Silicone as a smart solution for simulating soft tissue-an iterative approach to developing a high-fidelity sustainable training model for laparoscopic appendectomy.

Background: Laparoscopic appendectomy (LA) is an effective treatment for the surgical care of appendicitis, with this minimally invasive approach allowing patients to typically spend less time in hospital and promptly return to normal life activities. Residents can acquire the competence and confidence needed in a safe learning environment prior to real patient encounters through simulation-based learning of these techniques. We propose a low cost, sustainable, high fidelity simulation-based training model for LA to compliment regular resident practice of these skills.

Developing a high fidelity, low cost simulation model for retrosigmoid craniotomy and microvascular decompression of the trigeminal nerve.

Background: Trigeminal neuralgia is a very painful condition that may require a surgical approach as treatment, which is typically retrosigmoid craniotomy followed by microvascular decompression. Due to the limited margin for error when operating in the small triangular window of the cerebellopontine angle and the infrequency of this condition, the operating room can present a difficult learning environment for surgical trainees. Our aim is to create a synthetic, low-cost, high-fidelity, and largely reusable simulation model that will enable neurosurgical trainees to practice these procedural steps in a safe learning environment.

Developing and Implementing a Training Programme for Medical Students to Become Peer Educators in Simulation-Based Education.

Unlabelled: Peer assisted learning is a useful strategy for medical students to learn from one another in a safe, structured capacity. As a pilot, we designed a training programme in collaboration with medical students to equip them with the knowledge, skills and abilities to act effectively as peer educators in simulation-based education.

Supplementary Information: The online version contains supplementary material available at 10.

Development and validation of a simulation-based assessment of operative competence for higher specialist trainees in general surgery.

Background: Simulation is increasingly being explored as an assessment modality. This study sought to develop and collate validity evidence for a novel simulation-based assessment of operative competence. We describe the approach to assessment design, development, pilot testing, and validity investigation.

Remote feedback in endovascular simulation training: a mixed-methods study.

Background: There is an increasing need to increase simulation-based learning opportunities for vascular surgery residents in endovascular skills training. This study aims to explore the effectiveness of remote expert instructional feedback of endovascular simulation-based education, as a means of increasing training opportunities in this area for vascular surgery residents.

Methods: A mixed-methods study design was adopted.

Design and utilisation of a novel, high-fidelity, low-cost, hybrid-tissue simulation model to facilitate training in robot-assisted partial nephrectomy.

Robot-assisted partial nephrectomy (RAPN) has rapidly evolved as the standard of care for appropriately selected renal tumours, offering key patient benefits over radical nephrectomy or open surgical approaches. Accordingly, RAPN is a key competency that urology trainees wishing to treat kidney cancer must master. Training in robotic surgery is subject to numerous challenges, and simulation has been established as valuable step in the robotic learning curve.

Developing a clamshell thoracotomy training model to support hybrid teaching in simulation-based education.

Objective: Thoracotomy is an acute, time-sensitive procedure. Simulation-based education provides a safe-learning platform to learn these techniques under close supervision.

Methods: We used the spiral model and concepts of functional fidelity to guide the evolutionary design and fabrication of a hybrid thoracotomy simulator.

Collating evidence to support the validation of a simulated laparotomy incision and closure-training model.

Background: It is essential to evaluate the functionality of surgical simulation models, in order to determine whether they perform as intended. In this study, we assessed the use of a simulated laparotomy incision and closure-training model by collating validity evidence to determine its utility as well as pre and post-test interval data.

Method: This was a quantitative study design, informed by Messick's unified validity framework.

Generating a Prioritized List of Operative Procedures for Simulation-based Assessment of General Surgery Trainees Through Consensus.

Objective: To develop appropriate content for high-stakes simulation-based assessments of operative competence in general surgery training through consensus.

Background: Valid methods of summative operative competence assessment are required by competency-based training programs in surgery.

Method: An online Delphi consensus study was conducted.

A Mixed Methods Study Identifying the Competencies of Health Care Simulation Technicians.

Introduction: Health care simulation technicians (HSTs), also referred to as simulation operations specialists, are essential to the delivery of simulation-based education. The HST role draws on a broad range of knowledge, skills, and attitude competencies. However, because of the neoteric nature of the HST role and the ambiguity surrounding the core responsibilities of the position, it has proved difficult to identify the competencies required to perform this role successfully.

Direct carotid puncture for endovascular thrombectomy in acute ischemic stroke.

Background: Mechanical thrombectomy is the standard of care for acute ischemic strokes with proximal intracranial occlusion. Arterial access is commonly achieved with femoral artery puncture, although this is not always possible. In this case series, we describe 11 cases of anterior circulation stroke where direct carotid puncture was used to obtain vascular access.

Concentric and Eccentric Target MRI Signs in a Case of HIV-Associated Cerebral Toxoplasmosis.

Cerebral toxoplasmosis is one of the most common causes of focal brain lesions in immunocompromised patients, such as those with human immunodeficiency virus (HIV). Differentiating toxoplasmosis from other central nervous system (CNS) lesions provides a significant clinical challenge. Magnetic resonance (MR) imaging of the brain is key to prompt diagnosis and treatment of cerebral toxoplasmosis.

Direct Common Carotid Artery Puncture for Endovascular Treatment of Acute Large Vessel Ischemic Stroke in a Patient with Aortic Coarctation.

Coarctation of the aorta is a condition that typically presents in childhood as a congenital malformation. This report describes a case of acute right middle cerebral artery ischemic stroke, which occurred in a patient with aortic coarctation that remained undiagnosed until her eighth decade. Complex anatomical variant presented a significant technical challenge in establishing endovascular access for mechanical thrombectomy using standard femoral, brachial, or radial artery approaches.

Prevalence of prescribing in pregnancy using the Irish primary care research network: a pilot study.

Background: To establish the prevalence and patterns of prescribing to pregnant women in an Irish primary care setting.

Methods: We reviewed electronic healthcare records routinely collected in primary care, of pregnant women attending nine Dublin-based General Practices affiliated to the Irish Primary Care Research Network (IPCRN) for antenatal care between January 2007 and October 2013 (n = 2,361 pregnancies).

Results: Excluding folic acid, 46.

The role of leukotriene receptor antagonists in exercise induced bronchoconstriction in children.

Exercise induced bronchoconstriction (EIB) may complicate childhood asthma. Leukotriene receptor antagonists (LTRAs), such as montelukast, may be beneficial in protecting against EIB. Our aim was to systematically review the role of LTRAs in the treatment of asthmas complicated by exercise induced bronchoconstriction and to assess various clinical factors which may influence the therapeutic outcome.