PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

DISSERTATION PROPOSAL

“A STUDY TO EVALUATE THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING MANAGEMENT OF SHOULDER DYSTOCIA AMONG THIRD YEAR GNM STUDENTS IN SELECTED NURSING SCHOOLS AT TUMKUR.”

SUBMITTED BY:

JAISON ABRAHAM

1ST YEAR M.SC NURSING

MEDICAL AND SURGICAL NURSING

SRI RAMANA MAHARSHI COLLEGE OF NURSING

TUMKUR

(2012-2014)

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCE

BANGALORE, KARNATAKA ANNEXURE-II

SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECTS FOR

DISSERTATION

1 NAME OF THE CANDIDATE AND ADDRESS

JAISON ABRAHAM

1S YEAR M.sc NURSING SRI RAMANA MAHARSHI COLLEGE OF NURSING TUMKUR-06

2 NAME OF THE INSTITUTION SRI RAMANA MAHARSHI COLLEGE OF NURSING

3 COURSE STUDY AND SUBJECT 1ST YEAR M.sc NURSING.

MEDICAL AND SURGICAL NURSING

4 DATE OF ADMISSION TO COURSE

5 TITLE OF STUDY “A STUDY TO ASSESS THE

EFFECTIVENESS OF STRUCTURED

TEACHING PROGRAMME ON ROLE

OF NURSES IN REMOTE SURGERY

AMONG FINAL YEAR NURSING

STUDENTS IN SELECTED COLLEGES

IN TUMKUR.”

”

6.1 INTRODUCTION

Medical remote surgery is an active area of research on the application of computers and robotic

technology to surgery, in planning and execution of surgical operations and in training of

surgeons. In remote surgery, the goal is to develop robotic tools to augment or replace hand

instruments used in surgery. In remote surgery, the robotic tools are not automatedrobots but

teleoperated systems under direct control of the surgeon.One of the earliest remote surgeries was

conducted on 7 September 2001 across the Atlantic Ocean, with a surgeon (Dr. Jacques

Marescaux in New York performing acholecystectomy on a 68-year-old female patient

6,230 km away in Strasbourg , France named Operation Lindbergh. That operation, called

Project Lindbergh after Charles Lindbergh’s pioneering transatlantic flight from New York to

Paris, was conducted over a dedicated fiberoptic link to ensure guaranteed connectivity and

minimal lag.1

Remote surgery  is the ability for a doctor to perform surgery on a patient even though they are

not physically in the same location. . A robot surgical system generally consists of one or more

arms (controlled by the surgeon), a master controller (console), and a sensory system giving

feedback to the user. Remote surgery combines elements of robotics, cutting

edge communication technology such as high-speed data connections and elements

of management information systems. While the field of robotic surgery is fairly well established,

most of these robots are controlled by surgeons at the location of the surgery. Remote surgery is

essentially advanced telecommuting for surgeons, where the physical distance between the

surgeon and the patient is immaterial. It promises to allow the expertise of specialized surgeons

to be available to patients worldwide, without the need for patients to travel beyond their local

hospital. Telesurgery, also called remote surgery, is performed by a surgeon at a site removed

from the patient. Surgical tasks are directly performed by a robotic system controlled by the

surgeon at the remote site. The word "telesurgery" is derived from the Greek words tele ,

meaning "far off," and cheirourgia , meaning "working by hand."2

Rapid development of technology has allowed remote surgery rooms to become highly

specialized. At the Advanced Surgical Technology Centre at Mt. Sinai Hospital in Toronto,

Canada, the surgical room responds to the surgeon’s voice commands in order to control a

variety of equipment at the surgical site, including the lighting in the operating room, the

position of the operating table and the surgical tools themselves. With continuing advances in

communication technologies, the availability of greater bandwidth and more powerful

computers, the ease and cost effectiveness of deploying remote surgery units is likely to increase

rapidly.3

The possibility of being able to project the knowledge and the physical skill of a surgeon over

long distances has many attractions. There is considerable research underway in the subject. The

armed forces have an obvious interest since the combination of telepresence, teleoperation,

and telerobotics can potentially save the lives of battle casualties by providing them with prompt

attention in mobile operating theatres.4

Another potential advantage of having robots perform surgeries is accuracy. A study conducted

at Guy’s Hospital in London, Englandcompared the success of kidney surgeries in 304 dummy

