Upload
mateo-eccles
View
214
Download
0
Tags:
Embed Size (px)
Citation preview
MOOCs and other Ghostsin CV surgery
Paul SergeantKU.Leuven, Belgium
The educational curriculum of technical skills for anastomotic techniques in ischemic heart diseases
Science of learning
• Use of wiki-concepts• Affordable and ubiquitous available processes• Distributed and blended learning processes• Individualized adult-centered processes• Individualized learning communities• Institutional or regional supervision• Confidentiality of training processes with respect for scholar• Curricular design• Deconstruction in teachable components• Use of simulation preceding real-life surgery• Commitment to the simulator• Repeated guidance in simulation• Formative assessments, preferably using OSATS• Gamification• Discussion Boards
My virtual CV surgery is a series of four learning continua
Learning continuum of “my virtual anastomosis”
Process:
Step 1: Participate in a local simulation labStep 2: get your own simulator and materialStep 3: get an access code to the MOOCStep 4: follow a strict curriculum “in the cloud”Step 5: at regular steps an individualized formative assessment
The wiki-concept in the creation of low-fidelity simulators
Facts: manufactured in a protected workshop in Czech republicN=3400 in use worldwidecost 40 euro/simulatorhost/graft tubing at 0.1 euro/anastomosis
My virtual anastomosis simulation labs
Scholar sign-in in our MOOC
Curricular design for simulation lab and MOOC: step 1
Curricular design for simulation lab and MOOC:
step 2
step 3
step 4
Criterion Poor Avg ExcelArteriotomy(porcine model: able to identify target, proper use of blade, single groove, centered)
1 2 3 4 5
Graft Orientation(proper orientation for toe-heel, appropriate start and end-points)
1 2 3 4 5
Bite appropriate(entry and exit points, number of punctures, even and consistent distance from edge)
1 2 3 4 5
Spacing appropriate(even spacing, consistent distance from previous bite, too close vs too far)
1 2 3 4 5
Use of needle holder(finger placement, instrument rotation, facility, needle placement, pronation and supination, proper finger and hand motion, lack of wrist motion)
1 2 3 4 5
Use of forceps(facility, hand motion, assist needle placement, appropriate traction on tissue)
1 2 3 4 5
Needle angles(proper angle relative to tissue and needle holder, consider depth of field, anticipating subsequent angles)
1 2 3 4 5
Needle transfer(needle placement and preparation from stitch to stitch, use of instrument and hand to mount needle)
1 2 3 4 5
Suture management/tension(too loose vs tight, use of tension to assist exposure, avoid entanglement)
1 2 3 4 5
Knot tying(adequate tension, facility, finger and hand follow for deep knots)
1 2 3 4 5
TotalsGrand total
OSATS-based formative assesments for simulation labs and MOOC:
Objective Structured Assessments of a Technical SkillJTCVS2008;136:1486
Regular (8) mandatory interfaces (HIPAA-compliant) between scholar and trainer (blog, text, video and picts)
Regular (8) mandatory interfaces (HIPAA-compliant) between scholar and trainer (blog, tekst, video and picts)
Creation of an individualized HIPAA-compliant learning community
C. Schreiber Salzburg Oct 9 2013from zero skills to this in one day
Progress made in three hours simulation
Conclusions
• More than 500 surgeons in the MOOC from > 50 countries worldwide, adding around > 20 every week.
• A series of four integrated, blended and distributed learning continua have/are been created.– My virtual anastomosis – My virtual mitral valve– My virtual aortic valve and root– My virtual VSD
• The science of learning is meticulously implemented at every single step.
• The leverage of a global multinational MD company (Ethicon J&J)
• The leverage of an ad-hoc HIPAA-compliant health collaboration platform (Meplis Inteligência em Saude)
• The young surgeons will be ready to transfer their skills to patient care through an active structured process and not through saturation and saturation and saturation.