Examining outpatients' hand hygiene behaviour and its relation to COVID-19 infection prevention measures.

Background: The increasing demand for outpatient care is associated with a higher risk of infection transmission in these settings. However, there is limited research on infection prevention and control practices in ambulatory clinics, and none focuses on patients.

Aim: To examine outpatients' hand hygiene behaviours, their determinants, and their associations with other infection prevention measures during the COVID-19 pandemic.

Training in Bariatric Surgery: a National Survey of German Bariatric Surgeons.

Introduction: Skill in bariatric surgery has been associated with postoperative outcome. Appropriate surgical training is of paramount importance. In order to continuously improve training strategies, it is necessary to assess current practices.

Targeted surgical coaching can improve operative self-assessment ability: A single-blinded nonrandomized trial.

Background: The aim of the study was to investigate the effect of targeted surgical coaching on self-assessment of laparoscopic operative skill. Accurate self-assessment is vital for autonomous professional development. Surgical coaching can be used for performance improvement, but its role in this domain has been insufficiently investigated.

[Barriers to the German Society for General and Visceral Surgery (DGAV) accreditation "Center for bariatric and metabolic surgery"].

Introduction: The certification and accreditation process of the German Society for General and Visceral Surgery (DGAV) aims to improve the quality of care and enhance transparency in accredited centers. To achieve these goals a high level of infrastructural and staffing requirements are set out by the DGAV.

Aims: The Surgical Working Group on Obesity Treatment and Metabolic Surgery (CAADIP) survey 2017 of the members of the German Bariatric Society aimed to identify the perceived and encountered barriers in the DGAV accreditation process.

Comprehensive simulation-enhanced training curriculum for an advanced minimally invasive procedure: a randomized controlled trial.

Background: There is no comprehensive simulation-enhanced training curriculum to address cognitive, psychomotor, and nontechnical skills for an advanced minimally invasive procedure.

Objectives: 1) To develop and provide evidence of validity for a comprehensive simulation-enhanced training (SET) curriculum for an advanced minimally invasive procedure; (2) to demonstrate transfer of acquired psychomotor skills from a simulation laboratory to live porcine model; and (3) to compare training outcomes of SET curriculum group and chief resident group.

Setting: University.

Setting Performance Standards for Technical and Nontechnical Competence in General Surgery.

Objectives: The objectives of this study were to (1) create a technical and nontechnical performance standard for the laparoscopic cholecystectomy, (2) assess the classification accuracy and (3) credibility of these standards, (4) determine a trainees' ability to meet both standards concurrently, and (5) delineate factors that predict standard acquisition.

Background: Scores on performance assessments are difficult to interpret in the absence of established standards.

Methods: Trained raters observed General Surgery residents performing laparoscopic cholecystectomies using the Objective Structured Assessment of Technical Skill (OSATS) and the Objective Structured Assessment of Non-Technical Skills (OSANTS) instruments, while as also providing a global competent/noncompetent decision for each performance.

Training in Laparoscopic Gastric Cancer Surgery in the Western World: Current Educational Practices, Challenges, and Potential Opportunities at a Large University Centre.

Objective: The purpose of this study was to explore and understand how surgeons distribute tasks during a laparoscopic gastrectomy for gastric cancer in an academic teaching environment.

Design: An anonymous, cross-sectional, census survey was used to poll trainees' and staff members' opinions pertaining to laparoscopic gastrectomy.

Setting: Academic and community tertiary teaching hospitals, affiliated with the University of Toronto.

Implementation of an Effective Strategy for Teaching Nontechnical Skills in the Operating Room: A Single-blinded Nonrandomized Trial.

Objective: To evaluate the effectiveness of debriefing and feedback on intraoperative nontechnical performance as an instructional strategy in surgical training.

Background: Regulatory authorities for accreditation in North America have included nontechnical skills such as communication and teamwork in the competencies to be acquired by surgical residents before graduation. Concrete recommendations regarding the training and assessment of these competencies, however, are lacking.

Characterising 'near miss' events in complex laparoscopic surgery through video analysis.

Background: Root cause analyses of surgical complications are of high importance to ensure surgical quality, but specific details on technical causes often remain unclear. Identifying subclinical intraoperative incidents attributable to technical errors is essential for developing rescue mechanisms to prevent adverse outcomes.

Objective: Descriptive study to characterise intraoperative technical error-event patterns in successful laparoscopic procedures.

Comprehensive Surgical Coaching Enhances Surgical Skill in the Operating Room: A Randomized Controlled Trial.

Objectives: The aim of the study was to determine whether individualized coaching improved surgical technical skill in the operating room to a higher degree than current residency training.

Background: Clinical training in the operating room is a valuable opportunity for surgeons to acquire skill and knowledge; however, it often remains underutilized. Coaching has been successfully used in various industries to enhance performance, but its role in surgery has been insufficiently investigated.

Structured Training to Improve Nontechnical Performance of Junior Surgical Residents in the Operating Room: A Randomized Controlled Trial.

Objective: The objective of the study was to evaluate the effectiveness of structured training on junior trainees' nontechnical performance in an operating room (OR) environment.

Background: Nontechnical skills (NTS) have been identified as critical competencies of surgeons in the OR, and regulatory bodies have mandated their integration in postgraduate surgical curricula. Strong evidence supporting the effectiveness of curricular NTS training, however, is lacking.

