The Experts below are selected from a list of 20802 Experts worldwide ranked by ideXlab platform

Rajesh Aggarwal - One of the best experts on this subject based on the ideXlab platform.

  • implementation of a surgical simulation Care Pathway approach to training in emergency abdominal surgery
    World Journal of Surgery, 2020
    Co-Authors: Laura Beyerberjot, Pramudith Sirimanna, Daniel A. Hashimoto, Stephane Berdah, Vishal Patel, Ara Darzi, Rajesh Aggarwal
    Abstract:

    Background Simulation-based Care Pathway approach (CPA) training is a novel approach in surgical education. The objective of the present study was to determine whether CPA was feasible for training surgical residents and could improve efficiency in patients’ management. A common disease was chosen: acute appendicitis.

  • Implementation of a Surgical Simulation Care Pathway Approach to Training in Emergency Abdominal Surgery
    World Journal of Surgery, 2019
    Co-Authors: Laura Beyer-berjot, Pramudith Sirimanna, Daniel A. Hashimoto, Stephane Berdah, Vishal Patel, Rajesh Aggarwal
    Abstract:

    BackgroundSimulation-based Care Pathway approach (CPA) training is a novel approach in surgical education. The objective of the present study was to determine whether CPA was feasible for training surgical residents and could improve efficiency in patients’ management. A common disease was chosen: acute appendicitis.MethodsAll five junior residents of our department were trained in CPA: preoperative CPA consisted in virtual patients (VPs) presenting with acute right iliac fossa pain; intraoperative CPA involved a virtual competency-based curriculum for laparoscopic appendectomy (LAPP); finally, post-operative VP were reviewed after LAPP. Thirty-eight patients undergoing appendectomy were prospectively included before ( n  = 21) and after ( n  = 17) the training. All demographic and perioperative data were prospectively collected from their medical records, and time taken from admission to management was measured.ResultsAll residents had performed less than 10 LAPP as primary operator. Pre- and intraoperative data were comparable between pretraining and post-training patients. Times to liquid and solid diet were significantly reduced after training [7 h (2–20) vs. 4 (4–6); P  = 0.004, and 17 h (4–48) vs. 6 (4–24); P  = 0.005] without changing post-operative morbidity [4 (19%) vs. 0 (0); P  = 0.11] and length of stay [48 h (30–264) vs. 44 (21–145); P  = 0.22].ConclusionsCPA training is feasible in abdominal surgery. In the current study, it improved patients’ management in terms of earlier oral intake.

  • colorectal surgery and enhanced recovery impact of a simulation based Care Pathway training curriculum
    Journal of Visceral Surgery, 2017
    Co-Authors: L Beyerberjot, Daniel A. Hashimoto, Stephane Berdah, Ara Darzi, V Patel, P Pucher, Paul Ziprin, Rajesh Aggarwal
    Abstract:

    Summary Background The aim was to determine whether a simulation-based Care Pathway approach (CPA) curriculum could improve compliance for enhanced recovery programs (ERP), and residents’ participation in laparoscopic colorectal surgery (LCS). Indeed, trainee surgeons have limited access to LCS as primary operator, and ERP have improved patients’ outcomes in colorectal surgery (CS). Methods All residents of our department were trained in a simulation-based CPA: perioperative training consisted in virtual patients built according to guidelines in both ERP and CS, whilst intraoperative training involved a virtual reality simulator curriculum. Twenty consecutive patients undergoing CS were prospectively included before ( n  = 10) and after ( n  = 10) the training. All demographic and perioperative data were prospectively collected, including compliance for ERP. Residents’ participation as primary operator in LCS was measured. Results Five residents (PGY 4–7) were enrolled. None had performed LCS as primary operator. Overall satisfaction and usefulness were both rated 4.5/5, usefulness of pre-, post- and intraoperative training was rated 5/5, 4.5/5 and 4/5, respectively. Residents’ participation in LCS significantly improved after the training (0% (0–100) vs. 82.5% (10–100); P  = 0.006). Pre- and intraoperative data were comparable between groups. Postoperative morbidity was also comparable. Compliance for ERP improved at Day 2 in post-training patients (3 (30%) vs. 8 (80%); P  = 0.035). Length of stay was not modified. Conclusions A simulated CPA curriculum to training in LCS and ERP was correctly implemented. It seemed to improve compliance for ERP, and promoted residents participation as primary operator without adversely altering patients’ outcomes.

