Browsing by Author "Valencia Coronel, Brandon"

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    Five-Year Experience Training Surgeons with a Laparoscopic Simulation Training Program for Bariatric Surgery: a Quasi-experimental Design
    (2023) Duran Espinoza, Valentina; Belmar Riveros, Francisca; Jarry Trujillo, Cristian; Gaete Danobeitia, Maria Ines; Montero Jaras, Isabella; Miguieles Schilling, Mariana; Valencia Coronel, Brandon; Escalona, Gabriel; Achurra Tirado, Pablo; Quezada, Nicolas; Crovari, Fernando; Varas Cohen, Julian
    Purpose Nearly 200,000 laparoscopic Roux-en-Y gastric bypass (LRYGB) are performed yearly. Reported learning curves range between 50 and 150, even 500 cases to decrease the operative risk. Simulation programs could accelerate this learning curve safely; however, trainings for LRYGB are scarce. This study aims to describe and share our 5-year experience of a simulated program designed to achieve proficiency in LRYGB technical skills.Materials and Methods A quasi-experimental design was used. All recruited participants were previously trained with basic and advanced laparoscopic simulation curriculum completing over 50 h of practical training. Ex vivo animal models were used to practice manual and stapled gastrojejunostomy (GJ) and stapled jejunojejunostomy (JJO) in 10, 3, and 4 sessions, respectively. The main outcome was to assess the manual GJ skill acquisition. Pre- and post-training assessments using a Global Rating Scale (GRS; max 25 pts), Specific Rating Scale (SRS; max 20 pts), performance time, permeability, and leakage rates were analyzed. For the stapled GJ and JJO, execution time was registered. Data analysis was performed using parametric tests.Results In 5 years, 68 trainees completed the program. For the manual GJ's pre- vs post-training assessment, GRS and SRS scores increased significantly (from 17 to 24 and from 13 to 19 points respectively, p-value < 0.001). Permeability rate increased while leakage rate and procedural time decreased significantly.Conclusion This simulated training program showed effectiveness in improving laparoscopic skills for manual GJ and JJO in a simulated scenario. This new training program could optimize the clinical learning curve. Further studies are needed to assess the transfer of skills to the operating room.
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    Growth vs. fixed: evaluating the mindset of future surgeons
    (2024) Valencia Coronel, Brandon; Silva Rojas, Adriana; Jarry, Cristián; Belmar, Francisca; Vial, María Elena; Selman Álvarez, Rafael; Figueroa Fernández, Úrsula; Cruz Mackenna, Enrique; Escalona, Gabriel; Varas, Julián
    Introduction: The pursuit of surgical specialization often requires a robust mindset given the high stakes and demanding nature of surgical practice. The mindset of surgical residents, specifically the dichotomy of fixed versus growth mindset, may significantly influence their learning trajectory and eventual performance. This study seeks to explore the prevailing mindsets of surgical residents, with the goal of fostering a conducive learning environment that promotes continuous growth and excellence. Methods: A modified cross-sectional survey based on Dr. Carol S. Dweck's mindset theory was applied to surgical residents at our center. The purpose of this survey was to classify the predominant mindset into 4 groups (strong growth mindset, growth mindset with some fixed ideas, fixed mindset with some growth ideas, and strong fixed mindset) and assess whether this influenced residents' perceptions of performance. However, this study did not directly examine the underlying factors influencing these mindsets. Results: A total of 38 surgical residents participated in the study with a response rate of 95%. The mean age of participants was 31.61 years (range 25–37 years), with 52.6% males and 47.4% females. Regarding surgical specialties, 63.16% were specializing in General Surgery, 10.53% in Pediatric Surgery, 10.53% in Digestive Surgery, 10.53% in Urology, and 5.26% in Colorectal Surgery. Combining the mindset groups, it was found that 89.47% of residents were in the growth mindset category and 10.53% were in the fixed mindset category. In the different types of mindsets of the residents, the findings revealed that in the subgroup categories of mindset, we found 50% of strong growth mindset, 39.47% of growth mindset with some fixed ideas, and 10.53% in fixed mindset with some growth idea. Conclusión: This study highlights the prevalence of a growth mindset among surgical residents, indicating a willingness to adapt and learn continuously. The absence of a strong fixed mindset in the surveyed group reinforces the evolving nature of surgical education that emphasizes adaptability and resilience. This study lays the groundwork for more extensive research to understand the factors that foster these mindsets and to develop strategies to promote a growth mindset in surgical education.