Objective structured assessment of nontechnical skills: Reliability of a global rating scale for the in-training assessment in the operating room.

Background: Nontechnical skills are critical for patient safety in the operating room (OR). As a result, regulatory bodies for accreditation and certification have mandated the integration of these competencies into postgraduate education. A generally accepted approach to the in-training assessment of nontechnical skills, however, is lacking.

Contemporary management of paraesophaegeal hernias: establishing a European expert consensus.

Background: The surgical treatment of paraesophageal hernias remains a challenge due to the lack of consensus regarding principles of operative treatment. The objectives of this study were to achieve consensus on key topics through expert opinion using a Delphi methodology.

Methods: A Delphi survey combined with a face-to-face meeting was conducted.

Randomized clinical trial to evaluate mental practice in enhancing advanced laparoscopic surgical performance.

Background: Mental practice, the cognitive rehearsal of a task without physical movement, is known to enhance performance in sports and music. Investigation of this technique in surgery has been limited to basic operations. The purpose of this study was to develop mental practice scripts, and to assess their effect on advanced laparoscopic skills and surgeon stress levels in a crisis scenario.

Surgical training: design of a virtual care pathway approach.

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.

Introduction of a comprehensive training curriculum in laparoscopic surgery for medical students: a randomized trial.

Background: First- and second-year medical students have limited exposure to basic surgical skills. An introductory, comprehensive, simulation-based curriculum in basic laparoscopic skills may improve medical students' knowledge and technical and nontechnical skills and may raise their interest in a career in surgery. The purpose of this study was to (1) design a comprehensive, simulation-based training curriculum (STC) aimed to introduce junior medical students to basic laparoscopic skills and (2) compare structured and supervised learning and practice to a self-directed approach.

International consensus on safe techniques and error definitions in laparoscopic surgery.

Background: Definitions of errors and poor technique in laparoscopic surgery are lacking in modern clinical practice. As a result, educators often base their teaching on personal experience and individual preferences. The objective of this study was to achieve expert consensus regarding these definitions in order to provide a framework for a standardized approach to teaching safe technique and avoiding common errors in laparoscopic surgery.

Current concepts of team training in surgical residency: a survey of North American program directors.

Objectives: The purpose of the present survey was to (1) establish the prevalence of Crew Resource Management (CRM)- and team-training interventions among general surgery residency programs of the United States and Canada; (2) to characterize current approaches to training and assessment of nontechnical skills; and (3) to inquire about program directors' (PDs') recommendations for future curricula in graduate medical education.

Design: An online questionnaire was developed by the authors and distributed via email to the directors of all accredited general surgery residency programs across the United States and Canada. After 3 email reminders, paper versions were sent to all nonresponders.

Teaching nontechnical skills in surgical residency: a systematic review of current approaches and outcomes.

Background: A growing body of evidence suggests that nontechnical skills (NTS) of surgeons play an important role in patient safety in the operating room and can be improved through specific training interventions. The need to address communication and interpersonal skills in postgraduate medical education has been emphasized by the respective regulatory bodies for accreditation and certification. The present review had 2 purposes: To provide an overview of current approaches to training and assessment of NTS in surgery and to critically appraise the strength of the evidence supporting their effectiveness.

Error rating tool to identify and analyse technical errors and events in laparoscopic surgery.

Background: Surgical error analysis is essential for investigating mechanisms of errors, events and adverse outcomes. Furthermore, it provides valuable information for formative feedback and quality control. The aim of the present study was to design and validate a technical error rating tool in laparoscopic surgery.

Development, feasibility, validity, and reliability of a scale for objective assessment of operative performance in laparoscopic gastric bypass surgery.

Background: There is no objective scale for assessment of operative skill in laparoscopic gastric bypass (LGBP). The objective of this study was to develop and demonstrate feasibility of use, validity, and reliability of a Bariatric Objective Structured Assessment of Technical Skill (BOSATS) scale.

Study Design: The BOSATS scale was developed using a hierarchical task analysis (HTA), a Delphi questionnaire, and a panel of international experts in bariatric surgery.

Defining technical errors in laparoscopic surgery: a systematic review.

Background: Technical errors, a distinct subcomponent of surgical proficiency, have a significant impact on patient safety and clinical outcomes. To date, only a few studies have been designed to describe and evaluate these errors. This review was performed to assess technical errors described in laparoscopic surgery.

Laparoscopic simulation training: does timing impact the quality of skills acquisition?

Background: Current surgical training involves integration of educational interventions together with service requirements during regular working hours. Studies have shown that voluntary training has a low acceptance among surgical trainees and obligatory simulation training during the regular working week leads to better skill acquisition and retention. We examined the difference in training effectiveness depending on the time of day.

Blended learning in surgery using the Inmedea Simulator.

Background: Recently, medical education in surgery has experienced several modifications. We have implemented a blended learning module in our teaching curriculum to evaluate its effectiveness, applicability, and acceptance in surgical education.

Methods: In this prospective study, the traditional face-to-face learning of our teaching curriculum for fourth-year medical students (n = 116) was augmented by the Inmedea Simulator, a web-based E-learning system, with six virtual patient cases.