Digital platforms for surgical training literature review

This literature review is aimed at exploring the scope and limitations of web-based surgical training, especially in LMICs.

Search terms[edit | edit source]

• "open access" surgical training
• internet access hospital lmic
• web platform surgical training
• elearning landscape surgical limitations
• online platforms landscape surgical limitations
• mhealth landscape surgical
• definition of open access surgical

Consulted literature[edit | edit source]

The fate of medicine in the time of AI[edit | edit source]

Notes[edit | edit source]

• (Regarding the transformations in the field): “How should we prepare for these coming times? The most obvious step is to adapt clinical education to the digital world.”

Evidence in surgical training – a review[edit | edit source]

Notes[edit | edit source]

• “Surgical education does not only require learning the technical skills but also human factors as well as interdisciplinary and interprofessional handling.” (Fritz et al., 2019, p. 7) The importance of platforms to establish structure: “After reviewing the literature, we can only estimate that structured curricula are helpful because they provide assessments after defined time points, which allows the resident and the faculty to address problems.” (Fritz et al., 2019, p. 12)

Use of Innovative Technology in Surgical Training in Resource-Limited Settings: A Scoping Review[edit | edit source]

Notes[edit | edit source]

• nedd access

Building a Open Source Framework for Virtual Medical Training[edit | edit source]

Notes[edit | edit source]

• Only things to mention:
• This an open source framework for surgical training using VR simulation.
• The authors stress the importance of open licenses (they licensed the software using GNU GPL)
• A conclusion for them is the importance of the tool’s license and design practices to enable its use in other domains.

The cutting-edge training modalities and educational platforms for accredited surgical training: A systematic review[edit | edit source]

Notes[edit | edit source]

• “most of the practicing surgeons have learned emerging surgical technologies on patients without going through any formal training.” (Forgione and Guraya, 2017, p. 1) “These disappointing figures urge the surgical educators and trainees to explore gaps in laparoscopic surgery training and to recommend a unified training strategy that can produce safe and competent laparoscopic surgeons.” (Forgione and Guraya, 2017, p. 2)

Validation of the three web quality dimensions of a minimally invasive surgery e-learning platform[edit | edit source]

Notes[edit | edit source]

• “distance education has become an efficient method of teaching surgery [17], and is even more useful in the case of blended learning, that combines in-person and online learning” (Ortega-Morán et al., 2017, p. 3) “the three web quality dimensions [36,37]: web appearance, web content and technical adequacy.” (Ortega-Morán et al., 2017, p. 3)

Surgical training on the web[edit | edit source]

Notes[edit | edit source]

• Fairly old article (not citeable?) HCI levels:
• Abstract (not related to the geometry of the world)
• Virtual objects
• Physical manipulation of objects
• Application
• Geometric modeling: abstraction of the shapes
• Behavior modeling: behavior of tools and anatomic structures
• Until now all attempts to provide surgical training systems have been trapped in platform dependent, expensive and dedicated systems […] One solution to the training of medical staff is to make training systems widely accessible over a range of platforms with different capabilities

Virtual Surgical Training During COVID-19[edit | edit source]

Notes[edit | edit source]

• During the COVID pandemic
• “Currently, over 20 computer-based platforms, ranging over 9 surgical specialties, are available on the internet and are accessible from home.” (McKechnie et al., 2020, p. 0)
• “It has been demonstrated that residents with an active subscription to the Surgical Council on Resident Education Portal score higher on their American Board of Surgery Qualifying Examination.” (McKechnie et al., 2020, p. 0)

Multimedia-based training on Internet platforms improves surgical performance: a randomized controlled trial[edit | edit source]

Notes[edit | edit source]

• “In conclusion, multimediabased training is a low-cost, always-available means of education that should not replace face-to-face teaching. It can be seen as a reasonable additional tool to be included in surgical curricula because it leads to improvement in surgical performance.” (Pape-Koehler et al., 2013, p. 1746)

Systematic review of e-learning for surgical training[edit | edit source]

Notes[edit | edit source]