patients conducted traditionally as well as remotely and found that those conducted using robots

were more successful in accurately targeting kidney stone5

“

6.2 NEED FOR THE STUDY

As more surgeons perform robotic surgery and more patients seek the benefits robotics offers,

operating room nurses see their roles changing as well .Nurses make sure the large robotic

equipment is set up correctly in the room long before the patient arrives. The patient has to be

positioned a certain way depending on what surgery will be performed. Surgeons use different

tools attached to the robot’s arms depending on the type of surgery. Nurses have to make sure the

proper tools are ready to go. “Because of the technology, nurses must think of different ways of

doing the things we do to provide the best patient care During the procedure, the action taking

place in the patient’s body is displayed on a high-definition television in the operating room.

Nurses observe this and can better anticipate the needs of the surgeon. Plus, she says seeing the

surgery is interesting. “The reason why many nurses go into the OR is because we love anatomy

and physiology. The cool thing about the robot is that it allows us to see so much better on the

big screen.”6

.Robotic technology has increased the need for staff in the operating room, Filby says. When one

surgery ends, nurses and surgical techs are responsible for finishing the medical charts,

undocking the robot and doing an inventory of the robotic instruments. 7

“Then there’s clean up and set up for the next case. Everything happens at one time and it’s labor

intensive,” Filby says. Operating room staff strive to improve efficiency while maintaining the

highest quality to benefit the patient, surgeons and hospital. 7

Fostering a Team Approach :

Dr. Crane adds that the nurse coordinator and circulators involved in a robotics program become

as specialized as the doctors doing the actual surgery. “This creates much more of a team,

equality approach within the operating room, which I have found to be not only much more

efficient, but much friendlier, fun and, most of all, beneficial to the patient,” Dr. Crane says. 7

“There is no question that without the expertise of a good robotic nursing coordinator, circulators

and techs, our program would not be near where it is now,” Dr. Crane continues. “This team

approach has taken McKee’s robotics program to be recognized as one of the best in the United

States.” “Educating and preparing nurses to ensure an adequate workforce is important now and

will be even more critical in the years to come,” says Rick Sutton, CEO of NCMC. “We are

pleased to partner with UNC to assist in expanding their capabilities through this distinguished

professorship8

REVIEW OF LITERATURE

The purpose of review of literature is to obtain comprehensive knowledge base and in depth of

information from previous studies.

Review of literature is a key step in research process. Review of literature refers to an

extensive, exhaustive and systematic examination of publications relevant to the research

product.

The review of literature is defined as a broad comprehensive in depth; systematic and critical

view scholarly publications, unpublished scholarly print materials, audio visual materials and

personal communications.

The major goal of the review of literature is to develop a strong knowledge base to carryout

research.12

The related literatures are present in the following sub heading:

1) studies related to remote sutgery2) studies related to role of nurses in remote surgery

1) STUDIES RELATED TO REMOTE SURGERY

Jens C. Rückert, MD, PhD*, Marc Swierzy, MD, Mahmoud Ismail, MD

Department of General, Visceral, Vascular and Thoracic Surgery, Universitätsmedizin Berlin,

Charité Campus Mitte, Berlin, Germany. Conducted a retrospective cohort study on

remotesurgery of thorascopic thymectomise.objective of the study is to establish robotic

technique as a standard, the results of high-volume centers and comparison with traditional

surgery are mandatory. Methods of the study is the results of 79 thoracoscopic thymectomies

(October 1994 to December 2002) were compared with the results of 74 robotic thoracoscopic

thymectomies (January 2003 to August 2006). Data from both series were collected

prospectively. In both groups, all patients had myasthenia gravis. Both cohorts were

compared with respect to severity of disease, gender, age, histology, and postoperative

morbidity. All patients were analyzed for quantification of improvement of disease according

to the Myasthenia Gravis Foundation of America. Resultsof this study reveals that there were

no differences in age distribution and severity of myasthenia gravis. The dominant histologic

finding was follicular hyperplasia of the thymus in both groups with a significantly higher

percentage in the thoracoscopic thymectomy series (68% vs 45%, P < .001). After a follow-up

of 42 months, the cumulative complete remission rate of myasthenia gravis for robotic and

nonrobotic hymectomy was 39.25% and 20.3% (P=.01),respectively. Conclusions of the

