Thursday, December 5, 2019

Technical Skills and Learning Theories Accredited Institution

Question: Discuss about the Technical Skills and Learning Theories for Accredited Institution. Answer: After completing Honey and Mumfords Questionnaire and getting the score, I found that I have theorist learning style. This type of learners tries to understand the theory behind any action. They rely on different models, statistics, concepts and fact to get engaged in the learning process. They try to analyze information by theory and come to a conclusion after synthesizing new information into a systematic and logical theory. This report will design a skills teaching programme for this type of learners to get knowledge about the short surgical procedure. It will give them training about short surgical procedure according to the learning style of learner. It will also demonstrate how the program will be useful for the trainee. The skills teaching programme will be based on Kolb's learning cycle. This model will be helpful as it is designed according to a different style of learning. According to Kolb, learning cycle moves around phases like concrete experience, reflective observation, abstract conceptualization and active experimentation. This means surgical trainee will have to experience surgical procedure, reflect on the experience, deduce ideas regarding change in the surgical practice and then finally implement those changes in next procedure. Different learners will prefer various elements of the cycle. So, Kolb developed Learning Style Inventory (LSI) to maintain reliability and validity of learning according to different learning style. Theorist learner will prefer reflective observation and abstract conceptualization stages (1). Based on pattern of different learning style explained by Kolbs learning cycle, I will teach the theorist learner according to their preferred way of learning. These learners focus on reflective observation and abstract conceptualization. Therefore, my skills teaching programme will use surgical models and surgical evidence to teach them so that they reflect and learn from it. This form of progressive education will help them in attaining a state of equilibrium in surgical skills so that they become proficient in surgical procedures. I will try to give them background information about particular surgical procedure and teach them relevant theories. They will be able to apply these theories during their learning process and in this way they will get actively involved in the process. It will enable them to utilize the information and implement it in their clinical practice (4). The skills teaching programme will teach the learner carpel tunnel release surgery. It is required to treat patients with carpal tunnel syndrome. It is caused by pain in hand due to pressure on the median nerve in the wrist. The skills training programme will first teach learner about carpal tunnel release. A theorist needs to know all the theory and facts behind any surgery. So this knowledge will be essential for them. The median nerves and tendons of finger go through a passage called carpal tunnel in the wrist. As the tunnel is narrow, any swelling affects the nerve and cause pain. The carpal ligament is present at the surface of carpal tunnel. During the surgery, the surgeon requires cutting through the carpal ligament so that more space is created between the nerve and tendons (6). Figure 1: Tranverse carpal release surgery. 11. [Internet]. 2016 [cited 23 July 2016]. Available from: (2016). Aihw.gov.au. Retrieved 22 July 2016, from https://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442455071 The skill programme will teach the correct ways of surgery. It is performed in the following ways: First, numbing medicine should be given before surgery. A small surgical cut is made in the palm near the wrist, and the ligament over the carpal is cut. It serves the purpose of reducing the pressure on the median nerve. Then the skin and tissue are closed with sutures (7). This process is required when other non-surgical treatment options like anti-inflammatory medicines, therapy, shots of corticosteroids medicine, wrist splints, and behavioral changes fail. After the training of surgeons regarding ways to perform carpal tunnel release surgery, it will be necessary to assess motor skills of a surgeon to validate the surgical competency of the learner. Therefore, the competency of learner regarding the surgical procedure will depend on web-based knowledge test on surgical anatomy, surgical steps, the skill of dictating operating report and knowledge of surgical complication (2). A theorist is expected to excel in this test because they tend to learn things only after proper analysis of theories and information on the topic. So it is evident that they would have gained all relevant knowledge about the procedure before performing their first surgery on a patient. The second step will be an assessment of technical skills. This will depend on their level of practice and how far they were successful in performing the surgery. For structured assessment, each trainee surgeon will perform surgery on a cadaver specimen. The proficiency will depend on the time of completion of surgery. This will help in evaluating trainees ability to learn surgical techniques according to assessment tools. Both knowledge and cadaver test will assist in differentiating between a novice surgeon and an accomplished surgeon (7). Accurate training on surgical skill is necessary for satisfactory accreditation and to satisfy the community regarding the safety of the surgical technique. It is important for surgeons to prove their competency skills by the end of training programs. They should have declarative knowledge of surgery which means knowing about technical skills followed by their safe implementation in real clinical situations. The decision to label a surgeon surgically competent' depends on an assessment of record of in-training assessment (RITA) followed by written and oral test (3). However, this is not foolproof as many excel in the test but are technically deficient. It highlights the need for an alternative method of instruction and improving surgical skills and assessment methods (8). A theorist learner will adapt and integrate skill programmes teaching into logical theories. They will benefit extensively from the skill teaching programme. They will analyze patient's problems in a logical way. Even if they fail in initial skill assessment, they will not rest until they hone their skills. They value rationality and logic. They will assimilate each element of skill teaching programs and frequently question themselves like how does this step fit into my surgical practice?','what are the basic assumptions of the process?'. They always seek logical ways to solve problems and their effort is on maximizing certainty. Groat and Musson framework of learning style will be beneficial for such persons, and they will prefer challenging explanation of operation to debate the plan of action (5). They will benefits from skill programme as they will try to learn better from training and facts. Reference Caulley L, Wadey V, Freeman R. Learning styles of first-year orthopedic surgical residents at 1 accredited institution. Journal of surgical education. 2012 Apr 30;69(2):196-200.Dougherty P, Kasten SJ, Reynolds RK, Prince ME, Lypson ML. Intraoperative assessment of residents. Journal of graduate medical education. 2013 Jun;5(2):333-4.Ghaderi I, Manji F, Park YS, Juul D, Ott M, Harris I, Farrell TM. Technical skills assessment toolbox: a review using the unitary framework of validity. Annals of surgery. 2015 Feb 1;261(2):251-62.Hull L, Arora S, Symons NR, Jalil R, Darzi A, Vincent C, Sevdalis N. Training faculty in nontechnical skill assessment: national guidelines on program requirements. Annals of surgery. 2013 Aug 1;258(2):370-5.Luckin R, du Boulay B. of Supporting Model Building in Learning Science. The Role of Communication in Learning To Model. 2014 May 12;1:99.Mitchell EL, Arora S, Moneta GL, Kret MR, Dargon PT, Landry GJ, Eidt JF, Sevdalis N. A systematic review of assessment o f skill acquisition and operative competency in vascular surgical training. Journal of vascular surgery. 2014 May 31;59(5):1440-55.Noland SS, Fischer LH, Lee GK, Hentz VR. Essential hand surgery procedures for mastery by graduating orthopedic surgery residents: a survey of program directors. The Journal of hand surgery. 2013 Apr 30;38(4):760-5.Putnam MD, Kinnucan E, Adams JE, Van Heest AE, Nuckley DJ, Shanedling J. On Orthopedic Surgical Skill PredictionThe Limited Value of Traditional Testing. Journal of surgical education. 2015 Jun 30;72(3):458-70.

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