How could surgery experience be HIP? The National Survey of Student Engagement (NSSE) has identified the High Impact Practices (HIPs) as; learning community, community-based project (service-learning), undergraduate research, co-op, internship, field experience, student teaching, clinical placement, study abroad, and culminating senior experience such as capstone course, senior project or thesis, comprehensive exam, portfolio, or other similar learning opportunities. One of our bright students, Sarah Trent, creatively combined two of the HIP practices; undergraduate research and study abroad during the summer 2016. Sarah’s blog tells the story of her journey and summer research experience abroad. Sarah is biology major (class of 2018) and Spanish minor from Medford, N.J. At Loyola, Sarah is involved in Health Outreach Baltimore and a member of the Honors Program and the women’s swim team.
Bahram Roughani
Associated for the Natural and Applied Sciences
Loyola University Maryland
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This summer, I won a scholarship through the German Academic Foreign Exchange Program (DAAD) to research at Heidelberg University Hospital, an institution regarded as one of the leading teaching hospitals and medical schools in all of Germany. I found the scholarship through the Office of National Fellowships here at Loyola. At Heidelberg, I Participated in surgical education research, specifically in minimally invasive surgery.
Minimally invasive surgery (MIS) is a type of surgery in which the surgeon makes small incisions, no larger than the size of a penny, and uses long, thin instruments to perform the procedure. A small camera called an endoscope is inserted into an incision to project the image of the operating field onto a monitor. MIS provides great benefits to patients by reducing tissue trauma, wound complications and scarring as opposed to open surgery. However, MIS surgeons encounter limitations such as indirect view of the operating field and restricted degree of motion. It is difficult for new surgeons to become proficient in MIS, as MIS instruments are complex and unfamiliar to new surgeons and thus yield steep learning curves. MIS of the abdomen is specifically called laparoscopy. My MIS research focused on laparoscopic training.
MIS Developments
During my summer in Heidelberg, I assisted in the development of a sensor- and expert-model based laparoscopic training system. The device specifically targets task training in intracorporal suturing and knot tying (ICKT).
Optical tracking devices and sensors, specifically NDI Polaris, Microsoft Kinect v1 (more recently we’ve incorporated the v2) and electromyography, were used to record performance data from experts in the field of laparoscopy. This data was plotted to construct expert motion models with an optimal curve for each task or procedure. The same sensors can record a trainee’s motions and compare them to the expert models, thus providing continuous individualized, real-time feedback to the trainee. Ultimately, the goal of the system is to shorten the learning curve of complex laparoscopic skills.
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MIS Research
I also worked on a study that explored the best methodology for teaching and training laparoscopy. The aim of this study was to compare the effectiveness of Halsted’s classic surgical training dogma, “see one, do one, teach one,” with Peyton’s Four-Step Approach, which consists of demonstration, deconstruction, comprehension and performance, in teaching ICKT to medical students. [Fun Fact: Halsted was from Baltimore!] After analysis, Peyton’s Four-Step Approach appeared to be the preferable method for learning complex laparoscopic skills like ICKT. The publication of this study will be my first co-authorship!
Thank you Heidelberg, DAAD, and Loyola for allowing me the opportunity to take my first step into medical research and to get a taste of what it takes to be a surgeon.
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