study is there is an improved outcome for myasthenia gravis after robotic thoracoscopic

thymectomy compared with thoracoscopic thymectomy.9

This paper describes a newly developed position sensor system. The position sensing system is

designed to be combined with the radial permanent magnetic bearing and used for the control

of the axial active magnetic bearing. The rotor ring of the radial magnetic bearing is used as

field source, which shortens the rotor and saves space for artificial heart design. Linear hall

sensor is selected due to its low cost and miniature size. The principle of the position sensing

system is based on the analysis of the magnetic field of the permanent magnetic bearing and the

sensor module is designed via finite-element analysis to optimize sensitivity and accuracy of

the measured signal. An applied primary amplifier circuit for the position sensing is designed

and its performance is tested. The experimental results demonstrate that the position sensing

system has a satisfactory performance and is effective for axial control.10

A Prospective single-center cohort study has conducted by Gregory S. Weinstein, MD; Bert W.

O’Malley Jr, MD; Marc A. Cohen, MD; Harry Quon, MD Arch OtolaryngolHead Neck

Surg. 2010;136(11):1079-1085. doi:10.1001/archoto.2010.191 Objectives of this study is to

determine the oncologic and functional outcomes in patients undergoing primary transoral

remote surgery followed by adjuvant therapy as indicated with a minimum of 18-month follow-

up for advanced oropharyngeal carcinoma.Design of this study is: Prospective single-center

cohort study. Setting of this study is: Academic university health system and tertiary referral

center.Patients of this study are  Forty-seven adults with newly diagnosed and

previously untreated advanced oropharyngeal carcinoma.Intervention of this study is: Transoral

remote surgery with staged neck dissection and adjuvant therapy as indicated.Main Outcome

Measures of this study are Margin status, recurrence, disease-specific and disease-free survival,

gastrostomy tube dependence, and safety and efficacy end points.11

The advantages of a robotic approach are often difficult to quantify for surgical procedures that

can be performed laparoscopically. Using a novel subjective rating scale, this study

demonstrates a methodology to measure surgeon assessment of ease of use, comparing

complex operations performed robotically and laparoscopically. A subjective assessment scale

for remote surgery was developed that included 13 task-related factors assessing operative

challenges and ease of use. As part of a larger study comparing outcomes of laparoscopic and

robotic biliary-enteric anastomosis, a surgeon performing 20 choledochojejunal anastomoses in

an ex vivo pig model completed this scale after each procedure. Ten anastomoses were

performed laparoscopically and ten using da Vinci robot assistance. Overall difficulty was also

assessed using a 10-cm visual analog scale. Remote surgery was associated with superior ease

to laparoscopy in 8 of the 13 factors, including image quality, depth perception, comfort, eye

fatigue, dexterity, precision of motion, speed of motion, and range of motion. The visual analog

scale also showed a significant benefit in overall ease of the robotic over laparoscopic

procedure. Nonsignificant trends favoring robotics were seen with fluidity of motion and

equipment setup. Based on these results this study suggest that surgeon ease of use may be

quantified using this assessment scale and that robot assistance may be advantageous over

laparoscopy when performing complex surgical tasks in an ex vivo model from the surgeon’s

perspective12

 Sfakianos GP, Frederick PJ, Kendrick JE, Straughn JM, Kilgore LC, Huh WK background of

the study  In order to understand how remote surgery impacts gynecologic oncology fellowship

training and surgical practices, a survey of fellows and fellowship directors was conducted.

methods of the study   Questionnaires designed to determine the prevalence, application, and

acceptance of robotics were sent to fellows and fellowship directors in approved U.S.programs.

results of the study   Of the respondents, 95% have a robot at their institution and 95% utilize it.

Most responding fellowship directors (70%) reported that fellow education is enhanced by

remote surgery. Most fellows (65%) who responded feel comfortable using the robot, and 94%

plan on performing remote surgery upon completion of fellowship training. Conclusions of the

study   This survey demonstrates that remote surgery is utilized in the majority of responding

gynecologic oncology fellowship programs for a wide array of indications. Fellowship

directors and fellows-in-training generally have a favorable view of this evolving technology.

