1,721,494 research outputs found
Learning of robotic raical prostatectomy: the guy's experience
No full textIn most cases the learning curve of robotic radical prostatectomy is not completed during residency training. This is why international fellowship programs are becoming more popular. The aim of this study is to evaluate the efficiency of the fellowship program of the UK group
The European Association of Urology Robotic Training Curriculum: An Update
No full textThe European Association of Urology robotic training curriculum is a validated structured program to provide standardized training and to certify surgeons for specific urologic procedures
Pilot Validation Study of the European Association of Urology Robotic Training Curriculum
No full textThe development of structured and validated training curricula is one of the current priorities in robot-assisted urological surgery
Training Modalities in Robot-assisted Urologic Surgery: A Systematic Review
No full textContext Novel surgical techniques demand that surgical training adapts to the need for technical and nontechnical skills. Objective To identify training methods available for robot-assisted surgical (RAS) training in urology, evaluate their effectiveness in terms of validation, educational impact, acceptability, and cost effectiveness, and assess their effect on learning curves (LCs). Evidence acquisition A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines searched Ovid Medline, Embase, PsycINFO, and the Cochrane Library. Results were screened to include appropriate studies. Quality was evaluated. Each method was evaluated, and conclusions were drawn regarding LCs. Evidence synthesis Of 359 records, 24 were included (521 participants). Training methods included dry-lab training (n = 7), wet-lab training (n = 7), mentored training (n = 7), and nonstructured pathways (n = 5). Dry-lab training demonstrated educational impact by reducing console time and was acceptable in a study; 100% of participants confirmed face validity. Wet-lab training principally uses human cadaveric material; effectiveness is well rated, although dry-lab training and observation were rated as equally useful. Mentored programmes combine lectures, tutorials, observation, simulation, and proctoring. Minifellowships were linked to greater practice of RAS 1 yr later. LCs vary according to experience. One study found that surgeons from robot-related fellowships demonstrated fewer positive surgical margins than surgeons from laparoscopic-related fellowships (24% vs 34.6%; p = 0.05) and reduced time (132 vs 152 min; p = 0.0003). Five studies examined nonstructured training pathways (clinical practice). Experience correlated with fewer complications (p = 0.007), improved continence (p = 0.049), and reduced time (p = 0.002). Conclusions RAS training methods include dry and wet lab, mentored training, and nonstructured pathways. Limited available evidence suggests that they affect LCs differently and are rarely used alone. The different methods of training appear effective when combined. Their benefits must be explored to facilitate validated acceptable training with educational impact. Patient summary Robot-assisted training encompasses several methods used in combination, but more evidence is required to gain the greatest benefit and formulate future training pathways. © 2016 European Association of Urolog
Modular Training for Robot-Assisted Radical Prostatectomy: Where to Begin?
Full text linkOBJECTIVE: Effective training is paramount for patient safety. Modular training entails advancing through surgical steps of increasing difficulty. This study aimed to construct a modular training pathway for use in robot-assisted radical prostatectomy (RARP). It aims to identify the sequence of procedural steps that are learnt before surgeons are able to perform a full procedure without an intervention from mentor.
DESIGN: This is a multi-institutional, prospective, observational, longitudinal study. We used a validated training tool (RARP Score). Data regarding surgeons' stage of training and progress were collected for analysis. A modular training pathway was constructed with consensus on the level of difficulty and evaluation of individual steps. We identified and recorded the sequence of steps performed by fellows during their learning curves.
SETTING AND PARTICIPANTS: We included 15 urology fellows from UK, Europe, and Australia.
RESULTS: A total of 15 surgeons were assessed by mentors in 425 RARP cases over 8 months (range: 7-79) across 15 international centers. There were substantial differences in the sequence of RARP steps according to the chronology of the procedure, difficulty level, and the order in which surgeons actually learned steps. Steps were not attempted in chronological order. The greater the difficulty, the later the cohort first undertook the step (p = 0.021). The cohort undertook steps of difficulty level I at median case number 1. Steps of difficulty levels II, III, and IV showed more variation in median case number of the first attempt. We recommend that, in the operating theater, steps be learned in order of increasing difficulty. A new modular training route has been designed. This incorporates the steps of RARP with the following order of priority: difficulty level > median case number of first attempt > most frequently undertaken in surgical training.
CONCLUSIONS: An evidence-based modular training pathway has been developed that facilitates a safe introduction to RARP for novice surgeons. ((C) 2017 Association of Program. Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
- …
