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1.
Plast Reconstr Surg Glob Open ; 6(12): e2042, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30656119

RESUMO

It is important to optimize our current learning and teaching models, particularly in a climate of decreased clinical exposure. With technical advancements and clinical care now more accountable, traditional methods of skill acquisition need to be revisited. The past decade has seen changes in plastic surgery curricula. There has also been a shift toward competency-based training programs reflecting the growing emphasis on outcomes-based surgical education. This review explores the role of educational theory in promoting effective learning in practical skills teaching. Key models of educational theory are presented and their application to plastic surgery training to an expert level are highlighted. These models include (1) learning within communities of practice (Lave and Wenger's theory); (2) the role of the zone of proximal development and importance of the availability of expert assistance (Vygotsky's theory); (3) skill acquisition and retention (Dreyfus' and Dreyfus', and Fitts' and Posner's theories); (4) development of expertise after repeated practice and regular reinforcement (Ericsson's theory); and (5) the assessment of competence (Miller's triangle). Future plastic surgeons need to possess a thorough understanding of the technical and nontechnical skills required to manage patients effectively. Surgical educators are therefore compelled to develop practical training programs that can teach each of these skills in a safe, learner-centric manner. It is hoped that new approaches to surgical skills training are designed in light of our understanding of educational theory to optimize the training of the next generation of plastic surgeons.

2.
Eur J Orthop Surg Traumatol ; 28(2): 165-170, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28856452

RESUMO

AIM: To determine the prevalence of low back pain (LBP) among health sciences students and to identify the associated factors. METHODS: Cross-sectional study was conducted among 1163 students from five health sciences colleges during the academic year 2016-2017. Self-administered questionnaire was conducted and included 4 sections: demographic characteristics, risk factors, Nordic musculoskeletal questionnaire and Oswestry disability questionnaire. Data were analyzed using SPSS. RESULTS: Mean age was 20.74 ± (1.59 years). 70.9% of students were female. Lifetime prevalence of LBP was 56.6%, 12-month prevalence 48.8%, and point prevalence 21.2%. Dentistry students had highest lifetime prevalence of LBP (67.6%) with significant p value (<0.001). Male were found to have higher lifetime prevalence compared to female (p ≤ 0.001). Spending more than 10 h on computer or tablet was significantly associated with LBP (OR 2.19; 95% CI 1.30-3.70; p = 0.003). Feeling discomfort on bed was associated with LBP (OR 1.81; 95% CI 1.38-2.38; p ≤ 0.001). Uncomfortable college furniture was associated with LBP (OR 1.40; 95% CI 1.09-1.79; p = 0.008). Using heavy backpack was found to be associated with LBP (OR 1.49; 95% CI 1.01-2.03; p = 0.011). Most of students LBP (90.3%) found to cause minimal disability on Oswestry scale. CONCLUSION: This study has shown high prevalence of LBP among future healthcare provider. These risk factors should be well established to minimize the prevalence of LBP among future health sciences students. Dentistry students at higher risk of developing LBP compared to other students.


Assuntos
Dor Lombar/epidemiologia , Estudantes de Ciências da Saúde/estatística & dados numéricos , Adolescente , Computadores de Mão , Estudos Transversais , Avaliação da Deficiência , Feminino , Inquéritos Epidemiológicos , Humanos , Decoração de Interiores e Mobiliário , Masculino , Prevalência , Fatores de Risco , Arábia Saudita/epidemiologia , Fatores Sexuais , Estudantes de Odontologia/estatística & dados numéricos , Adulto Jovem
3.
Eur J Orthop Surg Traumatol ; 27(7): 961-965, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28386714

RESUMO

BACKGROUND: Coccygodynia is a pain of the coccyx that is typically exaggerated by pressure. Management includes anti-inflammatory medications, physiotherapy, and coccyx manipulation. Coccygectomy is the surgical approach for treating coccygodynia when the conservative management fails. Generally, coccygectomy yields good results. Its most common complication is wound infection. OBJECTIVE: To determine the effectiveness of coccygectomy in patients with coccygodynia. METHODS: A retrospective review of 70 patients (52 females and 18 males) with coccygodynia at King Khalid University Hospital in Riyadh was carried out, and the outcomes were studied. Twenty patients did not respond to conservative management; therefore, bimanual coccyx manipulation was done. Eleven were identified with instability and did not respond to coccygeal manipulation. Coccygectomy was performed on 8 patients while 3 declined. RESULTS: All patients who underwent coccygectomy showed improvement of their symptoms. One case of superficial wound infection and delayed wound healing was encountered. CONCLUSION: Coccygectomy provides effective pain relief to patients not responding to conservative therapies.


