OSABSS: An authentic examination for assessing basic surgical skills in surgical residents.

Objectives: This study aimed to develop and validate the OSABSS (Objective Structured Assessment of Basic Surgical Skills), a modified Objective Structured Clinical Examination (OSCE), to assess basic surgical skills in residents. Design: A developmental study conducted in two phases. Basic skills were identified through literature review and gap analysis. The OSABSS was then designed as a modified OSCE. Setting: This study took place at Alborz University of Medical Sciences in Iran. Interventions: The OSABSS was created using Harden's OSCE (Objective Structured Clinical Examination) methodology. Scenarios, checklists, and station configurations were developed through expert panels. The exam was piloted and implemented with residents as participants and faculty as evaluators. Participants: 32 surgical residents in gynecology, general surgery, orthopedics, and neurosurgery participated. 22 faculty members were evaluators. Primary and secondary outcome measures: The primary outcome was OSABSS exam scores. Secondary outcomes were written exam scores, and national residency entrance ranks. Main results: The mean OSABSS score was 16.59 ± 0.19 across all stations. Criterion validity was demonstrated through correlations between OSABSS scores, written scores and entrance ranks. Reliability was high, with a Cronbach's alpha of 0.87. No significant inter-rater score differences were found. Conclusions: The rigorous OSABSS development process produced an exam demonstrating strong validity and reliability for assessing basic surgical skills. The comprehensive station variety evaluates diverse technical and non-technical competencies. Further research should expand participant samples across surgical disciplines.

Explanation of the professional development process of general surgery residents in the operating rooms: A situational analysis.

Introduction: Numerous factors and elements are effective in the professional development of any field of study, including the educational structure, the individual characteristics of learners, and the educational atmosphere prevalent in the educational environment. Understanding each of these factors and elements and the relationships among them can guide educational system administrators in the direction of professional development. Surgical residents' professional development is no exception to this rule. As a consequence, the present research sought to explain and suggest a model for surgical assistant professional growth in Iranian operating rooms. Methods: The present research was a grounded theory study based on a post-positivist approach, in which data analysis was performed using Clark's situational analysis methodology by drawing three maps, situational map, social worlds/arenas map, and positional map. Results: In the presence of human and non-human factors, cultural, political, historical, and social components, the ordered situational map demonstrated the complexity of the operating room learning environment. The social worlds/arenas map confirmed the existence of several communities of practice wherein surgical residents were present with different power roles, and the positional map showed role of the educational level in the acquisition of the competence in the professional development pathway. Finally, the Triple Helix model of professional development was extracted, which has three components: psychological identity, social identity, and surgical competency. Conclusion: The surgical residents' professional development in operating rooms occurs due to the acquisition of surgical competency along with the growth of individuals and socialization. As a result, all factors and components impacting the residents' competence development process in this learning environment must be identified and their linkages clarified.

Exploring the surgical residents' experience of teaching and learning process in the operating room: A grounded theory study.

BACKGROUND: Despite the development of valuable teaching methods and assessment tools in the field of surgery education, yet unpreparedness for independence practice by surgical residents remains a problem in most of the countries. AIMS: This study aims to explain the surgical residents' experience of the teaching and learning process in the operating rooms in Iran. MATERIAL AND METHODS: This study is a qualitative research that was done from May 2019 to June 2020 in Tehran and eight other cities in Iran. The selected methodology was constructivist grounded theory. The study setting was 11 teaching hospitals. Data were collected through 36 in-depth interviews and 132 h of observation. Participants were selected initially by purposive sampling and then by theoretical sampling for covering gaps and completing categories. RESULTS: Findings showed that the confused educational system was the main concern of the residents' experience of the teaching and learning process in the operating room. This concern is investigated by dividing into four subcategories: Education in the shadow of treatment, inefficient education, patient safety versus trusting residents for independent practice, and unstructured assessment. CONCLUSION: Based on residents' experience about challenges such as inefficient education, the influence of patient safety versus trusting residents for independent practice, and unstructured assessment, the surgical residents' education in the operating rooms needs to revise.

Surgical residents' challenges with the acquisition of surgical skills in operating rooms: A qualitative study.

