Towards engineering a portable platform for laparoscopic pre-training in virtual reality with haptic feedback

Background Laparoscopic surgery is a surgical technique in which special instruments are inserted through small incision holes inside the body.For some time,efforts have been made to improve surgical pre training through practical exercises on abstracted and reduced models.Methods The authors strive for a portable,easy to use and cost-effective Virtual Reality-based(VR)laparoscopic pre-training platform and therefore address the question of how such a system has to be designed to achieve the quality of today's gold standard using real tissue specimens.Current VR controllers are limited regarding haptic feedback.Since haptic feedback is necessary or at least beneficial for laparoscopic surgery training,the platform to be developed consists of a newly designed prototype laparoscopic VR controller with haptic feedback,a commercially available head-mounted display,a VR environment for simulating a laparoscopic surgery,and a training concept.Results To take full advantage of benefits such as repeatability and cost-effectiveness of VR-based training,the system shall not require a tissue sample for haptic feedback.It is currently calculated and visually displayed to the user in the VR environment.On the prototype controller,a first axis was provided with perceptible feedback for test purposes.Two of the prototype VR controllers can be combined to simulate a typical both-handed use case,e.g.,laparoscopic suturing.A Unity based VR prototype allows the execution of simple standard pre-trainings.Conclusions The first prototype enables full operation of a virtual laparoscopic instrument in VR.In addition,the simulation can compute simple interaction forces.Major challenges lie in a realistic real-time tissue simulation and calculation of forces for the haptic feedback.Mechanical weaknesses were identified in the first hardware prototype,which will be improved in subsequent versions.All degrees of freedom of the controller are to be provided with haptic feedback.To make forces tangible in the simulation,characteristic values need to be determined using real tissue samples.The system has yet to be validated by cross-comparing real and VR haptics with surgeons.

Entrepreneurship training:its influences on innovation potentials among nursing students

Objective:To evaluate the influences of entrepreneurship training on the innovation potential among nursing students.Methods:A quasi-experimental design was utilized to conduct this study.The study was conducted in the classroom at the faculty of nursing,and the“i Hub”center at Ain Shams University(ASU)in Cairo,Egypt.A purposive sample of 42 nursing students who participated in the“Ain Shams University-innovate”competition from the Faculty of Nursing of ASU were included in this study.Data collection tools included(1)Nursing students'innovation skills assessment questionnaire and(2)Innovative projects evaluation tool.Results:There was a statistically significant difference between the mean scores of nursing students'total innovation skills pre-and post-implementation of entrepreneurship training,where P-value<0.05.Conclusions:The results of the current study support the research hypothesis because the implementation of entrepreneurship training positively affects nursing students'innovation potential.Developing entrepreneurship education in nursing and integrating it into nursing programs will stimulate creativity,innovation,and entrepreneurship among nursing students and health care services.

Exploring the Application Effect of Flipped Classroom Combined with Problem-Based Learning Teaching Method in Clinical Skills Teaching of Standardized Training for Resident Doctors of Traditional Chinese Medicine

Objective: To explore the application effect of flipped classroom combined with problem-based learning teaching method in clinical skills teaching of standardized training for resident doctors of traditional Chinese Medicine. Methods: The study used the experimental control method. The study lasted from September to November 2022. The subjects of this study were 49 students of standardized training for resident doctors of traditional Chinese Medicine from grades 2020, 2021 and 2022 of Dazhou integrated TCM & Western Medicine Hospital. They were randomly divided into experiment group (25) and control group (24). The experiment group adopted flipped classroom combined with problem-based learning teaching method, and the control group adopted traditional teaching method. The teaching content was 4 basic clinical skill projects, including four diagnoses of traditional Chinese Medicine, cardiopulmonary resuscitation, dressing change procedure, acupuncture and massage. The evaluation method was carried out by comparing the students’ performance and a self-designed questionnaire was used to investigate the students’ evaluation of the teaching method. Results: The test scores of total scores in the experimental group (90.12 ± 5.89) were all higher than those in the control group (81.47 ± 7.96) (t = 4.53, P P Conclusions: The teaching process of the flipped classroom combined with problem-based learning teaching method is conducive to improving the efficiency of classroom teaching, cultivating students’ self-learning ability, and enhancing students’ willingness to learn.

