Improving preclinical medical student’s perception of plastic and reconstructive surgery
Dylan SinghPeter DeptulaJustin ChengMallory RowleyKometh ThawanyaratHussein SaidFereydoun Don ParsaRahim Nazerali
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Reconstructive Surgery
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Objective: This study aims to evaluate the perception of medical teachers toward the integration of simulation-based medical education (SBME) in undergraduate curriculum and also identify contextual barriers faced by medical teachers.Methods: This cross-sectional observational study included medical teachers from three universities. A questionnaire was used to report teachers' perception.Results: SBME was perceived by medical teachers (basic sciences/clinical, respectively) as enjoyable (71.1%/75.4%), effective assessment tool to evaluate students' learning (60%/73.9%) and can improve learning outcome (88.8%/79.7%). Similarly, (91.1%/71%) of teachers think that simulation should be part of the curriculum and not stand alone one time activity. Teachers' training for SBME has created a significant difference in perception (p < 0.05). Lack of teachers' training, time, resources and the need to integrate in medical curriculum are major perceived barriers for effective SBME.Conclusion: Results highlight the positive perception and attitude of medical teachers toward the integration of SBME in undergraduate curriculum. Prior formal training of teachers created a different perception. Top perceived barriers for effective SBME include teachers' formal training supported with time and resources and the early integration into the curriculum. These critical challenges need to be addressed by medical schools in order to enhance the integration SBME in undergraduate curricula.
Medical psychology
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Understanding learning environments is vital for developing curricula. This study aims to evaluate medical students' achievements and perception of learning environments considering the Forensic Medicine and Clinical Toxicology course as an analog for the curricular transition process.A cross-sectional study was conducted among undergraduate medical students at the Faculty of Medicine, Tanta University, from August 2020 to October 2021. Using the Dundee Ready Education Environment Measure (DREEM) questionnaire, the perception of 621 students (of which 307 were enrolled in the integrated curriculum and 314 in the traditional curriculum) were compared. Furthermore, the appropriate tests of significance and correlations were used to compare students' perception according to their enrollment, age, gender, and previous year grade point average.The mean overall DREEM score was 121.04 ± 22.35, implying a more positive than negative learning environment, that is, a more positive learning perception, with students' perceptions of teachers moving in the right direction, students' academic self-perceptions getting more on the positive side, more positive attitudes regarding student's perceptions of the learning environment, and not-too-bad student's social self-perception. Medical students enrolled in the integrated curriculum showed higher DREEM scores, with significantly better learning and academic self-perceptions (p < 0.05). Knowledgeable, qualified faculties are the most significant characteristic feature in both systems. A significant number of students achieved excellent grades in the integrated curriculum (n = 740 out of 1076, 68.8%) than in the traditional one (n = 470 out of 961, 48.9%) (p < 0.0001).This study revealed a smooth, successful transition from the traditional to integrated curriculum among Egyptian medical students. The main areas for improvements are focusing on factual teaching, implementing student-centered teaching activities, promoting students' memorizing, and engaging students in activities that may help them enjoy learning.
Learning environment
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Background: In 2007 Faculty of Medicine (FOM), King Abdulaziz University (KAU) reoriented the medical curriculum and integrated professionalism. This study was conducted to assess the perception of professionalism attitudes by medical graduates who graduated from the new curriculum that incorporated the professionalism module and compare it to those who did not.Methods: This cross sectional study was conducted at the teaching hospital of the FOM, KAU using a modified version of the well-constructed questionnairedesigned to assess the student’s attitudes toward professionalism was distributed to all interns in the academic year of 2013-2014. Statistical analysis was carried out using Statistical Package of Social Science (SPSS) version 16.Results: Higher mean scores with significant differences in all aspects of professionalism were observed in interns graduated from the new curriculum when compared to those of the old one and was previously reported by Eldeek et al., (2012). The importance of adhering to high ethical and moral behavior and the need of humanity in the efficacy of the medical practice were the most significant attributes with effect size of 0.64 and 0.58 respectively. Studying in the clinical years represented the first helpful source of the participant to develop their perception about professionalism. Conclusion: The new developed curriculum at the FOM succeeded to improve the graduate perception about professionalism.
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Flap Method is the base of Plastic and Reconstructive surgery. Flap is a unit of tissue which is lifted from donor site and moved to a recipient site with an intact blood supply. It is done to fill a defect such as wound resulting from injury or surgery when the remaining tissue is unable to support a graft. Flap Method is a sub-speciality of plastic and Reconstructive surgery. Various types of flaps are performed, and the indications for them are even more diverse.1
Acharya Sushruta is the father of Surgery. First Nasal Reconstruction using a forehead flap was performed by Sushruta in India during 600 to 700 B.C.2 The basic principle during this surgery was Vascularisation.
This basic principle of vascularisation during flap method is used now-a-days in Limberg Rhomboid Flap surgery of Pilonidal Sinus. It describes a technique for closing a 600 rhombus shaped defect with transposition of flap. It is the practical application of flap method in Rhinoplasty of Sushruta.
