Do Good Non-Technical Skills Correlate With Good Clinical Outcomes in Endoscopy?
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ABSTRACT:
DISEASE(S): Bowel Cancer
PROVIDER: 2394724 | ecrin-mdr-crc |
REPOSITORIES: ECRIN MDR
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Project description:I plan to investigate the value of video-based feedback in endoscopic training - specifically, the role of terminal video feedback as compared to usual concurrent feedback on cold snare polypectomy technique in trainees, using Direct Observation of Polypectomy Skills (DOPyS) competency score. I have focused the study on the competency of cold snare polypectomy for subcentimeter polyps. The majority (>75%) of colon polyps are smaller than one centimeter. Cold snare polypectomy has been shown, and recommended by the American Society for Gastrointestinal Endoscopy (ASGE), to be an effective removal technique. However, its widespread use and moreover, its teaching to trainees is lacking. It takes time and resources to learn and teach endoscopic techniques. Our study will hope to identify a mechanism through video-based feedback that could help to improve the translation of the training of polypectomy skills to its actual performance, and to accelerate the learning curve.
| 2241449 | ecrin-mdr-crc
Project description:Objectives: To asses skin clearance and patient-reported outcomes for ixekizumab treatment. Methods: IXORA-R enrolled adults with moderate-to-severe plaque psoriasis, defined as static Physician’s Global Assessment ≥ 3, PASI ≥ 12 and involved body surface area ≥ 10%. The trial was registered with ClinicalTrials.gov (NCT03573323).
2023-04-10 | GSE178228 | GEO
Project description:BackgroundThe non-technical skills for surgeons (NOTSS) system was developed as a tool to assess surgical skills for patient safety during surgery. This study aimed to develop a NOTSS-based training system for surgical trainees to acquire non-technical skills using a chest surgery scenario in a wet lab.Materials and methodsTrainees were categorized into three subgroups according to the years of experience as follows: Level A: 6 years or more; Level B: 3-5 years; and Level C: 1-2 years. Three stages of surgical procedure were designed: 1. chest wall resection and right upper lobe lobectomy, 2. right middle lobe sleeve lobectomy, and 3. right lower lobe lobectomy. One instructor was assigned to each operation table, who evaluated each participant's NOTSS scores consisting of 16 elements.ResultsWhen comparing average NOTSS score of all the three procedures, significant differences were observed between Level A, B, and C trainees. As an example of varying elements by procedure, Level A trainees demonstrated differences in Situation Awareness, and a significant difference was observed in Level C trainees regarding the elements of Decision Making. On the contrary, no significant difference was observed among Level B trainees. In the comparison between first-time and experienced participants, a significant improvement was observed in some elements in Level B and C trainees.ConclusionThis study highlights the usefulness and feasibility of the NOTSS scoring system for surgeons with different experiences and the effectiveness of providing feedback to trainees during intraoperative handoffs in a wet lab.
| S-EPMC7505865 | biostudies-literature
Project description:Colorectal cancer survivors experience long-term negative physical and psychosocial consequences of their disease. There is a critical need to develop novel behavioral interventions for improving colorectal cancer survivor outcomes. The investigators have developed a pain management intervention for colorectal cancer survivors that focuses on addressing both pain and psychological distress. Colorectal cancer survivors who endorse pain and comorbid psychological distress as a concern during a clinic-based survivorship care consult will be recruited. Participants will be randomized into either: Telephone-Based Coping Skills Training (CST) for pain and comorbid psychological distress or standard care. The CST condition will receive 5 sessions of a cognitive behavior theory-based protocol that teaches coping skills (e.g., relaxation, activity pacing/planning, cognitive restructuring) relevant to managing pain and psychological distress. The standard care control condition will receive resources and referrals related to managing survivorship health.
| 2210091 | ecrin-mdr-crc
Project description:ImportancePostoperative complications remain common after surgery, but little is known about the extent of variation in operative technical skill and whether variation is associated with patient outcomes.ObjectivesTo examine the (1) variation in technical skill scores of practicing surgeons, (2) association between technical skills and patient outcomes, and (3) amount of variation in patient outcomes explained by a surgeon's technical skill.Design, setting, and participantsIn this quality improvement study, 17 practicing surgeons submitted a video of a laparoscopic right hemicolectomy that was then rated by at least 10 blinded peer surgeons and 2 expert raters. The association between surgeon technical skill scores and risk-adjusted outcomes was examined using data from the American College of Surgeons National Surgical Quality Improvement Program. The association between technical skill scores and outcomes was examined for colorectal procedures and noncolorectal procedures (ie, assessed on whether technical skills demonstrated during colectomy were associated with patient outcomes across other cases). In addition, the proportion of patient outcomes explained by technical skill scores was examined using robust regression techniques. The study was conducted from September 23, 2016, to February 10, 2018; data analysis was performed from November 2018 to January 2019.ExposuresColorectal and noncolorectal procedures.Main outcomes and measuresAny complication, mortality, unplanned hospital readmission, unplanned reoperation related to principal procedure, surgical site infection, and death or serious morbidity.ResultsOf the 17 surgeons included in the study, 13 were men (76%). The participants had a range from 1 to 28 years in surgical practice (median, 11 years). Based on 10 or more reviewers per video and with a maximum quality score of 5, overall technical skill scores ranged from 2.8 to 4.6. From 2014 to 2016, study participants performed a total of 3063 procedures (1120 colectomies). Higher technical skill scores were significantly associated with lower rates of any complication (15.5% vs 20.6%, P = .03; Spearman rank-order correlation coefficient r = -0.54, P = .03), unplanned reoperation (4.7% vs 7.2%, P = .02; r = -0.60, P = .01), and a composite measure of death or serious morbidity (15.9% vs 21.4%, P = .02; r = -0.60, P = .01) following colectomy. Similar associations were found between colectomy technical skill scores and patient outcomes for all types of procedures performed by a surgeon. Overall, technical skill scores appeared to account for 25.8% of the variation in postcolectomy complication rates and 27.5% of the variation when including noncolectomy complication rates.Conclusions and relevanceThe findings of this study suggest that there is wide variation in technical skill among practicing surgeons, accounting for more than 25% of the variation in patient outcomes. Higher colectomy technical skill scores appear to be associated with lower complication rates for colectomy and for all other procedures performed by a surgeon. Efforts to improve surgeon technical skills may result in better patient outcomes.
