How to achieve synergy between medical education and cognitive neuroscience? An exercise on prior knowledge in understanding

A major challenge in contemporary research is how to connect medical education and cognitive neuroscience and achieve synergy between these domains. Based on this starting point we discuss how this may result in a common language about learning, more educationally focused scientific inquiry, and multidisciplinary research projects. As the topic of prior knowledge in understanding plays a strategic role in both medical education and cognitive neuroscience it is used as a central element in our discussion. A critical condition for the acquisition of new knowledge is the existence of prior knowledge, which can be built in a mental model or schema. Formation of schemas is a central event in student-centered active learning, by which mental models are constructed and reconstructed. These theoretical considerations from cognitive psychology foster scientific discussions that may lead to salient issues and questions for research with cognitive neuroscience. Cognitive neuroscience attempts to understand how knowledge, insight and experience are established in the brain and to clarify their neural correlates. Recently, evidence has been obtained that new information processed by the hippocampus can be consolidated into a stable, neocortical network more rapidly if this new information fits readily into a schema. Opportunities for medical education and medical education research can be created in a fruitful dialogue within an educational multidisciplinary platform. In this synergetic setting many questions can be raised by educational scholars interested in evidence-based education that may be highly relevant for integrative research and the further development of medical education

Laparoscopic or Open Surgery: The Educational Benefit to Medical Students

Background Recent advances in surgery have enabled traditional open procedures to be performed laparoscopically. We carried out a survey in order to determine the impact of this on learning opportunities for students attending theatre. Methods We designed a nine point survey, completed by fifty medical students from Leicester Medical School on completion of their surgical attachment at a busy district general hospital. Results Undergraduates feel open procedures are superior over laparoscopic cases when asked specifically about anatomical knowledge gained, teaching delivered and the ability to follow surgical procedures. Conclusion We conclude that to continue to attract medical students into a surgical career undergraduate teaching ought to reflect current clinical practice. Novel educational techniques which utilize laparoscopy can be an excellent adjunct to traditional teaching methods

The Effects of Force Feedback on Surgical Task Performance: A Meta-Analytical Integration

Since the introduction of surgical robots into clinical practice, there has been a lively debate about the potential benefits and the need to implement haptic feedback for the surgeon. In the current article, a quantitative review of empirical findings from 21 studies (N = 332 subjects) is provided. Using meta-analytical methods, we found moderate effects on task accuracy (g = .61), large effect sizes of additional force feedback on average forces (g = .82) and peak forces (g = 1.09) and no effect on task completion times (g = -.05) when performing surgical tasks. Moreover, the magnitude of the force feedback effect was attenuated when visual depth information was available

Outcomes for trainees vs experienced surgeons undertaking laparoscopic antireflux surgery - is equipoise achieved?

BackgroundThere is a learning curve associated with laparoscopic antireflux surgery which has an impact on patient outcomes. It is unclear, however, whether this can be eliminated by supervision of early cases by experienced surgeons. The aim of this study was to evaluate the impact of training under supervision on outcomes for laparoscopic fundoplication.MethodPatients undergoing primary laparoscopic antireflux surgery from 1995 to 2009 were identified from a prospective database. Patients were classified according to whether they were operated on by an experienced consultant or supervised trainee, and sub-categorised according to the presence of a very large hiatus hernia. A standardised questionnaire was used to assess outcomes for heartburn, dysphagia and satisfaction at 1 and 5 years follow-up. Outcomes for the study groups were compared.ResultsOne thousand seven hundred and ten patients underwent surgery; 1,112 were operated on by consultants and 598 by trainees. The peri-operative complication rate was not different between the groups, although in patients operated on by trainees, there were increased rates of endoscopic dilatation (9 vs. 5 % p = 0.014) and re-operation (9 vs. 6 %, p = 0.031), and a lower satisfaction rate (76 vs. 82 %, p = 0.044) within 5 years of surgery. All other outcomes were similar for trainees vs. consultants.ConclusionThe learning curve for laparoscopic fundoplication had a small, but statistically significant, impact on patient outcomes, with slightly lesser outcomes when surgery was undertaken by trainees, even when supervised by experienced surgeons. Although the differences were not large, they raise questions about equipoise and highlight ethical dilemmas with teaching new generations of surgeons.Claire N. Brown, Lorelle T. Smith, David I. Watson, Peter G. Devitt, Sarah K. Thompson, Glyn G. Jamieso