  • surgical training design of a virtual Care Pathway approach
    Surgery, 2014
    Co-Authors: Rajesh Aggarwal, Laura Beyerberjot, Ara Darzi, V Patel, Amish Acharya, Dave Taylor, Esther M Bonrath, Teodor P Grantcharov
    Abstract:

    Background Both intra- and perioperative Care are essential for patients' safety. Training for intraoperative technical skills on simulators and for perioperative Care in virtual patients have independently demonstrated educational value, but no training combining these 2 approaches has been designed yet. The aim of this study was to design a Pathway approach for training in general surgery. A common disease requiring essential skills was chosen, namely, acute appendicitis. Methods Preoperative Care training was created using virtual patients presenting with acute right iliac fossa (RIF) pain. A competency-based curriculum for laparoscopic appendectomy (LAPP) was designed on a virtual reality simulator: Novices ( 100 LAPP) were enrolled to perform 2 virtual LAPP for assessment of validity evidence; novices performed 8 further LAPP for analysis of a learning curve. Finally, postoperative virtual patients were reviewed after LAPP. Results Four preoperative patient scenarios were designed with different presentations of RIF; not all required operative management. Comments were provided through case progression to allow autonomous practice. Ten novices and 10 experienced surgeons were enrolled for intraoperative training. Time taken (median values) of novices versus experienced surgeons (285 vs 259 seconds; P  = .026) and performance score (67% vs 99%; P P  = .113). Proficiency benchmark criteria were defined for measures with validity evidence. Two postoperative virtual patients were created with an uneventful or complicated outcome. Conclusion A virtual Care Pathway approach has been designed for acute appendicitis, enabling trainees to follow simulated patients from admission to discharge.

Laura Beyerberjot - One of the best experts on this subject based on the ideXlab platform.

  • implementation of a surgical simulation Care Pathway approach to training in emergency abdominal surgery
    World Journal of Surgery, 2020
    Co-Authors: Laura Beyerberjot, Pramudith Sirimanna, Daniel A. Hashimoto, Stephane Berdah, Vishal Patel, Ara Darzi, Rajesh Aggarwal
    Abstract:

    Background Simulation-based Care Pathway approach (CPA) training is a novel approach in surgical education. The objective of the present study was to determine whether CPA was feasible for training surgical residents and could improve efficiency in patients’ management. A common disease was chosen: acute appendicitis.

  • surgical training design of a virtual Care Pathway approach
    Surgery, 2014
    Co-Authors: Rajesh Aggarwal, Laura Beyerberjot, Ara Darzi, V Patel, Amish Acharya, Dave Taylor, Esther M Bonrath, Teodor P Grantcharov
    Abstract:

    Background Both intra- and perioperative Care are essential for patients' safety. Training for intraoperative technical skills on simulators and for perioperative Care in virtual patients have independently demonstrated educational value, but no training combining these 2 approaches has been designed yet. The aim of this study was to design a Pathway approach for training in general surgery. A common disease requiring essential skills was chosen, namely, acute appendicitis. Methods Preoperative Care training was created using virtual patients presenting with acute right iliac fossa (RIF) pain. A competency-based curriculum for laparoscopic appendectomy (LAPP) was designed on a virtual reality simulator: Novices ( 100 LAPP) were enrolled to perform 2 virtual LAPP for assessment of validity evidence; novices performed 8 further LAPP for analysis of a learning curve. Finally, postoperative virtual patients were reviewed after LAPP. Results Four preoperative patient scenarios were designed with different presentations of RIF; not all required operative management. Comments were provided through case progression to allow autonomous practice. Ten novices and 10 experienced surgeons were enrolled for intraoperative training. Time taken (median values) of novices versus experienced surgeons (285 vs 259 seconds; P  = .026) and performance score (67% vs 99%; P P  = .113). Proficiency benchmark criteria were defined for measures with validity evidence. Two postoperative virtual patients were created with an uneventful or complicated outcome. Conclusion A virtual Care Pathway approach has been designed for acute appendicitis, enabling trainees to follow simulated patients from admission to discharge.

Stephane Berdah - One of the best experts on this subject based on the ideXlab platform.

