Dataset Information

Novel Low-Cost, Low-Fidelity Hemorrhoidectomy Task Trainers.

ABSTRACT:

Objective

Develop and describe a set of low-cost hemorrhoidectomy task trainer prototypes in the setting of inadequate junior resident surgical skill preparation for anorectal cases.

Design

This is a study comparing expert and novice performance and opinions. Three task trainers were developed to simulate dissecting, knot-tying, and suturing in a confined space, like the anus. Participants were asked to dissect the peel off of an orange, tie seven 2-handed knots on a weight, and close a defect in a piece of felt with a running stitch. An 8-oz mason jar was used to simulate the confined space. Participants were asked to fill out a 5-point Likert-based evaluation regarding the skills. The primary outcome was time to complete each task in seconds. Secondary outcome measures were number of errors associated with each task, subjective achievability of tasks, and utility of tasks for improving surgical skills.

Setting

General surgery residency program at a safety-net academic center.

Participants

Forty subjects participated in this study. There were 20 experts (7 attending surgeons, 13 PGY-1-PGY-5 surgical residents) and 20 novices (11 third- and 9 fourth-year medical students).

Results

Experts knot-tied (59s vs 140s, p < 0.001) and sutured (219s vs 295s, p < 0.001) faster than novices. Experts were able to tie 7 knots in fewer attempts than novices (p < 0.001). There was no significant difference in speed of orange dissection between groups. There were no significant differences in the number or frequency of other errors. All participants felt the tasks were achievable (4.90/5) and would be useful in improving skills (4.93/5).

Conclusions

This study demonstrated that a set of low-cost, low-fidelity prototypical hemorrhoidectomy task trainers can discriminate between experts and novices. Simulation models such as these can offer useful practice opportunities for junior general surgery trainees.

SUBMITTER: Geary AD

PROVIDER: S-EPMC7487032 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:Variation in behaviour among group members often impacts collective outcomes. Individuals may vary both in the task that they perform and in the persistence with which they perform each task. Although both the distribution of individuals among tasks and differences among individuals in behavioural persistence can each impact collective behaviour, we do not know if and how they jointly affect collective outcomes. Here, we use a detailed computational model to examine the joint impact of colony-level distribution among tasks and behavioural persistence of individuals, specifically their fidelity to particular resource sites, on the collective trade-off between exploring for new resources and exploiting familiar ones. We developed an agent-based model of foraging honeybees, parametrized by data from five colonies, in which we simulated scouts, who search the environment for new resources, and individuals who are recruited by the scouts to the newly found resources, i.e. recruits. We varied the persistence of returning to a particular food source of both scouts and recruits and found that, for each value of persistence, there is a different optimal ratio of scouts to recruits that maximizes resource collection by the colony. Furthermore, changes to the persistence of scouts induced opposite effects from changes to the persistence of recruits on the collective foraging of the colony. The proportion of scouts that resulted in the most resources collected by the colony decreased as the persistence of recruits increased. However, this optimal proportion of scouts increased as the persistence of scouts increased. Thus, behavioural persistence and task participation can interact to impact a colony's collective behaviour in orthogonal directions. Our work provides new insights and generates new hypotheses into how variations in behaviour at both the individual and colony levels jointly impact the trade-off between exploring for new resources and exploiting familiar ones.