Training on synthetic ethylene-vinyl acetate bench model allows novice medical students to acquire suture skills

PURPOSE: To assess the acquisition of suture skills by training on ethylene-vinyl acetate bench model in novice medical students.METHODS: Sixteen medical students without previous surgery experience (novices) were randomly divided into two groups. During one hour group A trained sutures on ethylene-vinyl acetate (EVA) bench model with feedback of instructors, while group B (control) received a faculty-directed training based on books and instructional videos. All students underwent a both pre-and post-tests to perform two-and three-dimensional sutures on ox tongue. All recorded performances were evaluated by two blinded evaluators, using the Global Rating Scale.RESULTS: Although both groups have had a better performance (p<0.05) in the post-test when compared with the pre-test, the analysis of post-test showed that group A (EVA) had a better performance (p<0.05) when compared with group B (control).CONCLUSION: The ethylene vinyl acetate bench model allowed the novice students to acquire suture skills faster when compared to the traditional model of teaching.

Does bench model fidelity interfere in the acquisition of suture skills by novice medical students?

OBJETIVO: Embora vários modelos de bancada inanimados tenham sido descritos para o treinamento de habilidades de sutura, até o momento, não existe um método ideal para esse ensino e aprendizagem durante a formação médica. O objetivo foi avaliar se a fidelidade dos modelos de bancada interfere na aquisição de habilidades de sutura em estudantes de medicina iniciantes na prática cirúrgica. MÉTODOS: 36 estudantes de medicina sem exposição prévia a habilidades cirúrgicas foram randomizados em três grupos (n = 12): treinamento de suturas baseado em materiais didáticos (controle); treinamento de suturas em modelo de baixa-fidelidade (modelo de bancada de etileno vinil acetato); ou treinamento de suturas em modelo de alta-fidelidade (modelo de bancada de pele de pata de porco). Foram aplicados pré e pós-testes (realização de pontos simples e pontos subdérmicos invertidos em língua de boi). Três ferramentas (Global Rating Scale com avaliação cega, tamanho do efeito e autopercepção da confiança baseada em uma escala de Likert) foram utilizadas para mensurar todas as performances de sutura. RESULTADOS: A análise após o treinamento demonstrou que os estudantes que treinaram nos modelos tiveram um melhor (p < 0.0000) desempenho na avaliação pela Global Rating Scale, quando comparados com o controle, independente da fidelidade do modelo. A magnitude do efeito (treinamento) foi considerada grande (> 0.80) em todas as mensurações. Após o treinamento os alunos sentiram-se mais confiantes (p < 0.0000) para executarem os dois tipos de suturas. CONCLUSÃO: A aquisição de habilidades de suturas no modelo de baixa fidelidade foi semelhante à prática no modelo de alta fidelidade, sendo que a melhora no desempenho dos participantes que treinaram nesses dois modelos foi superior à aprendizagem baseada em materiais didáticos.

Tangential microfiltration of orange juice in bench pilot

O objetivo deste trabalho foi introduzir a técnica de microfiltração tangencial (MFT) na produção de suco de laranja. O suco microfiltrado (SMFT) foi comparado química e sensorialmente com um suco pasteurizado (testemunha). Utilizou-se um piloto de MFT munido de quatro membranas (0,1, 0,2, 0,8 e 1,4mm) cerâmicas monotubulares dispostas em série, cada uma delas com superfície de 0,005m². Suco de laranja comercial flash pasteurizado foi usado como produto inicial. O trabalho experimental foi dividido em três fases: a) caracterização do piloto de MFT; b) otimização das condições operacionais; c) produção do SMFT. Na fase de otimização, a membrana de 0,8mm apresentou os melhores fluxos de permeado, seguidas pelas de 1,4, 0,1 e 0,2mm. Para garantir a esterilidade do permeado, a membrana de 0,1mm foi escolhida para a terceira fase do trabalho. Na produção do SMFT, o suco de laranja foi peneirado para separar uma parte de sua polpa, sendo em seguida microfiltrado. Depois, a polpa foi misturada ao retentato e a mistura pasteurizada. O SMFT foi obtido adicionando a mistura pasteurizada ao permeado. O SMFT apresentou teor de sólidos solúveis (°Brix), polpa, pH e acidez titulável semelhante ao suco inicial pasteurizado (testemunha); embora, tenha perdido maior quantidade (28%) de vitamina C. de acordo com os provadores do painel, o suco testemunha apresentou melhores características sensoriais em relação ao SMFT, por apresentar maior intensidade de odor e sabor frutoso.

