Hamdorf J, Cregan P, Scott D, Maddern GJ (2006) Surgical simulation: a systematic review. Ann Surg 243:291–300PubMedCentralCrossRefPubMed
7.
Zurück zum Zitat Scott DJ, Bergen PC, Rege RV, Laycock R, Tesfay ST, Valentine RJ, Euhus DM, Jeyarajah DR, Thompson WM, Jones DB (2000) Laparoscopic training on bench models: better and more cost effective than operating room experience? J Am Coll Surg 191:272–283CrossRefPubMed Scott DJ, Bergen PC, Rege RV, Laycock R, Tesfay ST, Valentine RJ, Euhus DM, Jeyarajah DR, Thompson WM, Jones DB (2000) Laparoscopic training on bench models: better and more cost effective than operating room experience? J Am Coll Surg 191:272–283CrossRefPubMed
8.
Zurück zum Zitat Seymour NE, Gallagher AG, Roman SA, O’Brien MK, Bansal VK, Andersen DK, Satava RM (2002) Virtual reality training improves operating room performance: results of a randomized, double-blinded study. Ann Surg 236:458–463 (discussion 463–454) PubMedCentralCrossRefPubMed Seymour NE, Gallagher AG, Roman SA, O’Brien MK, Bansal VK, Andersen DK, Satava RM (2002) Virtual reality training improves operating room performance: results of a randomized, double-blinded study. Ann Surg 236:458–463 (discussion 463–454) PubMedCentralCrossRefPubMed
9.
Zurück zum Zitat Fried GM, Feldman LS, Vassiliou MC, Fraser SA, Stanbridge D, Ghitulescu G, Andrew CG (2004) Proving the value of simulation in laparoscopic surgery. Ann Surg 240:518–525 (discussion 525–518) PubMedCentralCrossRefPubMed Fried GM, Feldman LS, Vassiliou MC, Fraser SA, Stanbridge D, Ghitulescu G, Andrew CG (2004) Proving the value of simulation in laparoscopic surgery. Ann Surg 240:518–525 (discussion 525–518) PubMedCentralCrossRefPubMed
10.
Zurück zum Zitat Grantcharov TP, Kristiansen VB, Bendix J, Bardram L, Rosenberg J, Funch-Jensen P (2004) Randomized clinical trial of virtual reality simulation for laparoscopic skills training. Br J Surg 91:146–150CrossRefPubMed Grantcharov TP, Kristiansen VB, Bendix J, Bardram L, Rosenberg J, Funch-Jensen P (2004) Randomized clinical trial of virtual reality simulation for laparoscopic skills training. Br J Surg 91:146–150CrossRefPubMed
11.
Zurück zum Zitat Andreatta PB, Woodrum DT, Birkmeyer JD, Yellamanchilli RK, Doherty GM, Gauger PG, Minter RM (2006) Laparoscopic skills are improved with LapMentor training: results of a randomized, double-blinded study. Ann Surg 243:854–860 (discussion 860–853) PubMedCentralCrossRefPubMed Andreatta PB, Woodrum DT, Birkmeyer JD, Yellamanchilli RK, Doherty GM, Gauger PG, Minter RM (2006) Laparoscopic skills are improved with LapMentor training: results of a randomized, double-blinded study. Ann Surg 243:854–860 (discussion 860–853) PubMedCentralCrossRefPubMed
12.
Zurück zum Zitat Hyltander A, Liljegren E, Rhodin PH, Lonroth H (2002) The transfer of basic skills learned in a laparoscopic simulator to the operating room. Surg Endosc 16:1324–1328CrossRefPubMed Hyltander A, Liljegren E, Rhodin PH, Lonroth H (2002) The transfer of basic skills learned in a laparoscopic simulator to the operating room. Surg Endosc 16:1324–1328CrossRefPubMed
13.
Zurück zum Zitat Ahlberg G, Enochsson L, Gallagher AG, Hedman L, Hogman C, McClusky DA III, Ramel S, Smith CD, Arvidsson D (2007) Proficiency-based virtual reality training significantly reduces the error rate for residents during their first 10 laparoscopic cholecystectomies. Am J Surg 193:797–804CrossRefPubMed Ahlberg G, Enochsson L, Gallagher AG, Hedman L, Hogman C, McClusky DA III, Ramel S, Smith CD, Arvidsson D (2007) Proficiency-based virtual reality training significantly reduces the error rate for residents during their first 10 laparoscopic cholecystectomies. Am J Surg 193:797–804CrossRefPubMed
14.
