Abstract
Simulators have been widely adopted to help surgical trainees learn procedural rules and acquire basic psychomotor skills, and research indicates that this learning transfers to clinical practice. However, few studies have explored the use of simulators to help more advanced learners improve their understanding of operative practices. To model how surgeons with different levels of experience use procedural simulators, we conducted a quantitative ethnographic analysis of small-group conversations in a continuing medical education short course on laparoscopic hernia repair. Our research shows that surgeons who had less experience with laparoscopic surgery tended to use the simulators to learn and rehearse the basic procedures, while more experienced surgeons used the simulators as a platform for exploring a range of hernia presentations and operative approaches based on their experiences. Thus simple, inexpensive simulators may be effective with both novice and more experienced learners.
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References
Dawe, S.R., Windsor, J.A., Broeders, J.A., Cregan, P.C., Hewett, P.J., Maddern, G.J.: A systematic review of surgical skills transfer after simulation-based training: laparoscopic cholecystectomy and endoscopy. Ann. Surg. 259, 236–248 (2014)
Madani, A., et al.: What are the principles that guide behaviors in the operating room? creating a framework to define and measure performance. Ann. Surg. 265, 255–267 (2017)
Sullivan, S.A., Ruis, A.R., Pugh, C.M.: Procedural simulations and reflective practice: meeting the need. J. Laparoendosc. Adv. Surg. Tech. 27, 455–458 (2017)
Mattar, S.G., et al.: General surgery residency inadequately prepares trainees for fellowship: results of a survey of fellowship program directors. Ann. Surg. 258, 440–449 (2013)
Subhas, G., Mittal, V.K.: Minimally invasive training during surgical residency. Am. Surg. 77, 902–906 (2011)
Osman, H., Parikh, J., Patel, S., Jeyarajah, D.R.: Are general surgery residents adequately prepared for hepatopancreatobiliary fellowships? a questionnaire-based study. HPB 17, 265–271 (2015)
Bell, R.H.: Operative experience of residents in us general surgery programs: a gap between expectation and experience. Ann. Surg. 249, 719–724 (2009)
Iyasere, C.A., Baggett, M., Romano, J., Jena, A., Mills, G., Hunt, D.P.: Beyond continuing medical education: clinical coaching as a tool for ongoing professional development. Acad. Med. 91, 1647–1650 (2016)
Sachdeva, A.K.: The new paradigm of continuing education in surgery. Arch. Surg. 140, 264–269 (2005)
Shaffer, D.W.: Quantitative Ethnography. Cathcart Press, Madison (2017)
Pugh, C., Plachta, S., Auyang, E., Pryor, A., Hungness, E.: Outcome measures for surgical simulators: Is the focus on technical skills the best approach? Surgery 147, 646–654 (2010)
Hsieh, H.-F., Shannon, S.E.: Three approaches to qualitative content analysis. Qual. Health Res. 15, 1277–1288 (2005)
Eagan, B.R., Rogers, B., Pozen, R., Marquart, C., Shaffer, D.W.: rhoR: Rho for inter rater reliability (2016)
Marquart, C., Hinojosa, C.L., Swiecki, Z., Eagan, B.R., Shaffer, D.W.: Epistemic network analysis (2019)
Shaffer, D.W., Collier, W., Ruis, A.R.: A tutorial on epistemic network analysis: analyzing the structure of connections in cognitive, social, and interaction data. J. Learn. Anal. 3, 9–45 (2016)
Shaffer, D.W., Ruis, A.R.: Epistemic network analysis: a worked example of theory-based learning analytics. In: Lang, C., Siemens, G., Wise, A.F., and Gasevic, D. (eds.) Handbook of Learning Analytics, pp. 175–187. Society for Learning Analytics Research (2017)
Siebert-Evenstone, A.L., Irgens, G.A., Collier, W., Swiecki, Z., Ruis, A.R., Shaffer, D.W.: In search of conversational grain size: modelling semantic structure using moving stanza windows. J. Learn. Anal. 4, 123–139 (2017)
Schön, D.A.: The Reflective Practitioner: How Professionals Think in Action. Basic Books, New York (1983)
McGlinn, E.P., Chung, K.C.: A pause for reflection: Incorporating reflection into surgical training. Ann. Plast. Surg. 73, 117 (2014)
Jordan, M.E., McDaniel Jr., R.R.: Managing uncertainty during collaborative problem solving in elementary school teams: the role of peer influence in robotics engineering activity. J. Learn. Sci. 23, 490–536 (2014)
Husebø, S.E., O’Regan, S., Nestel, D.: Reflective practice and its role in simulation. Clin. Simul. Nurs. 11, 368–375 (2015)
Mamede, S., Schmidt, H.G.: Correlates of reflective practice in medicine. Adv. Health Sci. Educ. 10, 327–337 (2005)
McGaghie, W.C., Issenberg, S.B., Cohen, M.E.R., Barsuk, J.H., Wayne, D.B.: Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? a meta-analytic comparative review of the evidence. Acad. Med. 86, 706–711 (2011)
Davis, D., O’Brien, M.A.T., Freemantle, N., Wolf, F.M., Mazmanian, P., Taylor-Vaisey, A.: Impact of formal continuing medical education: do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes? J. Am. Med. Assoc. 282, 867–874 (1999)
Sachdeva, A.K., Blair, P.G., Lupi, L.K.: Education and training to address specific needs during the career progression of surgeons. Surg. Clin. North Am. 96, 115–128 (2016)
Ruis, A.R., Rosser, A.A., Quandt-Walle, C., Nathwani, J.N., Shaffer, D.W., Pugh, C.M.: The hands and head of a surgeon: modeling operative competency with multimodal epistemic network analysis. Am. J. Surg. 216, 835–840 (2018)
Godfrey, M., Rosser, A.A., Pugh, C.M., Shaffer, D.W., Sachdeva, A.K., Jung, S.A.: Teaching practicing surgeons what not to do: an analysis of instruction fluidity during a simulation-based continuing medical education course. Surgery 165, 1082–1087 (2019)
Acknowledgements
This work was funded in part by the National Science Foundation (DRL-1661036, DRL-1713110), the Wisconsin Alumni Research Foundation, and the Office of the Vice Chancellor for Research and Graduate Education at the University of Wisconsin-Madison. A. R. Ruis was supported by a University of Wisconsin-American College of Surgeons Education Research Fellowship. The opinions, findings, and conclusions do not reflect the views of the funding agencies, cooperating institutions, or other individuals.
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Ruis, A.R., Rosser, A.A., Nathwani, J.N., Beems, M.V., Jung, S.A., Pugh, C.M. (2019). Multiple Uses for Procedural Simulators in Continuing Medical Education Contexts. In: Eagan, B., Misfeldt, M., Siebert-Evenstone, A. (eds) Advances in Quantitative Ethnography. ICQE 2019. Communications in Computer and Information Science, vol 1112. Springer, Cham. https://doi.org/10.1007/978-3-030-33232-7_18
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