Use of virtual reality equipment to assess the manual dexterity of applicants for ophthalmology residency.

PURPOSE: To assess the microsurgery dexterity outcomes of two sequential training evaluations using virtual reality technology. METHODS: This was a multicenter cross-sectional study of all candidates who were accepted as first-year residents at one of six ophthalmology teaching institutions. Residents were subjected to two identical series of standardized, reproducible dexterity tests using virtual reality equipment (Eyesi®): "sequence 1" and "sequence 2." Each sequence consisted of five difficulty levels that were assessed using a proprietary scoring system. The data were tested for normality using the Shapiro-Wilk test. The differences between tests in sequences 1 and 2 were evaluated using the Wilcoxon signed-rank test. RESULTS: The data did not follow a normal distribution. There were improvements from sequence 1 in all the tests (all p values<0.05). The sum of all scores (total score) improved from sequence 1 (median= 152.50) to sequence 2 (median 256.00; p<0.001). There was no correlation between the delta sequence values and the average scores. CONCLUSION: Two sequential training evaluations using virtual reality technology showed relevant improvement in quantifications of microsurgery dexterity. This information should be considered if virtual reality approaches are used for testing purposes, as previous experience may lead to improved test results.

What do Cochrane systematic reviews say about cardiac arrest management?

CONTEXT AND OBJECTIVE: Cardiac arrest is associated with high morbidity and mortality and imposes a significant burden on the healthcare system. Management of cardiac arrest patients is complex and involves approaches with multiple interventions. Here, we aimed to summarize the available evidence regarding the interventions used in cardiac arrest cases. DESIGN AND SETTING: Review of systematic reviews (SRs), conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. METHODS: A systematic search was conducted to identify all Cochrane SRs that fulfilled the inclusion criteria. Titles and abstracts were screened by two authors. RESULTS: We included nine Cochrane SRs assessing compression techniques or devices (three SRs), defibrillation (two SRs) and other interventions (two SRs on hypothermia interventions, one on airway management and one on pharmacological intervention). The reviews included found qualities of evidence ranging from unknown to high, regarding the benefits of these interventions. CONCLUSION: This review included nine Cochrane systematic reviews that provided a diverse range of qualities of evidence (unknown to high) regarding interventions that are used in management of cardiac arrest. High-quality evidence was found by two systematic reviews as follows: (a) increased survival until hospital discharge with continuous compression, compared with interrupted chest compression, both administered by an untrained person and (b) no difference regarding the return of spontaneous circulation, comparing aminophylline and placebo, for bradyasystolic patients under cardiac arrest. Further studies are needed in order to reach solid conclusions.

What do Cochrane systematic reviews say about cardiac arrest management?

ABSTRACT CONTEXT AND OBJECTIVE: Cardiac arrest is associated with high morbidity and mortality and imposes a significant burden on the healthcare system. Management of cardiac arrest patients is complex and involves approaches with multiple interventions. Here, we aimed to summarize the available evidence regarding the interventions used in cardiac arrest cases. DESIGN AND SETTING: Review of systematic reviews (SRs), conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. METHODS: A systematic search was conducted to identify all Cochrane SRs that fulfilled the inclusion criteria. Titles and abstracts were screened by two authors. RESULTS: We included nine Cochrane SRs assessing compression techniques or devices (three SRs), defibrillation (two SRs) and other interventions (two SRs on hypothermia interventions, one on airway management and one on pharmacological intervention). The reviews included found qualities of evidence ranging from unknown to high, regarding the benefits of these interventions. CONCLUSION: This review included nine Cochrane systematic reviews that provided a diverse range of qualities of evidence (unknown to high) regarding interventions that are used in management of cardiac arrest. High-quality evidence was found by two systematic reviews as follows: (a) increased survival until hospital discharge with continuous compression, compared with interrupted chest compression, both administered by an untrained person and (b) no difference regarding the return of spontaneous circulation, comparing aminophylline and placebo, for bradyasystolic patients under cardiac arrest. Further studies are needed in order to reach solid conclusions.