Colonoscopy procedural skills and training for new beginners

The incidence of colorectal cancer has been increasing in the developed world including South Korea and China.Colonoscopy allows for greater diagnostic specificity and sensitivity compared with other types of examinations,such as the stool occult blood test,barium enema,and computed tomography colonography.Therefore,in recent years,the demand for colonoscopies has grown rapidly.New beginners including primary care physicians may help meet the increasing demand by performing colonoscopies.However,it is a challenge to learn the procedure due to the long learning-curve and the high rate of complications,such as perforation and bleeding,as compared to gastroscopy.Thus,considerable training and experience are required for optimal performance of colonoscopies.In order to perform a complete colonoscopic examination,there were a few important thingsto learn and remember,such as the position of examinee(e.g.,left and right decubitus,supine,and prone)and examiner(two-man method vs one-man standing method vs one-man sitting method),basic skills(e.g.,tip deflection,push forward and pull back,torque,air suction and insufflation),advanced skills(e.g.,jiggling and shaking,right and left turn shortening,hooking,and slide-by technique),assisting skills(e.g.,position change of examinee,abdominal compression,breathing-holding,and liquid-infusion technique),and intubation techniques along the lower gastrointestinal tract.In this article,we attempt to describe the methods of insertion and advancement of the colonoscope to the new beginners including primary care physician.We believe that this article may be helpful to the new beginners who wish to learn the procedure.

Entry-Level Forward Surgical Team Training Is Associated with Increased Confidence of Primary Combat Surgeons

Background: In recent years, we have established an entry-level Forward Surgical Team (FST) training program in a Chinese military medical university for the 5th grade undergraduates, who would be deployed to different military medical services as primary combat surgeons. This study aimed to assess the role of this pre-service training in improving their confidence with combat medical skills, after several years since they received the training. Methods: We conducted a nationwide survey of 239 primary combat surgeons who have ever participated in an entry-level FST training program before deployment between June 2016 and June 2020, which was for evaluating on a 5-point Likert scale the benefits of entry-level FST training and conventional surgery training in improving their confidence with combat medical skills. The difference in scores was compared using the student t-test. Significance was considered as P Results: The total score was significantly higher for entry-level FST training than that for conventional surgery training (30.76 ± 4.33 vs. 28.95 ± 4.80, P There was no significant difference between the training for surgical skills confidence scores (18.03 ± 8.04 vs. 17.51 ± 8.30, P = 0.098), but for non-technical skills, the score of entry-level FST training was significantly higher than that of conventional surgery training (12.73 ± 5.39 vs. 11.44 ± 5.62, P The distributions of confidence scores were different under various subgroups by demographics. There were no significant differences in scores between the two training in all specific surgical skill sets except “life-saving surgery” (P = 0.011). Scores of all 4 non-technical skill sets were significantly higher for entry-level FST than those for conventional surgery training (P Conclusions: The training should be considered as an essential strategy to improve confidence in combat medical skills, especially life-saving surgery and non-technical skills, for primary combat surgeons.

Evolution of surgical skills training

外科的训练正在变化：100 年传统被法律、道德的担心为耐心的安全，工作小时限制，手术室时间的费用，和复杂并发症正在质问。训练的外科的模拟和技巧提供一个机会在在生活病人上尝试他们前在手术室环境外面教并且练习先进技巧。当使用真实仪器和录像设备操作在一个盒子训练员模仿了“织物”，模拟训练能向前是同样直的。更先进的、虚拟现实模拟器现在为普遍使用可得到、准备好了。早系统表明了他们的有效性和歧视的能力。更新的系统启用全面课程和完整的程序的模拟的开发。医药教育是的毕业生的认证委员会(ACGME ) 要求了训练和评估的新奇方法的发展。外科的组织正在打电话让方法保证技巧的维护，并且，进展 surgical 训练信任外科医生作为技术上能干。在他们的当前的形式的模拟器被表明了改进外科的居民的手术室表演。训练课程标准化的开发仍然是一个迫切、重要的议程，特别地为最小的侵略外科。一条创新、进步的途径，从航空的域借经验，能为外科的训练的下一个世纪提供基础，保证产品的质量。当技术发展，我们练习的方法将继续演变，到医生和病人的利益。