Reconstructive Surgery
Sinus (botany)
Transposition (logic)
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Objective:The aim of this study was to discuss the subsequent stage plastic surgery of reconstructive mamaplasty with transverse rectus abdominis myocutaneous(TRAM)flap transplantation.Methods:The patients were followed up from 3 to 6 months after reconstructive mamaplasty.On the condition that defected configuration of breasts or abdominal wall were noticed,plastic surgeries were performed,respectively.Results:Thirty-two patients of breasts reconstruction with TRAM flap underwent various subsequent stage plastic surgeries,including topical liposuction,topical filling,'dog ear' correction of abdominal donor area,rectification of anterior axillary fold,excision of degenerated fat node,finishing of scar and wound line,augmentation with implants,contralateral breast plastic surgery.Among these patients,6 were given 1 plastic operation,11 were 2 operations,10 underwent 3 operations and 5 underwent 4 operations.Conclusion:After subsequent stage amendment,the appearance of the reconstructive breast and the abdominal donor site would be further improved.
Liposuction
Reconstructive Surgery
Abdominoplasty
Rectus abdominis muscle
Axillary lines
Single stage
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Бұл зерттеужұмысындaКaно моделітурaлы жәнеоғaн қaтыстытолықмәліметберілгенжәнеуниверситетстуденттерінебaғыттaлғaн қолдaнбaлы (кейстік)зерттеужүргізілген.АхметЯссaуи университетініңстуденттеріүшін Кaно моделіқолдaнылғaн, олaрдың жоғaры білімберусaпaсынa қоятынмaңыздытaлaптaры, яғнисaпaлық қaжеттіліктері,олaрдың мaңыздылығытурaлы жәнесaпaлық қaжеттіліктерінеқaтыстыөз университетінқaлaй бaғaлaйтындығытурaлы сұрaқтaр қойылғaн. Осы зерттеудіңмaқсaты АхметЯсaуи университетіндетуризмменеджментіжәнеқaржы бaкaлaвриaт бaғдaрлaмaлaрыныңсaпaсынa қaтыстыстуденттердіңқaжеттіліктерінaнықтaу, студенттердіңқaнaғaттaну, қaнaғaттaнбaу дәрежелерінбелгілеу,білімберусaпaсын aнықтaу мен жетілдіружолдaрын тaлдaу болыптaбылaды. Осы мaқсaтқaжетуүшін, ең aлдыменКaно сaуaлнaмaсы түзіліп,116 студенткеқолдaнылдыжәнебілімберугежәнеоның сaпaсынa қaтыстыстуденттердіңтaлaптaры мен қaжеттіліктерітоптықжұмыстaрaрқылыaнықтaлды. Екіншіден,бұл aнықтaлғaн тaлaптaр мен қaжеттіліктерКaно бaғaлaу кестесіменжіктелді.Осылaйшa, сaпa тaлaптaры төрт сaнaтқa бөлінді:болуытиіс, бір өлшемді,тaртымдыжәнебейтaрaп.Соңындa,қaнaғaттaну мен қaнaғaттaнбaудың мәндеріесептелдіжәнестуденттердіңқaнaғaттaну мен қaнaғaттaнбaу деңгейлерінжоғaрылaту мен төмендетудеосытaлaптaр мен қaжеттіліктердіңрөліaйқын aнықтaлды.Түйінсөздер:сaпa, сaпaлық қaжеттіліктер,білімберусaпaсы, Кaно моделі.
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Deep sternal wound infection (DSWI) is a life threatening complication after cardiac surgery. In severe cases, flaps are needed to cover the wound. However, it is controversial if an aseptic environment is necessary at the time of wound closure. This is a retrospective study of 73 patients with DSWI treated by debridement and local or free flap from June 2008 until December 2017. The influence of positive microbiological findings at the time of plastic reconstructive surgery on reoperation rate and length of in-hospital stay was analyzed. Microbiological exams revealed positive results in 47 (64.4%) and no results in 26 patients. Reoperation had to be performed in 21.3% (positive cultures) versus 15.4% (p = .54), mean in hospital stay was 24.1 days (positive cultures) versus 21.8 days (p = .39) and in-hospital mortality was 6.4% (positive cultures) versus 7.7% (p = .83). Positive microbial findings at the time of plastic reconstructive surgery in patients with DSWI are not associated with a higher reoperation or mortality rate or a longer in-hospital stay. Repeated debridement and vacuum-assisted therapy to achieve negative microbial results might not be necessary in the treatment of these patients.Key messagesPositive microbial findings at the time of plastic reconstructive surgery in patients with deep sternal wound infection seems not to be associated with a higher reoperation or mortality rate or a longer in-hospital stay.The influence of positive microbiological findings at the time of plastic reconstructive surgery on reoperation rate and length of in-hospital stay was analyzed in 73 patients with deep sternal wound infection.Microbiological exams revealed positive results in 47 (64.4%) and no results in 26 patients. Reoperation had to be performed in 21.3% (positive cultures) versus 15.4% (p = .54), mean in hospital stay was 24.1 days (positive cultures) versus 21.8 days (p = .39) and in-hospital mortality was 6.4% (positive cultures) versus 7.7% (p = .83).
Reconstructive Surgery
Debridement (dental)
Mediastinitis
Wound infection
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