Zurück zum Zitat Anastakis DJ, Regehr G, Reznick RK, Cusimano M, Murnaghan J, Brown M, Hutchison C (1999) Assessment of technical skills transfer from the bench training model to the human model. Am J Surg 177:167–170CrossRefPubMed Anastakis DJ, Regehr G, Reznick RK, Cusimano M, Murnaghan J, Brown M, Hutchison C (1999) Assessment of technical skills transfer from the bench training model to the human model. Am J Surg 177:167–170CrossRefPubMed
15.
Zurück zum Zitat Tsuda S, Scott D, Doyle J, Jones DB (2009) Surgical skills training and simulation. Curr Probl Surg 46:271–370CrossRefPubMed Tsuda S, Scott D, Doyle J, Jones DB (2009) Surgical skills training and simulation. Curr Probl Surg 46:271–370CrossRefPubMed
16.
Zurück zum Zitat Dawe SR, Windsor JA, Broeders JA, Cregan PC, Hewett PJ, Maddern GJ (2014) A systematic review of surgical skills transfer after simulation-based training: laparoscopic cholecystectomy and endoscopy. Ann Surg 259:236–248CrossRefPubMed Dawe SR, Windsor JA, Broeders JA, Cregan PC, Hewett PJ, Maddern GJ (2014) A systematic review of surgical skills transfer after simulation-based training: laparoscopic cholecystectomy and endoscopy. Ann Surg 259:236–248CrossRefPubMed
17.
Zurück zum Zitat Palter VN, Orzech N, Reznick RK, Grantcharov TP (2013) Validation of a structured training and assessment curriculum for technical skill acquisition in minimally invasive surgery: a randomized controlled trial. Ann Surg 257:224–230CrossRefPubMed Palter VN, Orzech N, Reznick RK, Grantcharov TP (2013) Validation of a structured training and assessment curriculum for technical skill acquisition in minimally invasive surgery: a randomized controlled trial. Ann Surg 257:224–230CrossRefPubMed
18.
Zurück zum Zitat Sroka G, Feldman LS, Vassiliou MC, Kaneva PA, Fayez R, Fried GM (2010) Fundamentals of laparoscopic surgery simulator training to proficiency improves laparoscopic performance in the operating room-a randomized controlled trial. Am J Surg 199:115–120CrossRefPubMed Sroka G, Feldman LS, Vassiliou MC, Kaneva PA, Fayez R, Fried GM (2010) Fundamentals of laparoscopic surgery simulator training to proficiency improves laparoscopic performance in the operating room-a randomized controlled trial. Am J Surg 199:115–120CrossRefPubMed
19.
Zurück zum Zitat Feldman LS, Fuchshuber P, Jones DB, Mischna J, Schwaitzberg SD, Force FT (2012) Surgeons don’t know what they don’t know about the safe use of energy in surgery. Surg Endosc 26:2735–2739CrossRefPubMed Feldman LS, Fuchshuber P, Jones DB, Mischna J, Schwaitzberg SD, Force FT (2012) Surgeons don’t know what they don’t know about the safe use of energy in surgery. Surg Endosc 26:2735–2739CrossRefPubMed
20.
Zurück zum Zitat Madani A, Watanabe Y, Vassiliou MC, Fuchshuber P, Jones DB, Schwaitzberg SD, Fried GM, Feldman LS (2014) Impact of a hands-on component on learning in the Fundamental Use of Surgical Energy (FUSE) curriculum: a randomized-controlled trial in surgical trainees. Surg Endosc 28:2772–2782CrossRefPubMed Madani A, Watanabe Y, Vassiliou MC, Fuchshuber P, Jones DB, Schwaitzberg SD, Fried GM, Feldman LS (2014) Impact of a hands-on component on learning in the Fundamental Use of Surgical Energy (FUSE) curriculum: a randomized-controlled trial in surgical trainees. Surg Endosc 28:2772–2782CrossRefPubMed
21.
Zurück zum Zitat Feldman LS, Brunt LM, Fuchshuber P, Jones DB, Jones SB, Mischna J, Munro MG, Rozner MA, Schwaitzberg SD, Committee SF (2013) Rationale for the fundamental use of surgical energy (FUSE) curriculum assessment: focus on safety. Surg Endosc 27:4054–4059CrossRefPubMed Feldman LS, Brunt LM, Fuchshuber P, Jones DB, Jones SB, Mischna J, Munro MG, Rozner MA, Schwaitzberg SD, Committee SF (2013) Rationale for the fundamental use of surgical energy (FUSE) curriculum assessment: focus on safety. Surg Endosc 27:4054–4059CrossRefPubMed
22.