| S-EPMC7439214 | biostudies-literature
Project description:Specially educated trainers will be responsible for colonoscopy training of junior doctors. The educated trainers will have attended seminars held by Valori et al.
The following fast track colonoscopy training program for junior doctors will consist of: 1) Endoscopy simulation training and theory course 2) supervised and partly supervised lower endoscopy. 3) Directly observed practical skills according graded by MCSAT (Mayo Clinical Skills Assessment Tool) .
| 2188600 | ecrin-mdr-crc
Project description:ObjectivesThe purpose of this study is to evaluate the effects of a tailor-made, non-technical skills seminar on medical student's behaviour, attitudes, and performance during simulated patient treatment.MethodsSeventy-seven students were randomized to either a non-technical skills seminar (NTS group, n=43) or a medical seminar (control group, n=34). The human patient simulation was used as an evaluation tool. Before the seminars, all students performed the same simulated emergency scenario to provide baseline measurements. After the seminars, all students were exposed to a second scenario, and behavioural markers for evaluating their non-technical skills were rated. Furthermore, teamwork-relevant attitudes were measured before and after the scenarios, and perceived stress was measured following each simulation. All simulations were also evaluated for various medical endpoints.ResultsNon-technical skills concerning situation awareness (p<.01, r=0.5) and teamwork (p<.01, r=0.45) improved from simulation I to II in the NTS group. Decision making improved in both groups (NTS: p<.01, r=0.39; control: p<.01, r=0.46). The attitude 'handling errors' improved significantly in the NTS group (p<.05, r=0.34). Perceived stress decreased from simulation I to II in both groups. Medical endpoints and patients´ outcome did not differ significantly between the groups in simulation II.ConclusionsThis study highlights the effectiveness of a single brief seminar on non-technical skills to improve student's non-technical skills. In a next step, to improve student's handling of emergencies and patient outcomes, non-technical skills seminars should be accompanied by exercises and more broadly embedded in the medical school curriculum.
| S-EPMC5376493 | biostudies-literature
Project description:Assessment of technical error in a dual-channel, two timepoint experiment using White lab Drosophila melanogaster microarrays Keywords: repeat sample
2005-05-12 | GSE2641 | GEO
Project description:BACKGROUND:Talent identification and development (TID) programs aim to identify players with the greatest potential for long-term success. Previous research suggests that the assessment of sport-specific technical skills is valuable for discriminating between more and less skilled individuals and/or for predicting future performance. OBJECTIVE:This review aims to provide an overview on both the instruments used to assess sport-specific technical skills and their discriminatory, explanatory and/or predictive findings in the context of TID. METHODS:Electronic searches were conducted in PubMed, Web of Knowledge, SPORTDiscus, SURF and Scopus (January 1990-October 2019). Search terms covered the areas of sport, technical skills assessment, performance, skill level and youth. In the end, 59 relevant studies were identified and evaluated. RESULTS:The results highlight the widespread and important role of technical skills in TID; almost all studies (93%) reported discriminatory, explanatory and/or predictive benefits for the assessment of sport-specific technical skills. Analyzing and categorizing the number of assessment methods applied in the studies (n?=?69) according to their method type ('technique-related' or 'outcome-related' variables) and method set-up ('experimental' or 'competition' data acquisition environment) indicated a clear tendency towards 'outcome-related' (73%) and 'experimental' (75%) assessment methods. We also found a strong overrepresentation of studies assessing cross-sectional data (75%) in soccer (53%) in male samples (74% of studies reporting subjects' sex) from European countries (64%). CONCLUSIONS:On the one hand, our findings demonstrate the great capability of sport-specific technical skills assessments to discriminate different performance levels and predict future performance in TID activities. On the other hand, this review highlights the focus on 'outcome-related' and 'experimental' methods in specific populations and, consequently, the limited knowledge in other areas. Here, the application of 'technique-related' and 'competition' methods appears promising for adding new knowledge, especially in the light of technological advances.
| S-EPMC7441090 | biostudies-literature
Project description:Simulation training may improve patient safety, decrease trainer and trainee anxiety, and reduce the number of cases needed for competency. Complications associated with dilation and evacuation (D&E) have been directly related to provider skill level, yet no low-fidelity model has been formally described or evaluated in the literature for second-trimester D&E training.We report physicians' assessments of the realism of 3 D&E models to establish a composite training model.We surveyed experienced providers at 2 national conferences to evaluate 3 D&E models and rate each model's components on a Likert scale.Fifty-five obstetrics-gynecology and family medicine physicians completed the survey. Most respondents rated 4 components of 1 model as somewhat realistic or very realistic. The components rated highest were the fetal parts (82% [45 of 55]) and placenta (60% [30 of 50]). This model was rated as more likely to be used in training by 80% (43 of 54) of participants than the 2 other models, as rated by 28% (15 of 54) and 9% (5 of 54) of participants.A model made from a plastic bottle containing a stuffed fabric form with detachable parts has tactile similarity to a D&E procedure and should be further developed for testing and training.
| S-EPMC3886469 | biostudies-other