A Comparison of the Effectiveness of Social Skills Training and Anger Management on Adjustment of Unsupervised Girl Adolescents

This study aimed at a comparison of the effectiveness of social skills training and anger management on adjustment of unsupervised girl adolescents between 15 - 18 years old in Tehran. This research was an experimental one with plan of pre-test and post-test control groups. The statistical universe of this research was consisted of all unsupervised girl adolescents between 15 - 18 years old in Tehran. The subject was 35 unsupervised girl adolescents who are assigned to two groups: experimental and control group. Data were collected by using the Adjustment Inventory for School Students (AISS). Multivariate analysis of covariance showed that the social skills training and anger management significantly increased social, emotional and educational adjustment on the experimental group (P < 0. 05). But Tukey’s follow-up test showed that there wasn’t significant difference between effectiveness of training anger control on compatibility and effectiveness of training social skills on individuals’ total compatibility. Findings showed that both trainings could be used in the same extent in order to enhance compatibility level.

Application of five-element music therapy in pain coping skills training in patients with knee osteoarthritis

Objective:The objective of this study is to assess the application effect of five elements music therapy introduced in the pain coping skills training of knee osteoarthritis(KOA).Materials and Methods:Totally,80 patients with KOA were selected and randomly divided into the experimental group(39 cases)and the control group(41 cases).The control group was only given routine nursing measures,and the experimental group was additionally treated with five-element music therapy on the basis of the control group,twice a day,28 days in total.The Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)was used to evaluate the functional status of the knee joint of the two groups.The clinical efficacy of the two groups was evaluated by Guiding Principles for Clinical Research of New Chinese Medicine in the Treatment of Osteoarthritis.Results:WOMAC score statistically significantly decreased in the experimental group(35.92±9.48 vs.16.17±5.43,P<0.01)and the control group(36.73±6.42 vs.22.53±7.51,P<0.01)after 28 days of intervention when compared with that before intervention;WOMAC score in the experimental group was lower than that of the control group after 28 days of intervention(16.17±5.43 vs.22.53±7.51,P<0.01).The total effective rate of the experimental group was statistically higher than that of the control group(82.0%vs.51.2%,χ2=11.97,P=0.003).Conclusion:The combination of five-element music therapy and routine nursing measures has better effect in relieving pain and bad emotions of patients with KOA when compared with routine nursing measures alone.

Virtual reality simulation in training endoscopic skills: A systematic review

Objective:Training young physicians in gastrointestinal endoscopy through virtual reality(VR)simulators has become popular.It is important to evaluate the benefits and usefulness of this technology for teaching endoscopic skills.The objective of this literature review is to understand the benefits of VR technology through quantitative and qualitative examination of learning outcomes.Methods:A literature search of 7 databases was conducted.Studies which compared the effects of learning through VR simulation and another method of learning were included.In addition,studies were included if they evaluated learning outcomes on clinical patients.Participants could be medical residents,fellows,physicians,or nurses.Common outcomes measured across studies included subjective overall performance scores,total procedure times,rate of successful procedure completion,error rates,patient pain or discomfort,and measures of independence.Results:A total of 22 studies were included.Overall,VR simulation training was seen to be comparable or significantly better than clinical training,no training,other types of simulation,and another form of VR training.Many authors reported increasing patient safety,reducing stress and time constraints,and shortening the learning curve as advantages of VR simulation training.However,this form of training is also expensive and may result in the learning of bad habits.Conclusion:VR simulation technology can be a valuable form of educating endoscopy novices if properly supervised during training,and if there is also integration of clinical training.