  • implementation of a surgical simulation Care Pathway approach to training in emergency abdominal surgery
    World Journal of Surgery, 2020
    Co-Authors: Laura Beyerberjot, Pramudith Sirimanna, Daniel A. Hashimoto, Stephane Berdah, Vishal Patel, Ara Darzi, Rajesh Aggarwal
    Abstract:

    Background Simulation-based Care Pathway approach (CPA) training is a novel approach in surgical education. The objective of the present study was to determine whether CPA was feasible for training surgical residents and could improve efficiency in patients’ management. A common disease was chosen: acute appendicitis.

  • Implementation of a Surgical Simulation Care Pathway Approach to Training in Emergency Abdominal Surgery
    World Journal of Surgery, 2019
    Co-Authors: Laura Beyer-berjot, Pramudith Sirimanna, Daniel A. Hashimoto, Stephane Berdah, Vishal Patel, Rajesh Aggarwal
    Abstract:

    BackgroundSimulation-based Care Pathway approach (CPA) training is a novel approach in surgical education. The objective of the present study was to determine whether CPA was feasible for training surgical residents and could improve efficiency in patients’ management. A common disease was chosen: acute appendicitis.MethodsAll five junior residents of our department were trained in CPA: preoperative CPA consisted in virtual patients (VPs) presenting with acute right iliac fossa pain; intraoperative CPA involved a virtual competency-based curriculum for laparoscopic appendectomy (LAPP); finally, post-operative VP were reviewed after LAPP. Thirty-eight patients undergoing appendectomy were prospectively included before ( n  = 21) and after ( n  = 17) the training. All demographic and perioperative data were prospectively collected from their medical records, and time taken from admission to management was measured.ResultsAll residents had performed less than 10 LAPP as primary operator. Pre- and intraoperative data were comparable between pretraining and post-training patients. Times to liquid and solid diet were significantly reduced after training [7 h (2–20) vs. 4 (4–6); P  = 0.004, and 17 h (4–48) vs. 6 (4–24); P  = 0.005] without changing post-operative morbidity [4 (19%) vs. 0 (0); P  = 0.11] and length of stay [48 h (30–264) vs. 44 (21–145); P  = 0.22].ConclusionsCPA training is feasible in abdominal surgery. In the current study, it improved patients’ management in terms of earlier oral intake.

  • colorectal surgery and enhanced recovery impact of a simulation based Care Pathway training curriculum
    Journal of Visceral Surgery, 2017
    Co-Authors: L Beyerberjot, Daniel A. Hashimoto, Stephane Berdah, Ara Darzi, V Patel, P Pucher, Paul Ziprin, Rajesh Aggarwal
    Abstract:

    Summary Background The aim was to determine whether a simulation-based Care Pathway approach (CPA) curriculum could improve compliance for enhanced recovery programs (ERP), and residents’ participation in laparoscopic colorectal surgery (LCS). Indeed, trainee surgeons have limited access to LCS as primary operator, and ERP have improved patients’ outcomes in colorectal surgery (CS). Methods All residents of our department were trained in a simulation-based CPA: perioperative training consisted in virtual patients built according to guidelines in both ERP and CS, whilst intraoperative training involved a virtual reality simulator curriculum. Twenty consecutive patients undergoing CS were prospectively included before ( n  = 10) and after ( n  = 10) the training. All demographic and perioperative data were prospectively collected, including compliance for ERP. Residents’ participation as primary operator in LCS was measured. Results Five residents (PGY 4–7) were enrolled. None had performed LCS as primary operator. Overall satisfaction and usefulness were both rated 4.5/5, usefulness of pre-, post- and intraoperative training was rated 5/5, 4.5/5 and 4/5, respectively. Residents’ participation in LCS significantly improved after the training (0% (0–100) vs. 82.5% (10–100); P  = 0.006). Pre- and intraoperative data were comparable between groups. Postoperative morbidity was also comparable. Compliance for ERP improved at Day 2 in post-training patients (3 (30%) vs. 8 (80%); P  = 0.035). Length of stay was not modified. Conclusions A simulated CPA curriculum to training in LCS and ERP was correctly implemented. It seemed to improve compliance for ERP, and promoted residents participation as primary operator without adversely altering patients’ outcomes.

Daniel A. Hashimoto - One of the best experts on this subject based on the ideXlab platform.

