3D visualization systems improve operator efficiency during difficult laparoscopic cholecystectomy: a retrospective blinded review of surgical videos

Background: 3D visualisation systems in laparoscopic surgery have been proposed to improve manual task handling compared to 2D, however, few studies have compared the intra-operative efficacy in laparoscopic cholecystectomy (LC). The aim of this study is to determine if there is a benefit in intra-operative efficiency when using a 3D visualisation in difficult LC compared to traditional 2D visualisation systems. Methods: Retrospective analysis of “difficult” LCs (grade 3 or 4) was completed. The assessor was blinded as all cases were recorded and viewed in 2D only. Variables collected included time to complete steps, missed hook diathermy attempts, failed grasp attempts, missed clip attempts and preparation steps for intra-operative cholangiogram (IOC). Multiple linear regression was undertaken for time variables, Poisson regression or negative binomial regression was completed for continuous variables. Results: 52 operative videos of “difficult” LC were reviewed. 3D systems were associated with reduced operative times, although this was not statistically significant (CI: -2.93-14.93, p-value=0.183). Dissection of the anterior fold to achieve the critical view of safety was significantly faster by 3.55 minutes (CI: 1.215-9.206, p-value=0.002), and with considerably fewer errors when using 3D systems. Fewer IOC preparation errors were observed with a 3D system compared with a 2D system. Conclusions: 3D systems appear to enhance operator efficiency, allowing faster completion of critical steps with fewer errors. This pilot study underscores the utility of video annotation for intra-operative assessment and suggests that, in larger multi-centre studies, 3D systems may demonstrate superior intra-operative efficiency over 2D systems during a “difficult” LC

Implementing shared decision making in UK : Progress 2017–2022

Peer reviewedPublisher PD

The Handbook of Fashion Studies

Edited volume of new writing representing a comprehensive survey of major concepts and current research in fashion studies. Editorial Introduction by Sandy Black, Amy de la Haye, Agnès Rocamora, Regina Root and Helen Thomas. Amy de la Haye is editor of Section IV Fashion and Materiality including: Introduction: Amy de la Haye, London College of Fashion, University of the Arts, UK Chapter 12: Unpicking the Threads: Technology and investigative methodologies, Philip A. Sykas, Manchester School of Art, Manchester Metropolitan University, UK Chapter 13: The Look: Looking at objects as subjects, Alexandra Palmer, Royal Ontario Museum, Canada Chapter 14: Anthropology and Materiality, Sarah Fee, Royal Ontario Museum, Canada Chapter 15: Immateriality, Robyn Healy, RMIT, Melbourne, Australi

Can patient involvement improve patient safety? : A cluster randomised control trial of the Patient Reporting and Action for a Safe Environment (PRASE) intervention

OBJECTIVE: To evaluate the efficacy of the Patient Reporting and Action for a Safe Environment intervention. DESIGN: A multicentre cluster randomised controlled trial. SETTING: Clusters were 33 hospital wards within five hospitals in the UK. PARTICIPANTS: All patients able to give informed consent were eligible to take part. Wards were allocated to the intervention or control condition. INTERVENTION: The ward-level intervention comprised two tools: (1) a questionnaire that asked patients about factors contributing to safety (patient measure of safety (PMOS)) and (2) a proforma for patients to report both safety concerns and positive experiences (patient incident reporting tool). Feedback was considered in multidisciplinary action planning meetings. MEASUREMENTS: Primary outcomes were routinely collected ward-level harm-free care (HFC) scores and patient-level feedback on safety (PMOS). RESULTS: Intervention uptake and retention of wards was 100% and patient participation was high (86%). We found no significant effect of the intervention on any outcomes at 6 or 12 months. However, for new harms (ie, those for which the wards were directly accountable) intervention wards did show greater, though non-significant, improvement compared with control wards. Analyses also indicated that improvements were largest for wards that showed the greatest compliance with the intervention. LIMITATIONS: Adherence to the intervention, particularly the implementation of action plans, was poor. Patient safety outcomes may represent too blunt a measure. CONCLUSIONS: Patients are willing to provide feedback about the safety of their care. However, we were unable to demonstrate any overall effect of this intervention on either measure of patient safety and therefore cannot recommend this intervention for wider uptake. Findings indicate promise for increasing HFC where wards implement ≥75% of the intervention components. TRIAL REGISTRATION NUMBER: ISRCTN07689702; pre-results

Reaching consensus on reporting patient and public involvement (PPI) in research: methods and lessons learned from the development of reporting guidelines

INTRODUCTION: Patient and public involvement (PPI) is inconsistently reported in health and social care research. Improving the quality of how PPI is reported is critical in developing a higher quality evidence base to gain a better insight into the methods and impact of PPI. This paper describes the methods used to develop and gain consensus on guidelines for reporting PPI in research studies (updated version of the Guidance for Reporting Patient and Public Involvement (GRIPP2)). METHODS: There were three key stages in the development of GRIPP2: identification of key items for the guideline from systematic review evidence of the impact of PPI on health research and health services, a three-phase online Delphi survey with a diverse sample of experts in PPI to gain consensus on included items and a face-to-face consensus meeting to finalise and reach definitive agreement on GRIPP2. Challenges and lessons learnt during the development of the reporting guidelines are reported. DISCUSSION: The process of reaching consensus is vital within the development of guidelines and policy directions, although debate around how best to reach consensus is still needed. This paper discusses the critical stages of consensus development as applied to the development of consensus for GRIPP2 and discusses the benefits and challenges of consensus development

The Agony and the Ecstasy: Student-Coaches’ Perceptions of a Heutagogical Approach to Coach Development

Heutagogy is the focus on self-determined learning by the learner. In a recent Insights paper, Stoszkowski and Collins offered a critical overview of heutagogy, highlighting the potential advantages for coaching and coach education, as well as some concerns with its use. The aim of the present study was to offer insight into student-coaches’ experiences on a sports coaching bachelor degree module that was underpinned by a heutagogical approach to learning. Twenty-six student-coaches (6 females and 20 males) took part in semi-structured group interviews, 19 of whom had completed an end of module survey. Data were analyzed inductively and findings revealed that performance on, and perceptions of, the module showed the approach was differentially effective, with three higher order themes representing the student-coaches’ articulation of their experiences: (a) attitudinal disposition, (b) knowledge and experience, and (c) skill set. Although the findings of present study suggest heutagogy is a potentially useful method in coach education, we also highlight some potentially essential caveats to the use of the method