Effect of Labor Skills Training on Industrial Development and Economic Benefits of Winter Potato in Regions Inhabited by Ethnic Minorities : A Case Study of Lancang Lahu Autonomous County

Using three kinds of labor skills training methods(expert team training,recruit training and local agricultural extension center training),based on enterprise planting and farmer planting,this paper analyzes the impact of training methods on the development of potato industry,such as yield,income and planting extension.The results show that the expert team training,recruit training and labor skills training of local agricultural extension center can significantly improve the labor quality and skills,and increase the yield and income of winter potatoes.The expert team training,recruit training and local agricultural extension center training can lift growers out of poverty and improve the willingness of people to plant and extend.The winter potato industry has become one of the pillar industries to shake off poverty and become rich,increasing local economic benefits.Through labor skills training,the winter potato industry has become one of the main industries to improve the quality of the local people and increase economic income,promoting the local people to shake off poverty and become well-off.

A virtual reality based surgical skills training simulator for catheter ablation with real-time and robust interaction

Background Atrial fibrillation(AF)is the most common sustained cardiac arrhythmia that can cause severe heart problems.Catheter ablation is one of the most ideal procedures for the treatment of AF.Physicians qualified to perform this procedure need to be highly skilled in manipulating the relevant surgical devices.This study proposes an interactive surgical simulator with high fidelity to facilitate efficient training and low-cost medical education.Methods We used a shared centerline model to simulate the interaction between multiple surgical devices.An improved adaptive deviation-feedback approach is proposed to accelerate the convergence of each iteration.The periodical beating of the human heart was also simulated in real time using the position-based dynamics(PBD)framework to achieve higher fidelity.We then present a novel method for handling the interaction between the devices and the beating heart mesh model.Experiments were conducted in a homemade simulator prototype to evaluate the robustness,performance,and flexibility of the proposed method.Preliminary evaluation of the simulator was performed by medical students,residents,and surgeons.Results The interaction between surgical devices,static vascular meshes,and beating heart mesh was stably simulated in a frame rate suitable for interaction.Conclusion Our simulator is capable of simulating the procedure of catheter ablation with high fidelity and provides immersive visual experiences and haptic feedback.

An Informative System Based on the Skill Gap Analysis to Planning Training Courses

By using the skill gap analysis we propose a new quantitative method to plan training courses. By comparing the differences between the competences needed to cover a position and the ones possessed, it is possible to find the cases that need to be trained. According to different situations we propose some algorithms to plan courses and to find the subjects that require to be trained.

Evaluation of Impact of Life-planning Skills Training among Senior High School Students in Shangcai County

Objective To evaluate the impact of sex and reproductive health education using lifeplanning skills training among senior high school students in a rural county. Methods The study was conducted in three senior high schools of Shangcai County with comparable socio-cultural, economic, and demographic characteristics, two as intervention sites and one as the control. A three-month life-planning skills training course was conducted among all grade one students in the intervention schools. The baseline survey was conducted prior to the intervention, once again three months after the intervention was initiated. Data were collected through questionnaires, FGDs and 1Dis to evaluate the effect of the intervention program. Results After the intervention, the median score of reproductive health knowledge was higher in the intervention group （55.66） than that in control group （38.68）. Students from the intervention group were also more comfortable with their developmental changes which were going through, In the end line survey, 92.70% of the students in the intervention group suggested that reproductive health education should be carried out among all middle school students in Shangcai County. Multivariate analysis also indicated that peers and family had a significant effect on students＇ sex-related knowledge, attitudes and behaviors. Conclusion Sex and reproductive health education via provision of life-planning skills training can significantly increase students＇ sex and reproductive health knowl- edge and was welcomed by students, teachers and parents.

Communication Skills Training for Residents: Which Variables Predict Learning of Skills?