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    Home-based training for first-year surgery residents: learning to perform an open manual intestinal anastomosis with remote and asynchronous feedback
    (2024) Miguieles Schilling, Mariana Andrea; Montero Jaras, Isabella; Valencia Coronel, Brandon; Durán Espinoza, Valentina Alexandra; Gaete Dañobeitia, María Inés; Belmar Riveros, Francisca Andrea; Rodríguez, Natalie; Mena, Felipe; Escalona Vives, Gabriel; Bellolio Roth, Felipe; Jarry Trujillo, Cristian Ignacio; Varas Cohen, Julián Emanuel
    Purpose This study explores the feasibility of remote training for complex surgical skills through an at-home open manual intestinal anastomosis (MIA) program for 1 year surgery residents. Methods and procedures A quasi-experimental design assessed an open MIA training module. It included (1) an MIA video tutorial, tutored class, and in-person feedback, and (2) at-home training with remote asynchronous feedback. Trainees video-recorded and uploaded their MIA attempts to receive feedback through a digital platform. All program completions between July 2021 and October 2022 were included. Two evaluators, blind to the participants and to the timing of the videos, assessed residents’ performance using global (GRS) and procedure specific (SRS) ratings scales, and measured procedural time. Pre-post analysis utilized first and last uploaded videos. A satisfaction survey gauged residents’ perception. Non-parametric statistics were used (p < 0.05). Results Fourteen residents completed the training program. Pre-post video assessments showed a non-significant trend towards improved GRS and SRS scores, with decreased procedural time. Median GRS scores were 15.75 vs. 15.75 (p = 0.71), and SRS scores were 13.5 vs. 14.5 (p = 0.85). Procedural time decreased from 34 to 32.1 min (p = 0.40). Among survey respondents, 71% found feedback helpful for error correction and skill improvement, and 86% reported increased confidence in performing open MIA. Conclusion Implementing an at-home training program for complex surgical skills is feasible. Remote and asynchronous digital feedback holds promise for enhancing technical skills, though further research is necessary to understand the learning process, and additional training sessions may be needed.
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    Inovações no treinamento cirúrgico: explorando o papel da inteligência artificial e dos grandes modelos de linguagem (LLM)
    (2023) Varas Cohen, Julián Emanuel; Valencia Coronel, Brandon; Villagrán Gutiérrez, Ignacio Andrés; Escalona Vivas, Gabriel Enrique; Hernández Román, Rocío Belén; Schuit Condell, Gregory Kees; Duran Espinoza, Valentina Alexandra; Lagos Villaseca, Antonia Elisa; Jarry Trujillo, Cristián Ignacio; Neyem, Hugo Andrés; Achurra Tirado, Pablo Andrés
    O cenário do treinamento cirúrgico está evoluindo rapidamente com o surgimento da inteligência artificial (IA) e sua integração na educação e simulação. Este artigo explora as aplicações e benefícios potenciais do treinamento cirúrgico assistido por IA, em particular o uso de modelos de linguagem avançados (MLAs), para aprimorar a comunicação, personalizar o feedback e promover o desenvolvimento de habilidades. Discutimos os avanços no treinamento baseado em simulação, ferramentas de avaliação impulsionadas por IA, sistemas de avaliação baseados em vídeo, plataformas de realidade virtual (RV) e realidade aumentada (RA), e o papel potencial dos MLAs na transcrição, tradução e resumo do feedback. Apesar das oportunidades promissoras apresentadas pela integração da IA, vários desafios devem ser abordados, incluindo precisão e confiabilidade, preocupações éticas e de privacidade, viés nos modelos de IA, integração com os sistemas de treinamento existentes, e treinamento e adoção de ferramentas assistidas por IA. Ao abordar proativamente esses desafios e aproveitar o potencial da IA, o futuro do treinamento cirúrgico pode ser remodelado para proporcionar uma experiência de aprendizado mais abrangente, segura e eficaz para os aprendizes, resultando em melhores resultados para os pacientes.
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    Train the trainers: a comparative analysis of medical students and residents as trainers for undergraduate med-school learners in surgical skills
    (2023) Duran Espinoza, Valentina; Montero Jaras, Isabella; Miguieles Schilling, Mariana; Valencia Coronel, Brandon; Belmar Riveros, Francisca; Jarry, Cristian; Cruz, Enrique; Jeffrey, Wiseman; Escalona Vives, Gabriel; Villagrán Gutiérrez, Ignacio Andrés; Corvetto, Marcia; Varas Cohen, Julian