Assuntos
Cóccix/cirurgia , Dor Lombar/cirurgia , Adolescente , Adulto , Feminino , Humanos , Dor Lombar/etiologia , Masculino , Manipulação Ortopédica/estatística & dados numéricos , Pessoa de Meia-Idade , Estudos Retrospectivos , Infecção da Ferida Cirúrgica/etiologia , Resultado do Tratamento , Cicatrização/fisiologia , Adulto Jovem
4.
Clin Teach ; 11(3): 179-83, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24802917

RESUMO

BACKGROUND: Changes in undergraduate medical curricula, combined with reforms in postgraduate education, have training implications for surgical skills acquisition in a climate of reduced clinical exposure. Confidence and prior experience influences the educational impact of learning. Currently there are limited formal basic surgical skills programmes integrated into UK undergraduate curricula. CONTEXT: Early skills targeting is valuable for students entering surgical, related allied specialties and even traditionally non-surgical specialties, such as General Practice. Such experience can make students more confident and subsequently competent future junior doctors and trainees. INNOVATION: The integration of skills training through the use of simple low-fidelity training models can bridge the gap between undergraduate skills education and postgraduate training, whereas approaches involving more recent advances in simulation may prepare students further by making available more contextualised and scenario-based learning environments. IMPLICATIONS: We suggest that it is an ideal time for the introduction of dedicated basic surgical skills programmes into UK undergraduate medical curricula. Training will benefit all students. Importantly, training can inspire confidence, clinical interest, and can also provide a solid foundation of skills that can support and enable junior doctors' further postgraduate training.


Assuntos
Competência Clínica , Educação de Graduação em Medicina/organização & administração , Procedimentos Cirúrgicos Operatórios/educação , Simulação por Computador , Currículo , Humanos , Reino Unido
5.
J Educ Eval Health Prof ; 11: 3, 2014 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-24699448

RESUMO

PURPOSE: To date no studies have specifically evaluated the use of handovers amongst core surgical trainees (CSTs) in the United Kingdom. We examined handover practice at the Oxford School of Surgery to assess and improve CSTs'perception of handover use as well as its quality, and ultimately patient care. METHODS: Based on guidelines published by the British Medical Association and Royal College of Surgeons, a 5-point Likert style questionnaire that collected data on handover practice, its educational value, and the CSTs'satisfaction with handover was given to 50 CSTs in 2010. RESULTS: Forty CSTs (80.0%) responded to the questionnaire. The most striking findings revolved around the perceived educational value, formal training, and auditing practice of handovers throughout various units, which were all remarkably lower than expected. As a result, handover practice amongst CSTs was targeted and revised at the University Hospital's Department of Plastic Surgery, with the implementation of targeted changes to improve handover practice. CONCLUSION: The execution of daily handovers was an underused educational tool amongst surveyed CSTs and may be an important modality to target, particularly in the competency-based, time-limited training CSTs receive. We recommend modifications to current practice based on our results and the literature and encourage the assessment of handover practice at other institutions.

6.
Int J Surg ; 11(9): 773-8, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23838344

RESUMO

The concept of surgical expertise and the processes involved in its development are topical, and there is a constant drive to identify reliable measures of expert performance in surgery. This review explores the notion of whether surgical experts are "born" or "made", with reference to educational theory and pertinent literature. Peer-reviewed publications, books, and online resources on surgical education, expertise and training were reviewed. Important themes and aspects of expertise acquisition were identified in order to better understand the concept of a surgical expert. The definition of surgical expertise and several important aspects of its development are highlighted. Innate talent plays an important role, but is insufficient on its own to produce a surgical expert. Multiple theories that explore motor skill acquisition and memory are relevant, and Ericsson's theory of the development of competence followed by deliberate self-practice has been especially influential. Psychomotor and non-technical skills are necessary for progression in the current climate in light of our training curricula; surgical experts are adaptive experts who excel in these. The literature suggests that surgical expertise is reached through practice; surgical experts are made, not born. A deeper understanding of the nature of expert performance and its development will ensure that surgical education training programmes are of the highest possible quality. Surgical educators should aim to develop an expertise-based approach, with expert performance as the benchmark.


Assuntos
Cirurgia Geral/educação , Cirurgia Geral/normas , Competência Clínica , Humanos
7.
Int J Surg ; 10(9): 458-62, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22935356

RESUMO

INTRODUCTION: Simulation occupies a central position in surgical education. It offers a safe environment for trainees to develop and improve their skills through sustained deliberate self-practice and appropriate feedback. This review explores the role of simulators and the simulation environment in light of educational theory to promote effective learning. DATA SOURCES: Information was obtained from peer-reviewed publications, books and online material. CONCLUSION: A simplistic perspective frames simulation as a means of gaining technical skills on basic models by offering a safe alternative to carrying out procedures on real patients. Although necessary, that aspect of simulation requires greater depth to satisfy the growing demand for alternatives to traditional clinical learning. A more realistic view should frame simulation as a means to gaining mastery within a complex clinical world. In order to strike the balance on simulating an ideal clinical scenario, alignment of the simulator and the simulation environment in the appropriate context appears crucial.


Assuntos
Cirurgia Geral/educação , Cirurgia Assistida por Computador/educação , Simulação por Computador , Humanos
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