  • implementation of a surgical simulation Care Pathway approach to training in emergency abdominal surgery
    World Journal of Surgery, 2020
    Co-Authors: Laura Beyerberjot, Pramudith Sirimanna, Daniel A. Hashimoto, Stephane Berdah, Vishal Patel, Ara Darzi, Rajesh Aggarwal
    Abstract:

    Background Simulation-based Care Pathway approach (CPA) training is a novel approach in surgical education. The objective of the present study was to determine whether CPA was feasible for training surgical residents and could improve efficiency in patients’ management. A common disease was chosen: acute appendicitis.

  • Implementation of a Surgical Simulation Care Pathway Approach to Training in Emergency Abdominal Surgery
    World Journal of Surgery, 2019
    Co-Authors: Laura Beyer-berjot, Pramudith Sirimanna, Daniel A. Hashimoto, Stephane Berdah, Vishal Patel, Rajesh Aggarwal
    Abstract:

    BackgroundSimulation-based Care Pathway approach (CPA) training is a novel approach in surgical education. The objective of the present study was to determine whether CPA was feasible for training surgical residents and could improve efficiency in patients’ management. A common disease was chosen: acute appendicitis.MethodsAll five junior residents of our department were trained in CPA: preoperative CPA consisted in virtual patients (VPs) presenting with acute right iliac fossa pain; intraoperative CPA involved a virtual competency-based curriculum for laparoscopic appendectomy (LAPP); finally, post-operative VP were reviewed after LAPP. Thirty-eight patients undergoing appendectomy were prospectively included before ( n  = 21) and after ( n  = 17) the training. All demographic and perioperative data were prospectively collected from their medical records, and time taken from admission to management was measured.ResultsAll residents had performed less than 10 LAPP as primary operator. Pre- and intraoperative data were comparable between pretraining and post-training patients. Times to liquid and solid diet were significantly reduced after training [7 h (2–20) vs. 4 (4–6); P  = 0.004, and 17 h (4–48) vs. 6 (4–24); P  = 0.005] without changing post-operative morbidity [4 (19%) vs. 0 (0); P  = 0.11] and length of stay [48 h (30–264) vs. 44 (21–145); P  = 0.22].ConclusionsCPA training is feasible in abdominal surgery. In the current study, it improved patients’ management in terms of earlier oral intake.

  • colorectal surgery and enhanced recovery impact of a simulation based Care Pathway training curriculum
    Journal of Visceral Surgery, 2017
    Co-Authors: L Beyerberjot, Daniel A. Hashimoto, Stephane Berdah, Ara Darzi, V Patel, P Pucher, Paul Ziprin, Rajesh Aggarwal
    Abstract:

    Summary Background The aim was to determine whether a simulation-based Care Pathway approach (CPA) curriculum could improve compliance for enhanced recovery programs (ERP), and residents’ participation in laparoscopic colorectal surgery (LCS). Indeed, trainee surgeons have limited access to LCS as primary operator, and ERP have improved patients’ outcomes in colorectal surgery (CS). Methods All residents of our department were trained in a simulation-based CPA: perioperative training consisted in virtual patients built according to guidelines in both ERP and CS, whilst intraoperative training involved a virtual reality simulator curriculum. Twenty consecutive patients undergoing CS were prospectively included before ( n  = 10) and after ( n  = 10) the training. All demographic and perioperative data were prospectively collected, including compliance for ERP. Residents’ participation as primary operator in LCS was measured. Results Five residents (PGY 4–7) were enrolled. None had performed LCS as primary operator. Overall satisfaction and usefulness were both rated 4.5/5, usefulness of pre-, post- and intraoperative training was rated 5/5, 4.5/5 and 4/5, respectively. Residents’ participation in LCS significantly improved after the training (0% (0–100) vs. 82.5% (10–100); P  = 0.006). Pre- and intraoperative data were comparable between groups. Postoperative morbidity was also comparable. Compliance for ERP improved at Day 2 in post-training patients (3 (30%) vs. 8 (80%); P  = 0.035). Length of stay was not modified. Conclusions A simulated CPA curriculum to training in LCS and ERP was correctly implemented. It seemed to improve compliance for ERP, and promoted residents participation as primary operator without adversely altering patients’ outcomes.

