Alphonsus Chong's Personal Wiki

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==== Surgical Education ====

I am interested in the teaching and learning of surgery, particular the technical skills in the OR. Using microvascular anastomosis as a model of a complex surgical task, I am interested to understand how simulation, particularly low-fidelity simulation models can be used to acquire the necessary skills for surgery.

Laparascopic surgery has the best developed simulation models and programmes for this. We should ride on the knowledge gained from their experience to also develop more effective, efficient, and evidence supported microvascular training programmes.

====Microsurgery Education====

[[Microsurgery Assessment]]

Does teaching/ learning of microsurgery help develop skills in other areas of surgery? and vice versa?

  * [[jnl:almeland2019]] suggests teaching microsurgery does not improve their macrosurgical skills, but does increase their interest in plastic surgery. I have some concerns about the study methodology.

How much time do you need to develop microsurgical skills?

  * [[jnl:onoda2015]] suggests 7-8 hours a day for 15 days is sufficient.

====Training====

[[Training]]

====Selection for Training====

There is some evidence that surgical aptitude and attitude can predict performance in surgical training see [[jnl:Moore2015]]

For medical students: the effect of a curriculum entering surgical rotation: [[jnl:shipper2017|Evaluation of Technical and Non-Technical Skills Curriculum for Students Entering Surgery]]
====Clinical Training====

  * Predictors of Surgical Performance: see [[jnl:Maan2012]]
  * Entrustable Professional Activities
      * [[jnl:vanloon2014|Potential benefits and pitfalls]]
  * [[Educational Needs in Hand Surgery]]

====Technical Skills====

   * [[pp:Fitts-Posner]]: [[Learning and Skilled Performance]]

=== Low Fidelity Training ===
There is good evidence that low fidelity/cheaper simulation works as well as more expensive high tech ones, particularly for novices. See this [[jnl:abi-rafeh2019|Systematic Review]]

  - [[jnl:wais2012|Low-Fi training can improve cadaveric endoscopic sinus surgery in cadaver]]
  - [[jnl:smink2017|May need at least moderate fidelity for non-technical skill acquisition]]
  - [[jnl:diesen2011|Box trainer as good as hi tech laparascopic trainer in novices]]



===Other aspects of Learning===
  - [[Retention and Decay]]
  - [[Motivation]]
  - [[Metacognition]]. See [[jnl:burman2014]]; also mentioned in [[jnl:peyre2011]]


=== Non-Technical Skills ===
  - [[jnl:smink2017|Technical and Non-technical skills are interdependent]]

=== Assessment of Technical Skills ===
  - [[jnl:Moorthy2003|Objective assessment of technical skills in surgery]]


== Product Assessment ==
  * [[jnl:kim2019]]


====Surgical Simulation====

How much simulation?
  * [[jnl:rabinovich2021|Does more simulation help in fracture reduction?]]

While becoming more common, there are concerns about:
  * transferability
    * [[jnl:anton2019|Predictors of transfer]]
  * retention
    * A [[jnl:atesok2016|recent review]]
  * [[jnl:agha2015|The role and validity of surgical simulation]]


[[Assessment]]

  * [[jnl:darzi2001|Surgical training assessment by Darzi]]
  * A secondary task can differentiate experts from trained and novices. See [[jnl:stefanidis2007]]
  * [[jnl:szasz2015|Systematic Review of Surgical Competency]]

[[Success|Success in Medicine]]

=== Review Articles ===

[[jnl:Peyre2011]] discusses [[ac:Fitts-Posner]], [[ac:Transfer Theory]], and [[ac:Expert Performance Theory]]

=== Outcomes ===

=== Development ===
[[jnl:challis2000|Personal Learning Plan]]

[[Expertise]]

[[Glossary]]

==== Sleep and Sleep deprivation ====

[[jnl:taffinder1992|Sleep Deprivation on Surgeon's Dexterity]]

==== See also ====
  * [[bk:schon1983|The reflective practitioner. How professionals think in action]]
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