ObjectiveRepeated practice, or spacing, can improve various types of skill acquisition. Similarly, virtual reality (VR) simulators have demonstrated their effectiveness in fostering surgical skill acquisition and provide a promising, realistic environment for spaced training. To explore how spacing impacts VR simulator-based acquisition of surgical psychomotor skills, we performed a systematic literature review.MethodsWe systematically searched the databases PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, ERIC and CINAHL for studies investigating the influence of spacing on the effectiveness of VR simulator training focused on psychomotor skill acquisition in healthcare professionals. We assessed the quality of all included studies using the Medical Education Research Study Quality Instrument (MERSQI) and the risk of bias using the Cochrane Collaboration’s risk of bias assessment tool. We extracted and aggregated qualitative data regarding spacing interval, psychomotor task performance and several other performance metrics.ResultsThe searches yielded 1662 unique publications. After screening the titles and abstracts, 53 publications were retained for full text screening and 7 met the inclusion criteria. Spaced training resulted in better performance scores and faster skill acquisition when compared to control groups with a single day (massed) training session. Spacing across consecutive days seemed more effective than shorter or longer spacing intervals. However, the included studies were too heterogeneous in terms of spacing interval, obtained performance metrics and psychomotor skills analysed to allow for a meta-analysis to substantiate our outcomes.ConclusionSpacing in VR simulator-based surgical training improved skill acquisition when compared to massed training. The overall number and quality of available studies were only moderate, limiting the validity and generalizability of our findings.
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Abstract Purpose Knowledge of clinical pharmacotherapy is essential for all who prescribe medication. The aims of this study were to investigate differences in the pharmacotherapy and polypharmacy knowledge of medical and surgical residents and consultants and whether this knowledge can be improved by following an online course. Methods Design: A before-and-after-measurement. Setting: An online course available for Dutch residents and consultants working in hospitals. Study population: Dutch residents and consultants from different disciplines who voluntarily followed an online course on geriatric care. Intervention An online 6-week course on geriatric care, with 1 week dedicated to clinical pharmacotherapy and polypharmacy. Variables, such as medical vs surgical specialty, consultant vs resident, age, and sex, that could predict the level of knowledge. The effects of the online course were studied using repeated measures ANOVA. The study was approved by the National Ethics Review Board of Medical Education (NERB dossier number 996). Results A total of 394 residents and 270 consultants, 220 from surgical and 444 from medical specialties, completed the online course in 2016 and 2017. Residents had higher test scores than consultants for pharmacotherapy (73% vs 70%, p<0.02) and polypharmacy (75% vs 72%, p<0.02). The learning effect did not differ. Medical residents/consultants had a better knowledge of pharmacotherapy (74% vs 68%, p<0.001) and polypharmacy (77% vs 66%, p<0.001) than surgical residents/consultants, but the learning effect was the same. Conclusions Residents and consultants had a similar learning curve for acquiring knowledge, but residents outperformed consultants on all measures. In addition, surgical and medical residents/consultants had similar learning curves, but medical residents/consultants had higher test scores on all measures.
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ObjectivesSeveral surgical techniques are available for the treatment of cervical degenerative disease. For resolving cervical nerve root compression, anterior cervical discectomy with fusion (ACDF) or posterior cervical foraminotomy (PCF) can be applied. Amongst neurosurgeons, there seems to be a tendency to prefer ACDF, even though there are some advantages in favor of PCF. The objective of present study is to evaluate which factors determine the choice for an anterior or posterior surgical approach in patients with cervical radiculopathy based on foraminal pathology.MethodsA web-based survey was sent to all 133 neurosurgeons in the Netherlands. The study followed a mixed methods cross-sectional design. The first part of the survey focused on general perceived (dis)advantages of ACDF and PCF. The second part concerned questions about the choice between the two procedures. Furthermore, it was analyzed if exposure during training, amount of performed surgeries, assumed reoperation and complication rates influenced the choice of procedure by conducting Chi-square tests with post-hoc analysis.ResultsA total of 56 neurosurgeons responded (42%). An overall preference for ACDF was observed, even when differentiating for a pure disc prolapse, a spondylotic or a combined stenosis of the neuroforamen. The most relative important factors for motivating the preference for either ACDF or PCF were: the assumed best decompression of the nerve root (18%), congruence with current literature (16%), exposure during residency (12%), personal comfort (11%) and experience (11%) with the technique.ConclusionIn this survey, there was an overall preference for ACDF above PCF for the surgical treatment of a foraminal cervical radiculopathy. In addition to subjective factors as “experience” and “comfort”, the respondents often motivated their choice as “the best one according to literature”. As there is currently no evidence about the superiority of any of the procedures in literature, this assumption is remarkable.
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Since 2015, the research group Lifelong Learning in Music of Hanze University of Applied Sciences Groningen, together with the University Medical Center Groningen (UMCG), has developed and researched the MiMiC practice for patients and nurses on surgical wards. The musicians make tailor-made music in the patients' rooms in collaboration with patients and nurses. They do this on the basis of verbal and non-verbal contact with patients and nurses. Person-centred music-making turns out to be easy to realise in a medical setting and to be meaningful for all involved. People who have just had surgery experience less pain. Nurses feel more deeply involved with their patients. Musicians show sensitivity for the social context in which they carry out their artistic practice.In this project the research group is developing an innovative artistic practice with a focus on elderly patients. Musicians work with patients and the care staff that are taking care of these patients during their stay in hospital. The research should lead to insights in the effects of this practice and to a new training for master students and professional musicians who want wish to specialise themselves in this field. Pilots on six different wards of the UMCG with professional musicians and master students are part of the research which will last two years in its entirety. The project has been granted funding from the 'Banning de Jong Fonds' of the national 'Prins Bernhard Cultuurfonds' and the 'Fonds Sluyterman van Loo'.