Ara Darzi - One of the best experts on this subject based on the ideXlab platform.

  • implementation of a surgical simulation Care Pathway approach to training in emergency abdominal surgery
    World Journal of Surgery, 2020
    Co-Authors: Laura Beyerberjot, Pramudith Sirimanna, Daniel A. Hashimoto, Stephane Berdah, Vishal Patel, Ara Darzi, Rajesh Aggarwal
    Abstract:

    Background Simulation-based Care Pathway approach (CPA) training is a novel approach in surgical education. The objective of the present study was to determine whether CPA was feasible for training surgical residents and could improve efficiency in patients’ management. A common disease was chosen: acute appendicitis.

  • colorectal surgery and enhanced recovery impact of a simulation based Care Pathway training curriculum
    Journal of Visceral Surgery, 2017
    Co-Authors: L Beyerberjot, Daniel A. Hashimoto, Stephane Berdah, Ara Darzi, V Patel, P Pucher, Paul Ziprin, Rajesh Aggarwal
    Abstract:

    Summary Background The aim was to determine whether a simulation-based Care Pathway approach (CPA) curriculum could improve compliance for enhanced recovery programs (ERP), and residents’ participation in laparoscopic colorectal surgery (LCS). Indeed, trainee surgeons have limited access to LCS as primary operator, and ERP have improved patients’ outcomes in colorectal surgery (CS). Methods All residents of our department were trained in a simulation-based CPA: perioperative training consisted in virtual patients built according to guidelines in both ERP and CS, whilst intraoperative training involved a virtual reality simulator curriculum. Twenty consecutive patients undergoing CS were prospectively included before ( n  = 10) and after ( n  = 10) the training. All demographic and perioperative data were prospectively collected, including compliance for ERP. Residents’ participation as primary operator in LCS was measured. Results Five residents (PGY 4–7) were enrolled. None had performed LCS as primary operator. Overall satisfaction and usefulness were both rated 4.5/5, usefulness of pre-, post- and intraoperative training was rated 5/5, 4.5/5 and 4/5, respectively. Residents’ participation in LCS significantly improved after the training (0% (0–100) vs. 82.5% (10–100); P  = 0.006). Pre- and intraoperative data were comparable between groups. Postoperative morbidity was also comparable. Compliance for ERP improved at Day 2 in post-training patients (3 (30%) vs. 8 (80%); P  = 0.035). Length of stay was not modified. Conclusions A simulated CPA curriculum to training in LCS and ERP was correctly implemented. It seemed to improve compliance for ERP, and promoted residents participation as primary operator without adversely altering patients’ outcomes.

  • surgical training design of a virtual Care Pathway approach
    Surgery, 2014
    Co-Authors: Rajesh Aggarwal, Laura Beyerberjot, Ara Darzi, V Patel, Amish Acharya, Dave Taylor, Esther M Bonrath, Teodor P Grantcharov
    Abstract:

    Background Both intra- and perioperative Care are essential for patients' safety. Training for intraoperative technical skills on simulators and for perioperative Care in virtual patients have independently demonstrated educational value, but no training combining these 2 approaches has been designed yet. The aim of this study was to design a Pathway approach for training in general surgery. A common disease requiring essential skills was chosen, namely, acute appendicitis. Methods Preoperative Care training was created using virtual patients presenting with acute right iliac fossa (RIF) pain. A competency-based curriculum for laparoscopic appendectomy (LAPP) was designed on a virtual reality simulator: Novices ( 100 LAPP) were enrolled to perform 2 virtual LAPP for assessment of validity evidence; novices performed 8 further LAPP for analysis of a learning curve. Finally, postoperative virtual patients were reviewed after LAPP. Results Four preoperative patient scenarios were designed with different presentations of RIF; not all required operative management. Comments were provided through case progression to allow autonomous practice. Ten novices and 10 experienced surgeons were enrolled for intraoperative training. Time taken (median values) of novices versus experienced surgeons (285 vs 259 seconds; P  = .026) and performance score (67% vs 99%; P P  = .113). Proficiency benchmark criteria were defined for measures with validity evidence. Two postoperative virtual patients were created with an uneventful or complicated outcome. Conclusion A virtual Care Pathway approach has been designed for acute appendicitis, enabling trainees to follow simulated patients from admission to discharge.