Based on these responses, remote surgery will play an increasingly important role in the future. To investigate obstetrics and gynecology residents’ access to training in robotics and their

opinions of its utility and future in gynecologic surgery a 31-item questionnaire was developed

and distributed to Ob/Gyn residents in the United States via email. A total of 470 residents

representative of all ACOG districts and PGY levels responded. A total of 72% of residents

reported ≥3 staff surgeons performing robotic gynecologic surgery at their institution and 70%

had participated in remote surgery in the past 12 months. Robotic hysterectomy (81%) and

oncologic surgery (76%) were the most frequently performed procedures.A total of 79%

believe their institution should provide formal training in robotics, but only 38% report access

to it. A total of 23% have operated at the surgeon console, and 44% plan to incorporate remote

surgery inttheir practice after completing residency. A total of 3.6% feel equipped to perform

remote surgery without additional training. A total of 63% believe remote surgery in

gynecology will continuto increase in popularity. Exposure to gynecologic robotic procedures

during residency is increasing. Although residents believe robotics has a place in gynecology,

many feel formalized training has not been successfully implemented into their residency.

Development of a structured program for training residents in robotics merits further

investigation13

The horizon of robotic paediatric surgery has grown in leaps and bounds with advances in

technology. The aim of this study was to analyse the extent of robotic involvement in paediatric

surgical practice. A systematic database search was performed. Data about children who had

undergone robot-assisted procedures were reviewed retrospectively from all published reports

up to October 2007. Success rates were defined in term of completion of the procedures, their

complications, and the time taken. These results were further studied in comparison with the

procedures performed by open and laparoscopic methods. A total of 31 studies were identified

describing 566 patients. Of these, four studies were case control, comparing with either

laparoscopic or open procedures, one study was a prospective trial, and the rest of the studies

were either case reports or series. The most common robotic system used was the da Vinci (23

studies) followed by the Zeus(fourstudies).The mean age of the children was 8.3 years. The

commonest operation was pyeloplasty (141 cases), followed by fundoplication (122 cases) and

patent ductus arteriosus ligation (50 cases). The mean operation time for robot-assisted

pyeloplasty was 221 min (open pyeloplasty 214 min). The mean operation times for

fundoplication wererobotic, 170 min, laparoscopic, 158 min, and open, 121 min. The mean

operation times for patent ductus arteriosus ligation were 166 min (robotic) and 83 min (open).

Overall conversion rate for all paediatric robotic procedures was 4.7% and complications

ranged from 0 to 15%. For robotic fundoplications the conversion and complication rates were

0.8 and 3.3%, respectively. For robotic pyeloplasties the conversion and complication rates

were 2.1 and 3.5%, respectively. Many other major operations were performed successfully.

All studies recommended robotic procedure as safe and feasible. Currently, the most

common robotic operations in practice are pyeloplasties and fundoplications. Most of the

authors concluded that, despite taking more time, roboticsurgery enables more refined hand–

eye coordination, superior suturing skills, better dexterity, and precise dissection with minimal

conversion and complication rates. The widespread acceptance of this technology largely

depends on solving the issues: learning curve; suitable machine size for neonates and infants;

ensuring efficacy and safety in all operations; and, most importantly, making this procedure

cost effective, so as to cater for the needs of most, if not all, children.14

Comparison of robotic and nonrobotic thoracoscopic thymectomy: A cohort study Objective

Radical thymectomy has become more popular in the comprehensive treatment of myasthenia

gravis. Minimally invasive techniques are increasingly used for thymectomy. The most recent

development in robotic thoracoscopic surgery has been successfully applied for mediastinal

pathologies. To establish robotic technique as a standard, the results of high-volume centers and

comparison with traditional surgery are mandatory. MethodsIn a retrospective cohort study, the

results of 79 thoracoscopic thymectomies (October 1994 to December 2002) were compared

with the results of 74 robotic thoracoscopic thymectomies (January 2003 to August 2006). Data

from both series were collected prospectively. In both groups, all patients had myasthenia gravis.