Objective: This study aimed to determine variables associated (predictors and correlates) with the learning of assessment and supportive skills in the context of a communication skills training for medical residents. Methods: Learning was measured by comparing residents’ communication skills in a simulated consultation before and after a communication skills training. Communication skills were transcribed and tagged with a computer-assisted program. Potential variables associated with learning (residents’ characteristics, contextual characteristics and pre-training communication skills) were measured before the training and entered in regression analysis. Results: Fifty-six residents followed the training between 2002 and 2006. Poor pre-training assessment and supportive skills predicted the respective learning of these skills. Better assessment skills’ learning was predicted by copings (i.e. lower level of emotional coping), lower levels of self-efficacy and depersonalization. Better supportive skills’ learning was predicted by a lower work experience and associated with a higher training attendance rate. Conclusions: Predictors and correlates of assessment and supportive skills learning were different. Trainers needed to detect certain residents’ characteristics (i.e. depersonalization) in order to optimize assessment skills learning. Trainers needed to be aware that supportive skills are difficult to learn and to teach and may need more training hours.

Correlation between Employment Quality and Skill Training of Land-expropriated Farmers

Based on field survey,an empirical analysis was made on the correlation between employment quality and skill training of landexpropriated farmers. The analysis indicated that there are differences in employment opportunity,employment sector,employment ability,wage income and employment stability between land-expropriated farmers. Besides,though skill training,it is feasible to effectively improve employment quality of land-expropriated farmers. The skill training exerts a significant effect on employment and urban adaptation of land-expropriated farmers. The mode of skill training promoting employment quality was proposed. Skill training can raise human resource level of land-expropriated farmers,and increase their labor and employment skills,to help them realize regular employment and smoothly become citizens. For fund sources for skill training,government and land expropriation unit should bring into play active role. And skill training should be undertaken under the guidance of government and support of land expropriation unit.

Skilling Requirements in Textiles: Technical Training and Its Trainers-Sri Lanka in Perspective

The textile and clothing industry has become very competitive in the world over. There are many players in the industry. The most prominent player is China. Recent statistics reveal that China continue to be the world’s largest textile and clothing producer in 2016 (Textiles outlook, 2017). China’s major export markets are EU, USA and Japan. However, rising labour costs and production costs of China will shift production to lower cost suppliers. This will give South Asia and South-East Asia an opportunity to capitalize in their exports. The question is, can these regions in Asia take this challenge? To overcome the challenges, they must be ready with highly skilled manpower. The Tertiary and Vocational Educational Training system across Asian region must be geared to take this challenge of training the new recruits. Can these countries have adequate numbers of skilled, effective and experienced trainers to train the new recruits? Qualified trainers may be in short supply. Then, how quickly can these trainers be made available for training? Half-baked trainers would turn half-baked workers that will not give right condition to meet the future challenges. A recent study by the author has revealed that there are not enough qualified trainers to impart knowledge and skill for those in the textile and clothing industry in Sri Lanka. This can be the case across Asia. It is time that responsible professionals in the training industry should consider about trainers if they are to launch a massive skilling project to meet requirements of the textile/clothing industry. Skilling the trainers must be a priority. It will be interesting to note that there is a mismatch between trainees and training courses. Also, students are not attracted to training courses. So, there is a concern about who should be trained and are they available?

Development of a Dietary Habit Self-Management Skills Scale for Post-Gastrectomy Cancer Patients in Japan