INTRODUCTION: Training in operating rooms is challenging. Specifically, surgical residents often experience a stressful environment in training arenas that, in turn, might affect their ability in the acquisition of the required qualifications. This study aims at the qualitative explanation of how the surgical residents acquire the surgical skills in operating rooms. METHODS: This qualitative study was conducted in 2019-2020 using the conventional content analysis method. Participants were selected using purposive sampling. Data were collected through 25 semi-structured in-depth interviews. Then, the interview transcriptions were analyzed in MaxQDA2 software using the content analysis method. RESULTS: The data were classified into two main categories, namely challenges/obstacles and strategies for dealing with the challenges. The data in the first category were further classified into four subcategories, including burnout, confusion in technique selection, unequal learning opportunities, ignorance, and responsibility misassignment. Similarly, four subcategories of establishing communication channels with chief residents and faculty members, learning by the non-surgeon pathway, covert progress in the learning path, and taking advantage of force from a position of power in the learning path were considered for the second category. CONCLUSION: Based on the findings of the study, surgical residents face serious challenges and obstacles in their training course. To address these challenges, the curriculum of the surgical course needs to be improved with the emphasis on the balanced responsibility assignment and enhanced human communication.

Comparison of the effect of two teaching methods on surgical technologist students' learning and satisfaction (flashcards vs. mobile-based learning).

BACKGROUND: M-learning is "learning across multiple contexts, through social and content interactions, using simple hand-held technologies, wireless and mobile network. This personal electronic device is a way to facilitate the transfer of learning and improve teaching. Hence, the researchers decided to design a mobile-based learning application to teach surgical instruments comprehensively and compare students' learning and satisfaction in both mobile-based learning and flashcards methods. MATERIALS AND METHODS: An interventional study was conducted on surgical technologist students in Alborz University of medical science (2019). Students were divided into two groups: flashcards (n = 21) and mobile application learning group (n = 21). The difference of pre- and post-test scores was considered for the evaluation of learning level in two groups. Data were entered into SPSS 20.0 software and analyzed by statistics tests. Data were analyzed by a paired t-test, independent t-test, and Pearson's correlation coefficient. RESULTS: There was no significant difference in students' knowledge level between two groups before intervention (P = 0.87) but there was significant difference between groups after the intervention (P = 0.003). In the evaluation of student's satisfaction, the mobile application was preferred by 84.28% of students. CONCLUSION: Given the effectiveness of using both methods (flashcards and mobile application), it is recommended that these methods especially mobile application be used for surgical instruments education.

A Comparison of Three Dressing Methods for Pilonidal Sinus Surgery Wound Healing.

OBJECTIVE: To evaluate the effect of different dressing methods on the wound healing process after pilonidal sinus surgery. METHODS: In this clinical trial, 60 patients undergoing pilonidal sinus surgery were randomly assigned to one of three groups. In the first group, hydrogel or alginate and hydrocolloid compounds were used as a standard occlusive dressing method. A modified dressing method was used for the second group, in which transparent hydrocolloid films were replaced by Vaseline gauze. The third group was treated using gauze swabs soaked in normal saline. The length and depth of the studied wounds were recorded once a week for a month. During dressing changes, patient pain was recorded using an 11-point numeric rating scale. The collected data were analyzed by descriptive and inferential statistical methods. RESULTS: There was a significant reduction in wound length after 2 weeks in all three groups (P < .05), and the pain experienced by the first and second groups was significantly lower than the third group. However, the modified method used for the second group was associated with a lower cost. CONCLUSIONS: Considering the beneficial results of using modern dressings for wound healing and reducing the severity of associated pain, providers may want to consider using modified wound dressings after pilonidal sinus surgery. Study authors recommend that providers receive training on how to use these products.

Effect of preoperative nursing visit on preoperative anxiety and postoperative complications in candidates for laparoscopic cholecystectomy: a randomized clinical trial.

BACKGROUND: Despite progress in surgery and anaesthesia techniques, anxiety remains an important problem that imposes tremendous barriers to postoperative recovery for surgery patients. AIMS: In this study, we investigated the effects of preoperative nursing visits on anxiety and postoperative complications in candidates for laparoscopic cholecystectomy. METHODS: One hundred consecutive patients were randomly assigned into two equal groups of 50 patients each. Anxiety was evaluated in both groups using a translated and validated Spielberger State-Trait Anxiety Inventory. Patients in the control group received routine nursing care. Patients in the intervention group received two preoperative interviews, one on the day before surgery and one just before entering the operating room. Pain, nausea, vomiting and other postoperative complications were compared. Pain was measured using a visual analogue scale. FINDINGS: All patients were women with a mean ± standard deviation age of 46.8 ± 10.6 years. At admission, state and trait anxiety measurements in the intervention and control groups were approximately 56 and 55 in both groups. Just before entering the operating room, these values reduced to 40.30 and 39.04 in the intervention group, with no significant change in the control group (p > 0.05). Mean time to reach an Aldrete consciousness score of 9, frequency of nausea and vomiting in the recovery room, level of postoperative pain, vital sign stabilization and time interval to get out of bed all improved significantly in the intervention group. CONCLUSIONS: Our study showed that preoperative nursing visits could decrease the level of preoperative anxiety and postoperative complications in this patient population.