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Team performance training for medical students: Low vs high fidelity simulation
(ELSEVIER SCI LTD, 2020-01-01) Nicolaides, Marios; Theodorou, Efthymia; Emin, Elif Iliria; Theodoulou, Iakovos; Andersen, Nikolai; Lymperopoulos, Nikolaos; Odejinmi, Funlayo; Kitapcioglu, Dilek; Aksoy, Mehmet Emin; Papalois, Apostolos; Sideris, Michail
Objectives: The aim of this study is to evaluate a simulation -based team performance course for medical students and compare its low- and high-fidelity components. Study design: This is a prospective crossover observational study. Groups participated in one low- and one high- fidelity session twice. Low -fidelity scenarios included management of an emergency case on a simulated -patient, whereas high-fidelity scenarios constituted of multiple -trauma cases where simulated -patients wore a hyper - realistic suit. Team performance was assessed objectively, using the TEAMTM tool, and subjectively using ques- tionnaires. Questionnaires were also used to assess presence levels, stress levels and evaluate the course. Results: Participants? team performance was higher in the low -fidelity intervention as assessed by the TEAMTM tool. An overall mean increase in self -assessed confidence towards non -technical skills attitudes was noted after the course, however there was no difference in self -assessed performance between the two interventions. Both reported mean stress and presence levels were higher for the high-fidelity module. Evaluation scores for all individual items of the questionnaire were ?4.60 in both NTS modules. Students have assessed the high-fidelity module higher (4.88 out of 5, SD = 0.29) compared to low -fidelity module (4.74 out of 5, SD = 0.67). Conclusions: Both the low- and high-fidelity interventions demonstrated an improvement in team performance of the attending medical students. The high-fidelity intervention was more realistic, yet more stressful. Furthermore, it proved to be superior in harvesting leadership, teamwork and task management skills. Both modules were evaluated highly by the students, however, future research should address retention of the taught skills and adaptability of such interventions.
Studying Brain Activation during Skill Acquisition via Robot-Assisted Surgery Training
(MDPI, 2021-01-01) Izzetoglu, Kurtulus; Aksoy, Mehmet Emin; Agrali, Atahan; Kitapcioglu, Dilek; Gungor, Mete; Simsek, Aysun
Robot-assisted surgery systems are a recent breakthrough in minimally invasive surgeries, offering numerous benefits to both patients and surgeons including, but not limited to, greater visualization of the operation site, greater precision during operation and shorter hospitalization times. Training on robot-assisted surgery (RAS) systems begins with the use of high-fidelity simulators. Hence, the increasing demand of employing RAS systems has led to a rise in using RAS simulators to train medical doctors. The aim of this study was to investigate the brain activity changes elicited during the skill acquisition of resident surgeons by measuring hemodynamic changes from the prefrontal cortex area via a neuroimaging sensor, namely, functional near-infrared spectroscopy (fNIRS). Twenty-four participants, who are resident medical doctors affiliated with different surgery departments, underwent an RAS simulator training during this study and completed the sponge suturing tasks at three different difficulty levels in two consecutive sessions/blocks. The results reveal that cortical oxygenation changes in the prefrontal cortex were significantly lower during the second training session (Block 2) compared to the initial training session (Block 1) (p < 0.05).
Performance Monitoring via Functional Near Infrared Spectroscopy for Virtual Reality Based Basic Life Support Training
(FRONTIERS MEDIA SA, 2019-01-01) Aksoy, Emin; Izzetoglu, Kurtulus; Baysoy, Engin; Agrali, Atahan; Kitapcioglu, Dilek; Onaral, Banu
The use of serious game tools in training of medical professions is steadily growing. However, there is a lack of reliable performance assessment methods to evaluate learner's outcome. The aim of this study is to determine whether functional near infrared spectroscopy (fNIRS) can be used as an additional tool for assessing the learning outcome of virtual reality (VR) based learning modules. The hypothesis is that together with an improvement in learning outcome there would be a decrease in the participants' cerebral oxygenation levels measured from the prefrontal cortex (PFC) region and an increase of participants' serious gaming results. To test this hypothesis, the subjects were recruited and divided into four groups with different combinations of prior virtual reality experience and prior Basic Life Support (BLS) knowledge levels. A VR based serious gaming module for teaching BLS and 16-Channel fNIRS system were used to collect data from the participants. Results of the participants' scores acquired from the serious gaming module were compared with fNIRS measures on the initial and final training sessions. Kruskal Wallis test was run to determine any significant statistical difference between the groups and Mann-Whitney U test was utilized to obtain pairwise comparisons. BLS training scores of the participants acquired from VR based serious game's the learning management system and fNIRS measurements revealed decrease in use of resources from the PFC, but increase in behavioral performance. Importantly, brain-based measures can provide an additional quantitative metric for trainee's expertise development and can assist the medical simulation instructors.
Integrating medical simulation programs into the Turkish undergraduate medical curriculum
(DOVE MEDICAL PRESS LTD, 2016-01-01) Kitapcioglu, Dilek; Aksoy, Mehmet Emin

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