Zurück zum Zitat Zevin B, Levy JS, Satava RM, Grantcharov TP (2012) A consensus-based framework for design, validation, and implementation of simulation-based training curricula in surgery. J Am Coll Surg 215(580–586):e583 Zevin B, Levy JS, Satava RM, Grantcharov TP (2012) A consensus-based framework for design, validation, and implementation of simulation-based training curricula in surgery. J Am Coll Surg 215(580–586):e583
23.
Zurück zum Zitat Madani A, Jones DB, Fuchshuber P, Robinson TN, Feldman LS (2014) Fundamental Use of Surgical Energy (FUSE): a curriculum on surgical energy-based devices. Surg Endosc 28:2509–2512CrossRefPubMed Madani A, Jones DB, Fuchshuber P, Robinson TN, Feldman LS (2014) Fundamental Use of Surgical Energy (FUSE): a curriculum on surgical energy-based devices. Surg Endosc 28:2509–2512CrossRefPubMed
24.
Zurück zum Zitat Fuchshuber PR, Robinson TN, Feldman LS, Jones DB, Schwaitzberg SD (2014) The SAGES FUSE program: bridging a patient safety gap. Bull Am Coll Surg 99:18–27PubMed Fuchshuber PR, Robinson TN, Feldman LS, Jones DB, Schwaitzberg SD (2014) The SAGES FUSE program: bridging a patient safety gap. Bull Am Coll Surg 99:18–27PubMed
25.
Zurück zum Zitat Mayooran Z, Pearce S, Tsaltas J, Rombauts L, Brown TI, Lawrence AS, Fraser K, Healy DL (2004) Ignorance of electrosurgery among obstetricians and gynaecologists. BJOG 111:1413–1418CrossRefPubMed Mayooran Z, Pearce S, Tsaltas J, Rombauts L, Brown TI, Lawrence AS, Fraser K, Healy DL (2004) Ignorance of electrosurgery among obstetricians and gynaecologists. BJOG 111:1413–1418CrossRefPubMed
26.
Zurück zum Zitat Ericsson K, Krampe R, Tesch-Romer C (1993) The role of deliberate practice in the acquisition of expert performance. Psychol Rev 100:363–406CrossRef Ericsson K, Krampe R, Tesch-Romer C (1993) The role of deliberate practice in the acquisition of expert performance. Psychol Rev 100:363–406CrossRef
27.
Zurück zum Zitat Ericsson K, Charness N (1994) Expert performance: its structure and acquisition. Am Psychol 49:725–747CrossRef Ericsson K, Charness N (1994) Expert performance: its structure and acquisition. Am Psychol 49:725–747CrossRef
28.
Zurück zum Zitat Jowett N, LeBlanc V, Xeroulis G, MacRae H, Dubrowski A (2007) Surgical skill acquisition with self-directed practice using computer-based video training. Am J Surg 193:237–242CrossRefPubMed Jowett N, LeBlanc V, Xeroulis G, MacRae H, Dubrowski A (2007) Surgical skill acquisition with self-directed practice using computer-based video training. Am J Surg 193:237–242CrossRefPubMed
29.
Zurück zum Zitat Dale E (1969) Audiovisual methods in teaching, 3rd edn. Holt, Reinhart and Winston, New York Dale E (1969) Audiovisual methods in teaching, 3rd edn. Holt, Reinhart and Winston, New York
30.
Zurück zum Zitat Lajoie S, Azevedo R (2006) Teaching and learning in technology-rich environments. In: Alexander P, Winne P (eds) Handbook of educational psychology. Routledge, New York, pp 803–821 Lajoie S, Azevedo R (2006) Teaching and learning in technology-rich environments. In: Alexander P, Winne P (eds) Handbook of educational psychology. Routledge, New York, pp 803–821
31.
Zurück zum Zitat Stefanidis D, Heniford BT (2009) The formula for a successful laparoscopic skills curriculum. Arch Surg 144:77–82 (discussion 82) CrossRefPubMed Stefanidis D, Heniford BT (2009) The formula for a successful laparoscopic skills curriculum. Arch Surg 144:77–82 (discussion 82) CrossRefPubMed
Metadaten
Titel
Long-term knowledge retention following simulation-based training for electrosurgical safety: 1-year follow-up of a randomized controlled trial
verfasst von
Amin Madani
Yusuke Watanabe
Melina C. Vassiliou
Pascal Fuchshuber
Daniel B. Jones
Steven D. Schwaitzberg
Gerald M. Fried
Liane S. Feldman
Publikationsdatum
01.03.2016
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 3/2016
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-015-4320-9

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