Construct Validity for a Cost-effective Arthroscopic Surgery Simulator for Resident Education.

INTRODUCTION: Arthroscopy is one of the most challenging surgical skills to assess and teach. Although basic psychomotor arthroscopic skills, such as triangulation and object manipulation, are incorporated into many simulation exercises, they are not always individually taught or objectively evaluated. In addition, arthroscopic instruments, arthroscopy cameras, and the cadaver or joint models necessary for practice are costly. METHODS: A low-cost arthroscopic simulator was created to practice triangulation, probing, horizon changes, suture management, and object manipulation. The simulator materials were purchased exclusively from national hardware stores with a total cost averaging $79. The universal serial bus (USB) camera is included in the total cost. Three residency programs accredited by the Accreditation Council for Graduate Medical Education were tested on the simulator. Replica boards were created at each institution. Participants included medical students (20), residents (46), and attending physicians (9). RESULTS: Construct validity-the ability to differentiate between novice, intermediate, and senior level participants-was obtained. On all tasks, junior residents scored at a statistically significant lower rate than senior residents and attending physicians. CONCLUSIONS: This cost-effective arthroscopic surgical simulator objectively demonstrated that attending physicians and senior residents performed at a higher level than junior residents and novice medical students. The results of this study demonstrate that this simulator could be an important training tool for resident education.

Validation of an effective, easy-to-make hemostasis simulator.

The purpose of this study is to describe the construction method of a cost-effective, easy-to-make hemostasis simulator and to compare its effectiveness as a training tool to cadaver training. The simulator is made of materials commonly found in hospitals and clinics. These include a column manometer, a 500-ml saline bag, two intravenous fluid lines, a three-way stopcock, and a 6-mm-diameter Penrose drain. The device was tested on 10 final-year veterinary students. All participants tied 40 knots on the simulator and 40 knots on equine jejunal arteries sourced from a local abattoir. They were then asked to fill out a questionnaire comparing both methods. Participants assigned an overall assessment median score of 8.5/10 to the simulator and of 6.2/10 to cadaver practice. The simulator provided reliable haptic feedback, giving trainees a lifelike feel very close to that experienced when actually closing a blood vessel. In addition, it was effective in objectively evaluating students' ability to place ligatures on vessels. After adequate training, students' skills had significantly improved, alongside their confidence in placing hemostatic sutures. This proves our model is also useful in teaching basic open-surgery skills. Finally, its low production cost makes it ideally suited for self-practice.

Ambiente virtual de aprendizagem sobre gerenciamento de custos de curativos em úlceras por pressão / Virtual learning environment for managing costs of dressings for pressure ulcers / Ambiente virtual de aprendizaje sobre gerenciamiento de costos de vendajes en úlceras por presión

Pesquisa descritiva e aplicada com objetivo de descrever a construção e avaliação de um ambiente virtual de aprendizagem na temática de gerenciamento de custos de curativos em úlceras por pressão, por meio da metodologia WebQuest. Nas etapas de planejamento e desenvolvimento, foram utilizados recursos tecnológicos simples e acessíveis, com ênfase nos aspectos pedagógicos. Na etapa de avaliação, quatro especialistas em informática, quatro enfermeiros docentes e quatro enfermeiros atuantes no gerenciamento de custos em enfermagem avaliaram os aspectos técnicos (Tempo de Resposta e Qualidade de Interface) e pedagógicos (Conteúdo, Atividade, Interação). Estes aspectos tiveram avaliação positiva (acima de 86% de características totalmente atendidas), exceto para o Tempo de Resposta (62% totalmente atendidas e 30% parcialmente atendidas). Os resultados evidenciaram a viabilidade da aplicação do ambiente virtual de aprendizagem para alunos de graduação em enfermagem visando à análise do impacto na aprendizagem sobre gerenciamento de custos de materiais em enfermagem.

A descriptive and applied study aimed at describing the construction and assessment of a virtual learning environment on the topic of cost management of pressure ulcer dressings, using WebQuest methodology. For the planning and development phases, we used simple and accessible technological resources, focused on educational aspects. During the assessment phase, four computer science specialists, four nursing professors and four nursing professionals who worked with cost management evaluated technical aspects (Response Time and Interface Quality) as well as educational ones (Content, Activity, Interaction). These aspects received positive evaluations (over 86% of criteria were fulfilled), except for Response Time (62% were totally fulfilled and 30% partially fulfilled). The results demonstrated that it is possible to make use of virtual learning environments with undergraduate nursing students in order to impact education regarding material cost management in nursing.

Investigación descriptiva, aplicada, objetivando describir la construcción y evaluación de un ambiente virtual de aprendizaje sobre temática de gerenciamiento de costos de vendajes en úlceras por presión, mediante la metodología WebQuest. En las etapas de planificación y desarrollo, fueron utilizados recursos tecnológicos simples y accesibles, enfatizándose los aspectos pedagógicos. En la etapa de evaluación, cuatro especialistas en informática, cuatro enfermeros docentes y cuatro enfermeros actuantes en gerenciamiento de costos en enfermería evaluaron los aspectos técnicos (Tiempo de Respuesta y Calidad de Interfaz) y pedagógicos (Contenido, Actividad, Interacción). Estos aspectos recibieron evaluación positiva (más del 86% de características totalmente atendidas), exceptuando al Tiempo de Respuesta (62% totalmente atendidas y 30% parcialmente atendidas). Los resultados evidenciaron la viabilidad de aplicación del ambiente virtual de aprendizaje para alumnos de grado en enfermería, apuntando al análisis del impacto en el aprendizaje sobre gerenciamiento de costo de materiales en Enfermería.

Training and simulation for patient safety.

BACKGROUND: Simulation-based medical education enables knowledge, skills and attitudes to be acquired for all healthcare professionals in a safe, educationally orientated and efficient manner. Procedure-based skills, communication, leadership and team working can be learnt, be measured and have the potential to be used as a mode of certification to become an independent practitioner. RESULTS: Simulation-based training initially began with life-like manikins and now encompasses an entire range of systems, from synthetic models through to high fidelity simulation suites. These models can also be used for training in new technologies, for the application of existing technologies to new environments and in prototype testing. The level of simulation must be appropriate to the learners' needs and can range from focused tuition to mass trauma scenarios. The development of simulation centres is a global phenomenon which should be encouraged, although the facilities should be used within appropriate curricula that are methodologically sound and cost-effective. DISCUSSION: A review of current techniques reveals that simulation can successfully promote the competencies of medical expert, communicator and collaborator. Further work is required to develop the exact role of simulation as a training mechanism for scholarly skills, professionalism, management and health advocacy.