More than a camera holder: teaching surgical skills to medical students.

BACKGROUND: Students often experience passive learning in their surgical rotations as they are delegated to holding the camera during laparoscopic cases. We introduced a laparoscopic skills course to medical students to provide hands-on experience. We hypothesized that the course will improve basic laparoscopic skills and increase interest in a surgical career. MATERIALS AND METHODS: All students on the core surgery rotation attended two sessions in the surgical simulation laboratory lead by Department of Surgery faculty members. Surveys were used before and after the course to assess video game (VG) use and interest in a surgical career. Course effectiveness was assessed with a laparoscopic peg transfer exercise. RESULTS: One hundred one students participated with 82 students documenting preinstruction and postinstruction peg transfer times. There was an overall improvement in median transfer times after instruction (before 63 s [interquartile range {IQR} 46-84.5] versus after 50.5 s [IQR 39-65.2], P < 0.001). When stratified by gender, men (n = 40) had faster median preintervention peg transfer times than women (n = 61; 65 s [IQR 51-88]) versus 81 s [IQR 65-98] (P = 0.030). However, both genders had equivalent postinstruction transfer times (men 48 s [IQR 36-61] versus women 51.3 s [IQR 43.2-68.3], P = 0.478). A similar trend was observed between students with and without prior VG use. Of the 50 students who completed both surveys, there was no significant increase (pre-24% versus post-34%, P = 0.29) or decrease (pre-32% versus post-22%, P = 0.13) in interest in a surgical career after the course. CONCLUSIONS: A laparoscopic course for medical students is effective in improving laparoscopic skills. Although male gender and VG use may be associated with better intrinsic skills, instruction and practice allow female students and non-VG users to "catch up." A longer follow-up study is warranted to determine true interest in a surgical career.

Mass gathering medicine: the Melbourne 2006 Commonwealth Games experience.

OBJECTIVE: To investigate the nature and acuity of medical presentations of patrons and staff attending the Melbourne 2006 Commonwealth Games (M2006) venues and festival live sites. DESIGN AND SETTING: Retrospective case series chart audit of patients who were managed by St John Ambulance during the M2006. PARTICIPANTS: Patients who presented requiring first-aid review or treatment at any of the 21 designated event venues or 16 live sites during their prescribed operating hours between 15 March 2006 and 26 March 2006. MAIN OUTCOME MEASURES: Provisional diagnosis and ambulance transport to hospital. RESULTS: A total of 3514 presentations occurred during the study period, of which 2279 (64.9%, 95% CI, 63.3%-66.4%) occurred at event venues. Headaches, soft tissue injuries, blisters and other wounds accounted for 64.1% (95% CI, 62.5%-65.73%) of presentations. A total of 303 patients were referred for further medical care, including 69 patients (1.96%, 95% CI, 1.54%-2.49%) who required transport to hospital via ambulance. Traumatic injuries accounted for 42.0% (95% CI, 30.5%-54.5%) of patients transported by ambulance to hospital. The patient presentation rate across all venues was 0.857 per 1000 patrons. The transport to hospital rate was 0.0186 per 1000 patrons. CONCLUSIONS: The majority of first-aid presentations during the M2006 were of low acuity and treatment resulted in return of patrons to the event, with only a small number requiring ambulance transport to hospital.