Purpose: The purpose of the present study was to develop a Dietary Habit Self-Management Skill (DHSMS) scale, and to test the reliability and validity of this scale. Methods: A questionnaire survey was then conducted using a 69-item DHSMS scale (second draft) for which content validity had been confirmed. The participants were post-gastrectomy cancer patients aged from 40 to under 80 years who had undergone initial gastrectomy with an interval of from 1 month since discharge to <3 years post-operative. Results: The scale is a second-order factor model with “Dietary habit self-management skills” as a higher-order factor, four factors—”Skill to form partnerships with other important people”, “Skill to prevent or cope with post-gastrectomy disorder”, “Skill to grasp issues accompanying post-gastrectomy disorder”, and “Self-efficacy”—and 27 items. The construct validity of the scale was confirmed. Cronbach’s alpha coefficient of the DHSMS scale was 0.915. The criterion- related validity of the DHSMS scale was confirmed based on the correlations between overall DHSMS scale scores and “Number of post-gastrectomy disorder symptoms experienced”, the score for the subscale “Skill to grasp issues accompanying post-gastrectomy disorder” and “Number of post-gastrectomy disorder symptoms experienced”, and the subscale “Self-efficacy” and the SF-8. Discussion: By using patients’ self-administered DHSMS scale scores, medical professionals are able to assess the level of a patient’s self-management skills and the status of their dietary habits as a result of post-gastrectomy disorder.

Effects of combination pharmacotherapy and social skills training for schizophrenia: A randomized controlled trial

Pharmaco-psychosocial treatment (PPST) refers to a treatment paradigm combining pharmacotherapy with psychosocial therapy. We conducted an 18-month randomized controlled tracking study to evaluate the efficacy of social skills training (SST) in 11 individuals with schizophrenia on risperidone monotherapy. They were randomized to either SST or non-SST group, and Global Assessment Functioning (GAF) and Brief Psychiatric Rating Scale (BPRS) scores in the 2 groups showed gradual improvement. In the SST group, Digit Span Distraction Test (DSDT) at 12 and 18 months showed significant improvement. The Subjective Deficit Syndrome Scale (SDSS) scores in the SST group showed significant improvement after 6 months and showed a significant difference in comparison between the groups. After the subjective feeling of health was recovered, the items of motivation were recovered as a direct effect of SST. Some items of the Life Assessment Scale for the Mentally Ill (LASMI) score showed significant improvement (or significant trend) in only the SST group after 6 months. Items of daily life, work skills, and self-recognition were continuously improved. We report 2 cases in the SST group that had DSDT improvement in parallel with change of action and communication as a change of social function. This study is only exploratory due to the small number of cases. However, we have demonstrated potential improvement in cognitive function due to learning experiences that required working memory and attention, thus providing improvement in social life.

The Effectiveness of Life Skills Training on Enhancing the Self-Esteem of Hearing Impaired Students in Inclusive Schools

This research investigates the effectiveness of life skills training on enhancing the self-esteem of 8-16 years-old students with hearing impairment in inclusive schools. The sample was included of 54 students with hearing impairment from inclusive school whom their age and IQ were matched. They were randomly divided into an experimental and a control group (27 students in each group). The participants were assessed by Coopersmith Self-esteem Inventory (58-items version). The gathered data were analysed using the t-test method through the SPSS package. The results showed that training life skills to students with hearing impairment promote their self-esteem. In other words, life skills training is effective for enhancing the self-esteem of hearing impaired students in inclusive schools.

A multi-screen collaboration-based low-cost portable dry-lab simulator for basic laparoscopic skills training: A technical note

Laparoscopic skills training has always been crucial for novice surgeons. Readily accessible equipment, aswell as structured training curriculum should be provided to guarantee adequate practice hours and skillproficiency. Dry-lab training is typically adopted before animal model surgery, usually comprising ofpurpose-built bulky simulators that is neither accessible nor portable. In this technical note, we designed ahome-made simulator, using two 4 L water jugs as operating space that are communicated inside, plus anobservation hole taped in between to mimic the triangular working space of laparoscopic surgery. Imagingwas achieved via smartphone camera, which was wirelessly connected to a laptop and a projector for realtime display on multiple screens, using built-in multi-screen collaboration software. A self-regulated andproficiency-based training curriculum was adopted. This dry-lab simulator is low-cost, highly portable andeasily replicable for basic laparoscopic skills training for the beginners to intermediate surgeons, whichmay serve as a good way for the standardized residency and specialist training program.