Browsing by Author "Belmar Riveros, Francisca"

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    Five-Year Experience Training Surgeons with a Laparoscopic Simulation Training Program for Bariatric Surgery: a Quasi-experimental Design
    (2023) Duran Espinoza, Valentina; Belmar Riveros, Francisca; Jarry Trujillo, Cristian; Gaete Danobeitia, Maria Ines; Montero Jaras, Isabella; Miguieles Schilling, Mariana; Valencia Coronel, Brandon; Escalona, Gabriel; Achurra Tirado, Pablo; Quezada, Nicolas; Crovari, Fernando; Varas Cohen, Julian
    Purpose Nearly 200,000 laparoscopic Roux-en-Y gastric bypass (LRYGB) are performed yearly. Reported learning curves range between 50 and 150, even 500 cases to decrease the operative risk. Simulation programs could accelerate this learning curve safely; however, trainings for LRYGB are scarce. This study aims to describe and share our 5-year experience of a simulated program designed to achieve proficiency in LRYGB technical skills.Materials and Methods A quasi-experimental design was used. All recruited participants were previously trained with basic and advanced laparoscopic simulation curriculum completing over 50 h of practical training. Ex vivo animal models were used to practice manual and stapled gastrojejunostomy (GJ) and stapled jejunojejunostomy (JJO) in 10, 3, and 4 sessions, respectively. The main outcome was to assess the manual GJ skill acquisition. Pre- and post-training assessments using a Global Rating Scale (GRS; max 25 pts), Specific Rating Scale (SRS; max 20 pts), performance time, permeability, and leakage rates were analyzed. For the stapled GJ and JJO, execution time was registered. Data analysis was performed using parametric tests.Results In 5 years, 68 trainees completed the program. For the manual GJ's pre- vs post-training assessment, GRS and SRS scores increased significantly (from 17 to 24 and from 13 to 19 points respectively, p-value < 0.001). Permeability rate increased while leakage rate and procedural time decreased significantly.Conclusion This simulated training program showed effectiveness in improving laparoscopic skills for manual GJ and JJO in a simulated scenario. This new training program could optimize the clinical learning curve. Further studies are needed to assess the transfer of skills to the operating room.
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    Taking advantage of asynchronous digital feedback: development of an at‑home basic suture skills training program for undergraduate medical students that facilitates skills retention
    (2023) Belmar Riveros, Francisca; Gaete Dañobeitia, María Inés; Durán Espinoza, Valentina; Chelebifski Vargas, Slavka; Jarry Trujillo, Cristián; Ortiz Koh, Catalina; Escalona, Gabriel; Villagrán Gutiérrez, Ignacio Andrés; Alseidi, Adnan; Zamorano Rivera, Elga; Pimentel Muller, Fernando; Crovari Eulufi, Fernando; Varas Cohen, Julián; Pontificia Universidad Católica de Chile. Centro de Cirugía Experimental y Simulación. Departamento de Cirugía Digestiva; Pontificia Universidad Católica de Chile. Departamento de Cirugía Digestiva
    Purpose to date, there are no training programs for basic suturing that allow remote deliberate practice. This study seeks to evaluate the efectiveness of a basic suture skills training program and its 6-month skill retention applying unsupervised practice and remote digital feedback. Methods Fourth-year medical-student trainees reviewed instructional videos from a digital platform and performed unsu pervised practice as needed at their homes. When they felt competent, trainees uploaded a video of themselves practicing the skill. In<72 h, they received expert asynchronous digital feedback. The course had two theoretical stages and fve video-based assessments, where trainees performed diferent suturing exercises. For the assessment, a global (GRS) and specifc rating scale (SRS) were used, with a passing score of 20 points (max:25) and 15 (max:20), respectively. Results were compared to previously published work with in-person expert feedback (EF) and video-guided learning without feedback (VGL). A subgroup of trainees underwent a 6-month skills retention assessment. Results Two-hundred and forty-three trainees underwent the course between March and December 2021. A median GRS of 24 points was achieved in the fnal assessment, showing signifcantly higher scores (p<0.001) than EF and VGL (20.5 and 15.5, respectively). Thirty-seven trainees underwent a 6-month skills retention assessment, improving in GRS (23.38 vs 24.03, p value=0.06) and SRS (18.59 vs 19, p value=0.07). Conclusion It is feasible to teach basic suture skills to undergraduate medical students using an unsupervised training course with remote and asynchronous feedback through a digital platform. This methodology allows continuous training with the repetition of quality practice, personalized feedback, and skills retention at 6 months.
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    Train the trainers: a comparative analysis of medical students and residents as trainers for undergraduate med-school learners in surgical skills
    (2023) Duran Espinoza, Valentina; Montero Jaras, Isabella; Miguieles Schilling, Mariana; Valencia Coronel, Brandon; Belmar Riveros, Francisca; Jarry, Cristian; Cruz, Enrique; Jeffrey, Wiseman; Escalona Vives, Gabriel; Villagrán Gutiérrez, Ignacio Andrés; Corvetto, Marcia; Varas Cohen, Julian