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Efficacy testing of an affordable and realistic small bowel simulator for hand-sewn anastomosis
Background: General surgery residents need to master the hand-sewn bowel anastomosis (HSBA) technique. However, practice opportunities outside of the operating room are rare, and commercial simulators are often costly. The objective of this study was to assess the efficacy of a new, affordable silicone small bowel simulator, made with a 3D-printed mould, as a training tool to learn this technique. Methods: This was a single-blinded pilot randomized controlled trial comparing 2 groups of 8 junior surgical residents. All participants completed a pretest using an pensive, 3D-printed simulator. Next, participants randomized to the experimental group practised the HSBA skill at home (8 sessions), while those randomized to the control group did not receive any hands-on practice opportunities. A posttest was done using the same simulator used for the pretest and practice sessions, and the transfer test was performed on an anesthetized porcine model. Pre-, post- and transfer tests were filmed and graded by a blinded evaluator based on technical skills, procedural knowledge and quality of the final product. Results: The experimental group significantly improved after practising with the model (p = 0.01), while an equivalent improvement was not noted in the control group (p = 0.07). Moreover, the experimental group's performance remained stable between the posttest and the transfer test (p = 0.95). Conclusion: Our 3D-printed simulator is an affordable and efficacious tool to teach residents the HSBA technique. It allows development of surgical skills that are transferable to an in vivo model.
Journal Article
13 things mentally strong women don't do : own your power, channel your confidence, and find your authentic voice for a life of meaning and joy
A guide for women to become mentally strong, confident, and your true self.
Book
Assessment tools for evaluating competency in videoassisted thoracoscopic lobectomy: a systematic review
Background: The advent and widespread adoption of competency-based education increased the need for objective and valid assessment tools (ATs) of operative skill. However, commonly used ATs are generic, limiting their ability to assess and provide feedback for proficiency in specialized procedures. Video-assisted thoracoscopic lobectomy (VATSL) is a complex procedure requiring knowledge and skills not captured by generic ATs. Therefore, the objective was to identify and evaluate VATSL ATs assessing surgical proficiency. Methods: A systematic literature search was performed using Embase, Google Scholar, Ovid Medline, PubMed and Web of Science (1990-2020). Conference abstracts, letters, commentaries, ATs assessing bronchoscopy, open surgery, pneumonectomy, wedge resections and ATs not evaluating technical skills were excluded. Results: Of 523 unique publications, 4 were included. One article described the development of an 8-item assessment tool (VATSAT) by iterative Delphi consensus with 31 experts but did not describe any validation. VATSAT was then modified by the same group to permit assessments of performance on a virtual reality simulator (mVATSAT). mVATSAT had high intraclass correlation coefficients for single (0.78, p < 0.001) and average (0.91, p < 0.001) measures and high reliability scores (G coefficient 0.79, Pearson coefficient 0.70, p < 0.001), but the proposed cut score had high false passing (29%) and failing (43%) rates compared with predicted performance by clinical experience. The third tool (TCAT-ARC) comprised 35 items scored on a 5-point Likert scale. TCAT-ARC was developed by iterative expert consensus and tested in simulated and clinical environments. TCAT-ARC had high discriminatory ability to differentiate novices from experts (Cronbach a 0.93, interobserver reliability 0.73, correlation with objective structured assessment of technical skills 0.68). However, a threshold score indicative of competence was not determined. The fourth used an error score to assess a porcine simulator but did not provide details regarding development or validation. Conclusion: This review identified 4 VATSL ATs evaluating technical skills: 1 has validity evidence from the clinical environment and none have a reliable competence threshold score. Further study is needed to refine VATSL ATs.
Journal Article
Skills for the labor market in the Philippines
This book investigates trends in skills demand and supply over the past two decades for insights into ways to build (and use) the critical skills needed to sustain competitiveness of the Philippine economy. Part one of the book investigates trends in demand for skills in the country overall and by sectors, explores its possible determinants, and attempts to identify emerging skills gaps. Part two turns to the analysis of the supply of skills in the country with a focus on the ability of education and training to provide highly skilled labor, keeping workers' skills updated, and providing skills development opportunities for the unskilled. It explores employers' perceptions on the quality of institutions and provides detailed analysis of the main characteristics, outcomes, and challenges in four key (or growing) subsectors of the provision of skills in the country: higher education, postsecondary technical-vocational education, non-formal secondary education, and postemployment training. It concludes with a summary of policy recommendations.
eBook
Determinants of 21st-Century Skills and 21st-Century Digital Skills for Workers: A Systematic Literature Review
This study brings attention to the determinants of 21st-century skills and 21st-century digital skills. The following skills are investigated: technical, information, communication, collaboration, critical thinking, creativity, and problem-solving skills. To understand differences in the level of these skills among workers, we need to know the factors that determine an individual’s skill level. A systematic literature review was conducted to provide a comprehensive overview of empirical studies measuring skill determinants. The results show that there is strong need for research on determinants of communication and collaboration skills. In a digital context, determinants for creativity and critical thinking are hardly studied. Furthermore, the identified determinants of 21st-century skills studies are limited to personality and psychological determinants, neglecting, for example, social determinants such as social support. Although digital skills studies show more variety, they mostly cover demographic and socioeconomic determinants.
