Leander De Mol
Chest Tube Insertion (CTI) is a potentially life-saving surgical procedure, and is carried out in both the emergency and elective setting. The aim of the procedure is to insert a plastic tube in the pleural cavity in order to evacuate air, blood or other fluid so that the lung can expand in a normal fashion. However, CTI has a relatively high complication rate. Most of these complications can be linked to lack of theoretical knowledge or a lack of surgical training. In other words, physicians in training (residents) do not have access to safe learning environments where they can train their procedural skills without potentially endangering patients. Simulation-based training aims to resolve this problem. During simulation-based training, residents have a chance to train their skills on realistic representations of the human body. During these training sessions, residents are observed and assessed using valid assessment tools, which generates valuable feedback in order to guide future training sessions. Only when a resident is deemed proficient on the simulator, will they progress to the next stage in their training. This ‘mastery learning’ has already demonstrated superior results compared to the traditional resident education. The goal of this PhD project is to develop a stepwise, simulation-based training curriculum where junior residents can train their skills in CTI. The project will focus on constructing valid assessment tools on different simulators (porcine rib models and Thiel embalmed human cadavers), after which the effect of the proposed curriculum will be evaluated. Implementing this training program in resident education may deliver physicians that are more competent than those who follow the traditional education, but does not remove the need for training under supervision on patients.
Anatomy learning based on drawings, cadaver dissections and prosections has long been the sole way for students to appreciate three-dimensional (3D) relationships in the human body. More recently, anatomy education has been revolutionized through innovative tools. Ultrasound-based anatomy as well as digital media have provided teachers with opportunities to supplement traditional anatomy teaching. As a non-invasive and non-destructive way to look inside the living body, ultrasound can be seen as tool to improve students’ understanding and retention of three-dimensional anatomical structures. Furthermore, as a real-time imaging modality, it has the ability to show dynamic changes of anatomical structures, e.g. sliding of tendons. However, the impact of ultrasound on anatomy learning and student cognitions is scarce. Therefore, the objective of this PhD project is to assess the effectiveness of ultrasound in the anatomy curriculum. Due to lack in curricular time, trained faculty, an increasing student numbers and rising costs, educators went looking for digital tools to provide answers to these challenges. Moreover, the Covid-19 pandemic imposed unexpected disruptions to anatomical educational practice. As a consequence, face-to-face teaching needed to be abandoned and courses shifted to the virtual mode. In this light, the development of virtual learning resources accelerated. Currently, the variety of digital anatomical models is large, ranging from animated models to high-fidelity models, and from desktop-based to fully immersive models. The objective of this PhD project is to assess the effectiveness of these 3D anatomical models in the anatomy curriculum.
During endovascular procedures, a high incidence of adverse events has been described, sometimes causing lifelong impairment and death. Are these caused by the patient’s condition, procedure’s complexity, or influenced by team members' psychosocial well-being, work environmental and/or organizational factors? Errors, adverse events and patient outcomes will be analyzed during elective endovascular procedures in a hybrid room using the OR Black Box technology. Technical and non-technical skills of the endovascular team will be studied to characterize a chain of events, to detect areas of improvement and to identify high-risk interventions. Likewise, training of endovascular skills with its inherent learning curve is often associated with errors. By allowing surgical trainees to learn knowledge and endovascular technical skills in a safe, simulated environment using a stepwise, structured endovascular training curriculum prior to treat real patients, errors by surgical trainees may be reduced. Radiation is inevitably another major hazard for patients and healthcare personnel in the hybrid room. Radiation protection courses are often too theoretical to safely learn how to use X- rays in daily practice. A massive open online course including knowledge, examples of good and poor radiation protection behavior and serious game will be implemented and its impact on radiation safety behavior of the endovascular team will be studied using the OR Black Box.