Simulation-based cutaneous surgical-skill training on a chicken-skin bench model in a medical undergraduate program

Background: Because of ethical and medico-legal aspects involved in the training of cutaneous surgical skills on living patients, human cadavers and living animals, it is necessary the search for alternative and effective forms of training simulation. Aims: To propose and describe an alternative methodology for teaching and learning the principles of cutaneous surgery in a medical undergraduate program by using a chicken-skin bench model. Materials and Methods: One instructor for every four students, teaching materials on cutaneous surgical skills, chicken trunks, wings, or thighs, a rigid platform support, needled threads, needle holders, surgical blades with scalpel handles, rat-tooth tweezers, scissors, and marking pens were necessary for training simulation. Results: A proposal for simulation-based training on incision, suture, biopsy, and on reconstruction techniques using a chicken-skin bench model distributed in several sessions and with increasing levels of difficultywas structured. Both feedback and objective evaluations always directed to individual students were also outlined. Conclusion: The teaching of a methodology for the principles of cutaneous surgery using a chicken-skin bench model versatile, portable, easy to assemble, and inexpensive is an alternative and complementary option to the armamentarium of methods based on other bench models described. © Indian Journal of Dermatology 2013.

Energy expenditure during multiple sets of leg press and bench press

The purpose of this study was to quantify energy expenditure (EE) during multiple sets of leg press (LP) and bench press (BP) exercises in 10 males with at least 1 yr of resistance training (RT). The subjects underwent two sessions to determine 1 repetition maximum (1RM) on the BP and LP and one protocol consisting of a warm up and 4 sets for 10 repetitions at 70% 1RM with a 3-min rest period between sets for each exercise. Energy expenditure was calculated as the sum of oxygen uptake (aerobic component), EPOC, and lactate production (anaerobic component). There were no significant differences in EE between exercises for sets 1 to 4 and the total energy expended. However, statistical analysis revealed a significant difference (P<0.05) between exercises in RT economy (BP, 0.0206 ± 0.0044 kcal·kg-1 vs. LP, 0.0051 ± 0.0015 kcal·kg-1). Within exercise comparison showed set 4 was significantly different from sets 1 and 3 for BP, and for LP a significant difference was found between set 4 and sets 1, 2 and 3. Our results point to an increase in EE during multiple sets at 70% 1RM and show that in spite of the difference in muscle mass involved and total work done during each type of exercise, EE was not different due to greater economy during the LP.

ICE-KEEL SCOUR MARKS IN THE GEOLOGICAL RECORD: EVIDENCE FROM CARBONIFEROUS SOFT-SEDIMENT STRIATED SURFACES IN THE PARANA BASIN, SOUTHERN BRAZIL

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Teaching elliptical excision skills to novice medical students: a randomized controlled study comparing low- and high-fidelity bench models

Background: The search for alternative and effective forms of training simulation is needed due to ethical and medico-legal aspects involved in training surgical skills on living patients, human cadavers and living animals. Aims : To evaluate if the bench model fidelity interferes in the acquisition of elliptical excision skills by novice medical students. Materials and Methods: Forty novice medical students were randomly assigned to 5 practice conditions with instructor-directed elliptical excision skills' training (n = 8): didactic materials (control); organic bench model (low-fidelity); ethylene-vinyl acetate bench model (low-fidelity); chicken legs' skin bench model (high-fidelity); or pig foot skin bench model (high-fidelity). Pre- and post-tests were applied. Global rating scale, effect size, and self-perceived confidence based on Likert scale were used to evaluate all elliptical excision performances. Results : The analysis showed that after training, the students practicing on bench models had better performance based on Global rating scale (all P < 0.0000) and felt more confident to perform elliptical excision skills (all P < 0.0000) when compared to the control. There was no significant difference (all P > 0.05) between the groups that trained on bench models. The magnitude of the effect (basic cutaneous surgery skills' training) was considered large (>0.80) in all measurements. Conclusion : The acquisition of elliptical excision skills after instructor-directed training on low-fidelity bench models was similar to the training on high-fidelity bench models; and there was a more substantial increase in elliptical excision performances of students that trained on all simulators compared to the learning on didactic materials.