Both cohorts were compared with respect to severity of disease, gender, age, histology, and

postoperative morbidity. All patients were analyzed for quantification of improvement of disease

according to the Myasthenia Gravis Foundation of America.ResultsThere were no differences in

age distribution and severity of myasthenia gravis. The dominant histologic finding was

follicular hyperplasia of the thymus in both groups with a significantly higher percentage in the

thoracoscopic thymectomy series (68% vs 45%, P < .001). After a follow-up of 42 months, the

cumulative complete remission rate of myasthenia gravis for robotic and nonrobotic thymectomy

was 39.25% and 20.3% (P = .01), respectively. ConclusionsThere is an improved outcome for

myasthenia gravis after robotic thoracoscopic thymectomy compared with thoracoscopic

thymectomy.18

2) STUDIES RELATED TO ROLE OF NURSES IN REMOTE SURGERY

A questionnaire was sent to the chief OT nurses at 141 Swiss hospitals to evaluate their

knowledge and acceptance of remote surgery among nurses. The response rate was 69%.

Ninety-three per cent of all surgical departments used computer technology, 85% regularly

used the Web and 88% had an internal hospital network. ISDN lines were used in 58% of the

participants' hospitals. While 35% of respondents had participated at least once in networking,

only 8% regularly used telemedicine. The opinion was that access to therapeutic advice (87%)

was a better use of telemedicine than was obtaining a primary diagnosis (24%), although the

majority accepted the principle of making (91%) and receiving (94%) a remote diagnosis. The

survey suggested that nurses are interested in telemedicine and open to its development,

although their experience and knowledge are limited. Therefore, telemedicine in surgery may

be advanced by creating surgical networks for teleconsultation and tele-education15

Marie-Pierre Gagnon, Julie Duplantie, Jean-Paul Fortin, Penny Jennett andRichard Scott studied

the utility of various telehealth applications to support practice in rural and remote regions from

the nurses point of view. A postal survey was conducted among nurses from rural and remote

regions of Alberta and Eastern Quebec. A total of 321 questionnaires were returned (13%

response rate), comprising 180 from Quebec (16%) and 141 from Alberta (11%). Differences in

the perceived utility of telehealth applications were explored using univariate and multivariate

analyses. Telehealth applications were grouped into four categories: (1) asynchronous; (2)

synchronous; (3) education; and (4) access to health information. The perceived utility of each

application varied significantly between provinces. However, the two categories of telehealth

applications perceived to be the most relevant were the same in both provinces: access to health

information and applications for tele-education16

A compararitive study has conducted in nurses background: For nurses working in rural and

remote areas, access to advanced surgical care is frequently limited or even nonexistent.

Establishment of telementoring and remote telesurgical networks would enable patients in these

areas to benefit from the knowledge of expert surgeons in distant urban centres. methods:

Literature review and personal experience. results: Telementoring provides a convenient and

effective means for community surgeons to learn new surgical techniques. Although still in its

infancy, initial experience with routine clinical use of remote telepresence surgery indicates that

it can be used to safely offer surgery to patients in a rural community. However, a number of

technical, ethical, and legal challenges still exist. conclusions: As telecommunications and

robotic technology evolve, remote telesurgical programs will play an increasing role in providing

high-quality surgical care in rural communities and may even facilitate emergency surgical care

in remote areas in the absence of a local physician.17

STATEMENT OF THE PROBLEM

“A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING

PROGRAMME ON ROLE OF NURSES IN REMOTE SURGERY AMONG FINAL YEAR

NURSING STUDENTS IN SELECTED COLLEGES IN TUMKUR.”

6.3 OBJECTIVES OF THE STUDY

1) to assess the existing knowledge regarding role of nurses in remote surgery among the among final year BSc nursing students

2) to develop and implement the STP on role of nurses in remote surgery among final year BSc nursing students in selected colleges in tumkur

3) to determine the effectiveness of STP on knowledge regarding role of nurses in remote surgery by comparing pre and post test knowledge scores

4) to find out the association between the post test knowledge of among final year BSc nursing students with selected demographic variables

6.4 OPERATIONAL DEFENITIONS

ASSESS: it is the process of documenting, usually in measurable terms, knowledge, skills, attitudes and beliefs.

EFFECTIVENESS: refers to significant gain in knowledge as determined by significant difference in pre and post test scores

STRUCTURED TEACHING PROGRAMME (STP): in this study structured teaching programme means a well prepared teaching programme designed to provide information regarding role of nurses in remote surgery to final year BSc nursing students.

KNOWLEDGE: is defined as the correct responses of final year bsc nursing students to the items in the self structured interview regarding role of nurses in remote surgery

NURSES: persons trained and experienced in nursing matters and entrusted with the care of the sick and the carrying out of medical and surgical routines.

