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Resumo:
The financial crisis has highlighted some of the limitations of the global system. Enterprises previously thought to be too big to fail have learned the harsh realities of capitalism (Merill Lynch, Lehman Bros, Northern Rock), countries have been shaken considerably from the bankruptcy of Iceland to the near-collapse of the markets in Greece, Ireland and Italy. The current age of austerity has largely dominated supra-national and indeed global politics in the last few years. The extent of the crisis has illustrated that relationships between business, governments and society needs to be re-evaluated in light of shifts in the global market thereby recognizing that some countries have a more limited power of persuasion than some corporations.
Resumo:
OBJECTIVES:: We assessed the effectiveness of ToT from VR laparoscopic simulation training in 2 studies. In a second study, we also assessed the TER. ToT is a detectable performance improvement between equivalent groups, and TER is the observed percentage performance differences between 2 matched groups carrying out the same task but with 1 group pretrained on VR simulation. Concordance between simulated and in-vivo procedure performance was also assessed. DESIGN:: Prospective, randomized, and blinded. PARTICIPANTS:: In Study 1, experienced laparoscopic surgeons (n = 195) and in Study 2 laparoscopic novices (n = 30) were randomized to either train on VR simulation before completing an equivalent real-world task or complete the real-world task only. RESULTS:: Experienced laparoscopic surgeons and novices who trained on the simulator performed significantly better than their controls, thus demonstrating ToT. Their performance showed a TER between 7% and 42% from the virtual to the real tasks. Simulation training impacted most on procedural error reduction in both studies (32- 42%). The correlation observed between the VR and real-world task performance was r > 0·96 (Study 2). CONCLUSIONS:: VR simulation training offers a powerful and effective platform for training safer skills.