• Literature review
• “E-learning provides unparalleled accessibility, not restricted by location, faculty availability, time restrictions or user costs” (Maertens et al., 2016, p. 1428)
• “Platforms with a hands-on technical training component, including the use of hardware other than a standard computer monitor, keyboard, mouse or touch-screen device, were excluded” (Maertens et al., 2016, p. 1429).
• “Surgical skills were broadly categorized into psychomotor skills, cognitive skills (for example procedural or disease-related knowledge, pattern recognition) and non-technical interpersonal skills (communication, leadership, team dynamics, professionalism).” (Maertens et al., 2016, p. 1430)
• Table 4 describes the following component types: multimedia, interactive, formative feedback, assessment, virtual patients, virtual reality, spaced education (schedule-spacing), community-based learning, gamification. “most showed greater effectiveness for e-learning teaching tools versus independent reading of a textbook chapter or article, simulation-based curricula, small-group seminars run by a facilitator, online supplemental material, a teaching video or clinical exposure.” (Maertens et al., 2016, p. 1433) “The majority of studies comparing e-learning with didactic lecture-based curricula showed no difference.” (Maertens et al., 2016, p. 1433) (Sounds like structure is the biggest contribution of platform-based education). “These modules should ideally be complemented with other activities such as simulation-based training to develop the entire spectrum of surgical competency, and this can result in effective training curricula” (Maertens et al., 2016, p. 1435) “but more advanced phases require a degree of automaticity and effortless thinking that can be attained only through repeated and focused practice, through simulation and clinical exposure.” (Maertens et al., 2016, p. 1435) “These results are consistent with other simulation-based curricula, suggesting that distributed practice with ongoing learning decreases the performance decay that occurs over time compared with a single training session” (Maertens et al., 2016, p. 1436)

A review of online platforms in training and surgical education[edit | edit source]

Notes[edit | edit source]

• Blended learning or hybrid learning, also known as technology-mediated instruction, web-enhanced instruction, or mixed-mode instruction, is an approach to education that combines online educational materials and opportunities for interaction online with physical place-based classroom methods. Wikipedia “We envisaged the use of online classrooms in surgical education because of its simple format, easy access, low costs, and interaction-inspiring nature between teachers and students in professional surgical education.” (El Boghdady et al., 2019, p. 41)
• This literature review saw a predominance of blended learning (i.e. using technology to accompany other learning pathways).
• “In agreement, blended learning was thought to require the physical presence of teacher and students” (El Boghdady et al., 2019, p. 43)
• Articles evaluated from 1998 to 2018 (n = 22)
• Blended learning integrates a variety of digital components, not only a platform
• “The major advantage of online or blended learning consists in less costly teaching and time-saving approaches to deliver better than the face-to-face methods.” (El Boghdady et al., 2019, p. 46)
• “In addition, to benefit from online platforms, access to electronic devices and fast Internet connections forlargedata admittance are obligatory. These requirements can be unaffordable for less economically fortunate students.” (El Boghdady et al., 2019, p. 46)

Design, Realization, and First Validation of an Immersive Web-Based Virtual Patient Simulator for Training Clinical Decisions in Surgery[edit | edit source]

Notes[edit | edit source]

• Clinical education is characterized by the transfer of declarative (“what to do”) into procedural knowledge (“how to do it”).
• There is no academic-driven simulator that is freely accessible to every student and combines high immersion grade with a profound amount of medical content.
• Furthermore, we revealed that immersive simulators are mostly developed by commercial companies and limit the target audience on paying customers.

Haptic, Physical, and Web-Based Simulators: Are They Underused in Maxillofacial Surgery Training?[edit | edit source]

Notes[edit | edit source]

• Although students found the haptic simulator to be more effective than the Web-based simulator, they rated their improved skill set as high and suggested that the combined simulators continue to be used in the maxillofacial surgery curriculum

Implementation of a Web- and simulation-based curriculum to ease the transition from medical school to surgical internship[edit | edit source]

Notes[edit | edit source]

• Need access

Mobile Applications for the Health Sector[edit | edit source]

Notes[edit | edit source]

• health workers: they will need new skills to use mHealth services for medical surveillance and treatment. This needs will require creating courses, developing training institutions, accrediting trainers and workers, and providing oversight to ensure quality and enforcement of standards in training and use.

eSurgery—digital transformation in surgery, surgical education and training: survey analysis of the status quo in Germany[edit | edit source]

Notes[edit | edit source]

• According to 79.0% of the participants, the integration of digital technologies in surgical education for basic and advanced stage surgeons should be aimed for. Data protection (1.7) and e‑Learning (1.7) were rated as the most important teaching content. The greatest discrepancy between importance and implementation was seen in the teaching content of big data (mean: 2.2–3.8).