REMOTE SURGERY: remote surgery  is the ability for a doctor to perform surgery on a patient even though they are not physically in the same location

NURSING STUDENTS: persons studying at nursing college to accomplish their graduation or diploma in nursing.

6.5 HYPOTHESIS

H1:There is significant difference between the pre and post test knowledge scores of the final year BSc nursing students regarding role of nurses in remote surgery

H2: there is a significant association between the post test knowledge score of the final year BSc nursing students and the selected demographic variables

6.6 ASSUMPTIONS

The final year BSc nursing students may have minimal knowledge regarding the role of nurses in remote surgery

STP provides an opportunity for learning and better understanding regarding the role of nurses in remote surgery

6.7 DELIMITATIONS

The study is limited to the final year BSc nursing students who:-

Will be present during the period of data collection Are willing to participate in the study The sample size is limited to 60 final year BSc nursing students from the selected

colleges in tumkur

6.8 PILOT STUDY

The pilot study will be conducted with 10 final year BSc nursing students and who will be excluded in the main study. The purpose of pilot study is to find out the feasibility of conducting study and design on plan of statistical analysis. The findings of the pilot study samples will not be excluded in the main study.

6.9 VARIABLES

Research variables are the concept of various levels of abstractions that are entered manipulated and collected in a study.

Dependent variable: knowledge regarding role of nurses in remote surgery

Independent variables: structured teaching programme Demographic variables: age,sex,educational qualification etc

6.10 METERIALS AND METHOD

this study is designed to assess the effectiveness of STP on knowledge regarding role of nurses in remote surgery among students of final year BSc nursing students

7.1 SOURCES OF DATA

THE DATA WILL BE COLLECTED FROM THE final YEAR BSC NURSING STUDENTS FROM SELECTED COLLEGES IN TUMKUR.

7.1.1 RESEARCH DESIGN

The design is selected for the present study is quasi- experimental design in which one group pre and post test design without control group.

7.1.2 RESEARCH APPOROACH

An evaluative research approach will be used

7.1.3 RESEARCH SETTINGS

The study wil be conducted in selected nursing colleges at tumkur

7.1.4 PPOPULATION

the population for the study are the students of final year BSc nursing class who are studying in tumkur

7.2 METHODS OF DATA COLLECTION

The data collection procedure will be carried for a period of 3 weeks. The study will be conducted after obtaining permission from the concerned authorities and informed consent from the samples

The data will be conducted in three phases

PHASE I: a pre test will be administered to final year BSc nursing students using a structured questionnaire to assess their knowledge on role of nurses in remote surgery

PHASE II : A structured teaching programme on knowledge regarding the role of nurses in remote surgery will be conducted for about 45 minutes on the same day immediately after the pre test.

PHASE III: after an interval of 7 days , a post test will be conducted for the sample using structured questionnaire for assess the effectiveness of STP.

7.2.1 SAMPING PROCEDURE

Purposive sampling technique will be selected for the present study.

7.2.2 SAMPLE SIZE

The sample comprised of 60 final year bsc nursing students from selected colleges in tumkur and who will be available during the data collection

CRITERIA FOR SAMPLE SELECTION

7.2.3 INCLUSION CRITERIA

The finalyear BSc nursing students

Who are willing to participate in the study Who are present during the data collection

7.2.4 EXCLUSION CRITERIA

Who are not willing to participate in the study Who are not available during the data collection period

7.2.5 TOOLS FOR DATA COLLECTION

the types of tools will be used for the study are

SECTION A: a schedule to assess the demographic data of final year BSc nursing students such as age,sex, etc.

SECTION B : The investigator will develop structured questionnaire on role of nurses in remote surgery to assess the knowledge on the role of nurses in remote surgery

SECTION C: STP on role of nurses in remote surgery and content validity will be establish by requesting the experts to go through the developed tool and give their valuable suggestions.

7.2.6 PLAN FOR DATA ANALYSIS

the data collected will be analyzed by a means of descriptive and inferential statistics.

(A).IN DESCRIPTIVE STATISTICS:

Mean standard deviation, range and mean scores of subject will be used to quantifying the level of knowledge regarding role of nurses in remote surgery among final year BSc nursing students

(B). IN INFERENTIAL STATISTICS:

Paired t-test will be used to examine the effectiveness of STP by comparing pre and post test scores. And to find out the difference in knowledge between pre and post test

The chi-square will be used to find out the association between socio demographical variables of final year BSc nursing students pre test knowledge scores. The data will be planned to present in the form of tables and figures.