Journal Article
The growing importance of social skills in the labor market
The labor market increasingly rewards social skills. Between 1980 and 2012, jobs requiring high levels of social interaction grew by nearly 12 percentage points as a share of the U.S. labor force. Math-intensive but less social jobs—including many STEM occupations—shrank by 3.3 percentage points over the same period. Employment and wage growth were particularly strong for jobs requiring high levels of both math skill and social skills. To understand these patterns, I develop a model of team production where workers “trade tasks” to exploit their comparative advantage. In the model, social skills reduce coordination costs, allowing workers to specialize and work together more efficiently. The model generates predictions about sorting and the relative returns to skill across occupations, which I investigate using data from the NLSY79 and the NLSY97. Using a comparable set of skill measures and covariates across survey waves, I find that the labor market return to social skills was much greater in the 2000s than in the mid-1980s and 1990s.
Journal Article
The effects of VR-based multi-task sensorimotor intervention on motor performance in children with ADHD and DCD comorbidity
Attention-Deficit/Hyperactivity Disorder (ADHD) and Developmental Coordination Disorder (DCD) are two prevalent neurodevelopmental disorders among children. Both of these diseases, occurring independently or in combination, can result in significant motor skill deficits. The purpose of this study was to observe the improvement in motor performance and skill acquisition of children with ADHD + DCD in comparison with their peers with ADHD or DCD, through repeated practice in the MTSI game. A total of 139 children (37 ADHD, 33 ADHD + DCD, 34 DCD, 35 TD: Typically Developing) participated in the MTSI (Multi-task Sensorimotor Intervention), which involved five sensorimotor intervention tasks. The change of motor performance scores provided by the MTSI system was assessed with repeated measurements, and the skill acquisition in gross & fine motor skills before and after intervention was analyzed with a mixed-design repeated measures ANOVA with post hoc analysis. All groups of children demonstrated a significant increase in motor performance during repeated practice in MTSI and displayed great improvements in gross and fine motor skills, with ADHD + DCD children benefiting more in the magnitude. Multi-task sensorimotor intervention (MTSI) can effectively improve gross and fine motor skills for children with ADHD or DCD, and particularly for those with ADHD and DCD comorbidity, with tailored, multidimensional intervention strategies.
Journal Article
Effects of Parent-Implemented Interventions on Outcomes of Children with Autism: A Meta-Analysis
Children with autism spectrum disorder (ASD) have been shown to benefit from parent-implemented interventions (PIIs). This meta-analysis improved on prior reviews of PIIs by evaluating RCTs and multiple potential moderators, including indicators of research quality. Fifty-one effect sizes averaged moderately strong overall benefits of PIIs (g = 0.553), with studies having lower risk of research bias yielding lower estimates (g = 0.47). Parent and observer ratings yielded similar averaged estimates for positive behavior/social skills (g = 0.603), language/communication (g = 0.545), maladaptive behavior (g = 0.519), and to a lesser extent, adaptive behavior/life skills (g = 0.239). No other study, intervention, or participant characteristic moderated outcomes. PIIs with children with ASD tend to be effective across a variety of circumstances.
Journal Article
Motor Skills in Children Aged 7–10 Years, Diagnosed with Autism Spectrum Disorder
This study used the Movement Assessment Battery for Children (M-ABC2) to assess motor skills in children aged 7–10 years with autism (
n
= 18) in comparison to two groups of age-matched typically developing children; a receptive vocabulary matched group (
n
= 19) and a nonverbal IQ matched group (
n
= 22). The results supported previous work, as indicated by a significant general motor impairment in the group with autism. However, sub-analysis of the M-ABC2 revealed that there were only 2 out of 8 subcomponent skills which showed universal significant specific deficits for the autism group; i.e. catching a ball and static balance. These results suggest that motor skill deficits associated with autism may not be pervasive but more apparent in activities demanding complex, interceptive actions or core balance ability.
Journal Article