The future of orthopaedic surgical education: Where do we go now?[edit | edit source]

Notes[edit | edit source]

• Digital learning programmes were already widely adopted in many sectors before the COVID-19 pandemic struck, and we have seen a marked increase in such learning programmes in the wake of this crisis. E: In some cases, these resources have supplemented the learning activities, while in some others, they have substituted them, especially during the pandemic or in other cases Describe the difference between supplementary and substitute medical training. In some cases, describe what we consider the “better-than-nothing”. A blended approach, combining virtual teaching, face-to-face instruction and distance learning tools, based on the evidence we have provided, would improve the quality of knowledge reception and retention, and learner satisfaction.

Does E-learning Improve Plastic Surgery Education?: A System... : Annals of Plastic Surgery[edit | edit source]

Notes[edit | edit source]

• Need access

Implementation of an E-Learning Academic Elective for Hands-On Basic Surgical Skills to Supplement Medical School Surgical Education[edit | edit source]

Notes[edit | edit source]

• self-assessment using video and a checklist
• not focused on the platform but on the user journey:
• Self-assessment
• Remote
• Hands-on
• individualized instruction
• structure 1) learning objectives, goals and timeframe, 2) learning materials, 3) assignments and assessments, 4) post-module survey
• However, traditional e-Learning may neglect hands-on skills and offer little of the high-quality, individualized instruction and performance feedback required for surgical training.

Digital Teaching in Medical Education: Scientific Literature Landscape Review[edit | edit source]

Notes[edit | edit source]

• It’s a literature review about digital teaching
• “By examining the data, we noticed that one of the keywords with highest CPP was “low- and middle-income countries”” (Yeung et al., 2022, p. 8)
• “Low-income countries together accounted for 0.9% of the publications, and their works were infrequently cited.” (Yeung et al., 2022, p. 9)
• “Importantly, not all populations can readily access the internet for digital teaching” (Yeung et al., 2022, p. 10)
• “Although digital teaching can take place in many formats, internet accessibility remains to be a mandatory requirement. In countries and regions where medical students cannot connect to the internet anytime and anywhere, perhaps asynchronous formats will be more suitable, such as a MOOC course.” (Yeung et al., 2022, p. 10)

The Future of Immersive Technology in Global Surgery Education[edit | edit source]

Notes[edit | edit source]

• Types
• Virtual reality
• Artificial intelligence
• Considerations
• “Affordability, availability, accessibility and appropriateness” (Pears and Konstantinidis, 2022, p. 281)
• Co-creation process of these tools
• Sustainability
• “India has added more than 240 million smartphone users since 2014” (Pears and Konstantinidis, 2022, p. 282)

The Limits of Empowerment: How to Reframe the Role of mHealth Tools in the Healthcare Ecosystem[edit | edit source]

Notes[edit | edit source]

• Very much focused on patient-doctor relationship but can be stretched to LMIC students and practitioners. “As a result, mHealth tools have come to be presented in a techno-utopian manner, which may go as far as portraying self-tracking as the panacea for preventive medicine (Smith and Vonthethoff 2017).” (Morley and Floridi, 2020, p. 1160)
• Authors introduces the concept of accompaniment of technology.
• “technologies are also constitutive components of the informational turn in sociopolitical power (Floridi 2015) and essential for the creation of an environment in which individuals can even be perceived as being complicit in their own self surveillance (Rich and Miah 2014).” (Morley and Floridi, 2020, p. 1161)

Open mHealth Architecture: A Primer for Tomorrow's Orthopedic Surgeon and Introduction to Its Use in Lower Extremity Arthroplasty[edit | edit source]

Notes[edit | edit source]

• Portability and interactivity A limitation of the current mHealth landscape is the fragmentation and lack of interconnectivity between the myriad of available apps. The importance behind the currently lacking open mHealth architecture is underscored by the offer of improved research, increased workflow efficiency, and value capture for the orthopedic surgeon.

Applying the Participatory Slow Design Approach to a mHealth Application for Family Caregivers in Pediatric Ear, Nose, and Throat Surgery[edit | edit source]

Notes[edit | edit source]

• Very much focused on families and patients, not on training.

Surgery and the Smartphone: Can Technology Improve Equitable Access to Surgical Care?[edit | edit source]

Notes[edit | edit source]

Successful mLearning Pilot in Senegal: Delivering Family Planning Refresher Training Using Interactive Voice Response and SMS[edit | edit source]

Notes[edit | edit source]

Does mobile phone survey method matter? Reliability of computer-assisted telephone interviews and interactive voice response non-communicable diseases risk factor surveys in low and middle income countries[edit | edit source]

Notes[edit | edit source]

• Not relevant

References[edit | edit source]