7.2.7 TIME AND DURATION OF THE STUDY

the time and duration of the study will be limited to 3 months or as per guidelines of university

7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR INTERVENTION TO BE CONDUCTED ON PATIENT OR OTHER HUMAN OR ANIMAL? IF SO, PLEASE DESCRIBE BRIEFLY.

Yes,structured teaching programme will be administered as an intervention to the final year BSc nursing students.

7.4 HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION?

Yes, the pilot study and the main study will be conducted after the approval from the research committee.permission will be obtained from the concerned head of the institutions. The purpose and details of the study will be explained to the study subject and an informed consent will be obtained from them. Assurance will be given to the study subjects on the confidentiality and anonymity of the data collected from them.

BIBLIOGRAPHY

1) http://allaboutroboticsurgery.com ,International Journal of Robotics Research archive ,

Rogério Richard, Philippe Poignet

Chao Liu Volume 29 , Issue 2-3 (February 2010)

2) http://www.bannerhealth.com

3)  Hanly, Miller, Kumar, Coste-Maniere, Talamini, Aurora, and Schenkman. 2006.

“Mentoring Console Improves Co... [J Laparoendosc Adv Surg Tech A. 2006] - PubMed

- NCBI.” J Laparoendosc Adv Surg Tech A. 5: 445–451.

4) Sandor, Jozsef, Tamas Haidegger, and Zoltan Benyo. 2010. “Surgery in Space: The

Future of Robotic Telesurgery” Surgical Endoscopy 26, no. 1 (2012): 681–690.

5) Sandor, Jozsef, Tamas Haidegger, and Zoltan Benyo. 2010. “Surgery in Space: The

Future of Robotic Telesurgery” Surgical Endoscopy 26, no. 1 (2012): 681–690.

6) a Murphy, Challacombe, Khan, and Dasgupta. 2006. “Robotic Technology in surgery.”

Postgraduate Medical Journal 82, no. 973: 743–747.

7) Intuitive Surgical. 2012. “The Da Vinci Surgical System.” Intuitive

Surgical. http://www.intuitivesurgical.com/products/davinci_surgical_system/.

8) Rosen, Jacob, Blake Hannaford, and Richard M. Satava. 2010. Surgical Robotics:

Systems Applications and Visions. Springer

9) Jens C. Rückert, MD, PhD*, Marc Swierzy, MD, Mahmoud Ismail, MD, The Journal of

Thoracic and Cardiovascular Surgery, Volume 141, Issue 3 , Pages 673-677, March 2011

10) J Telemed Telecare1 April 2006 vol. 12 no. 3 130-135

11) by Gregory S. Weinstein, MD; Bert W. O’Malley Jr, MD; Marc A. Cohen, MD; Harry

Quon, MD Arch OtolaryngolHead Neck Surg. 2010;136(11):1079-1085.

12) The Journal of Thoracic and Cardiovascular Surgery, Volume 141, Issue 3 , Pages 673-

677, March 2011

13)  Sfakianos GP, Frederick PJ, Kendrick JE, Straughn JM, Kilgore LC, Huh WK J Telemed

Telecare1 April 2006 vol. 12 no. 3 136-140

14) J Telemed Telecare1 April 2006 vol. 12 no. 3 141-145

15) tp://allaboutroboticsurgery.com John Y.K. Leea, Bert W. O’Malley, Jr.b, Jason G.

Newmanb, Gregory S. Weinsteinb, Bradley Legaa, Jason Diazb, M. Sean

GradyaDepartments ofaNeurosurgery andb Otolaryngology, University of Pennsylvania,

Philadelphia, Pa., USA, ht

16) Marie-Pierre Gagnon, Julie Duplantie, Jean-Paul Fortin, Penny Jennett andRichard Scott

J Telemed Telecare1 April 2006 vol. 12 no. 3 151-158

17) Antoniou GA , Riga CV, Mayer EK, Cheshire NJ, Bicknell CD Source: J Vasc Surg Aug

27, 2010

18) J Telemed Telecare1 April 2006 vol. 12 no. 3 159-160