Simulation-based training in maxillofacial surgery: are we going to be left behind?

Simulation is an important way both to optimise a trainee’s learning time and reduce morbidity and operating time for patients. We have reviewed the current use of simulation in training for maxillofacial surgery, and provide an overview of areas of practice where it may be useful. A web-based survey of trainees’ opinions of it was made in February 2018, and disseminated using the Junior and Fellows in Training group mailing lists. We also reviewed popular current simulation courses that are available. A total of 45 of the 57 trainees who replied agreed that simulation-based training would be beneficial in maxillofacial surgery, particularly with regard to maxillofacial surgical emergencies. A total of 54 of the 57 also agreed that simulation-based training would be a useful adjunct to their clinical training. However, most of the simulation-based courses available were priced beyond the budgets available to UK-based trainees for study, although funding changed in April 2018. While other surgical disciplines have adopted simulated clinical teaching and its benefits, maxillofacial surgery has limited the use of all types of formal simulation. Surgical simulation training is increasingly being used to complement the traditional surgical apprenticeship in other specialties, and ours needs to consider ways in which we can use it, given that trainees within the specialty think that it would be useful. Other specialties have shown that there is good transfer of skills from simulation to the actual clinical operating environment, and this increases satisfaction, decreases morbidity, and reduces the time required for intraoperative teaching.     

Training simulation for oral and maxillofacial surgeons based on the techniques of arthroscopy in the temporomandibular joint

Arthroscopy is a diagnostic-therapeutic technique used in the treatment of disorders of the temporomandibular joint (TMJ). The difficulties of arthroscopy lie in the manipulation of the tools, which is why training in the technique of triangulation in artificial models is essential. We developed a training system based on the techniques of arthroscopy in the TMJ, using simulators. The first simulator was a metal box containing three holes for insertion of the instruments, and the second was a human artificial model made of polymers. We found that they facilitated training in the techniques of arthroscopy, which subsequently reduced operating time and led to a better execution of skills in reality.     

Professional paths of alumni from doctorate programs in health and biological sciences

OBJECTIVE

To analyze the career path and professional satisfaction of alumni from the doctorate degree programs in health sector.

METHODS

Exploratory study with 827 alumni of doctoral programs in public health, biological and health sciences at the Fundação Oswaldo Cruz , RJ, Southeastern Brazil, from1984 to 2007. The subjects were grouped in three cross-temporal cohorts according to year. The profiles of the alumni were analyzed, their career paths mapped and information on the perceptions of the education they received and the reasons that led them to choose the institute for their doctoral courses gathered, as well as their evaluations of the courses. The data were collected by means of an online questionnaire.

RESULTS

There are differences between cohorts of alumni related to the periods they followed the courses, their distinct educational backgrounds and labor processes between those from the biological and health sciences areas, and to the specificities of the different areas where the institution offers doctoral courses: public health, biological and health sciences.

CONCLUSIONS

The results allow the academic management of the educational processes to expend its knowledge, thus establishing a baseline for tracking the trajectory of alumni, and may contribute to upgrading the follow up process of Brazilian graduate programs.     

纤维鼻咽喉镜吞咽功能检查对脑卒中吞咽障碍患者摄食训练的指导价值

目的 分析纤维鼻咽喉镜吞咽功能检查(FEES)对脑卒中吞咽障碍患者摄食训练的指导价值。方法 采用随机信封法将2019年1月-2021年1月北京市大兴区中西医结合医院和北京市丰台区南苑医院收治的120例脑卒中吞咽障碍患者分为观察组(n=60)和对照组(n=60)。对照组采用标准吞咽功能评估(SSA),在阴性后进行摄食训练,观察组采用FEES,在阴性后进行摄食训练,最终观察组纳入55例,对照组纳入54例。比较治疗前1周和治疗后1周两组患者的动脉血气分析、并发症发生情况、误吸程度、吞咽功能评级和安全性指标水平。结果 两组患者治疗后动脉血二氧化碳分压(PaCO₂)水平、误吸和腹胀发生率均较治疗前降低,且观察组较对照组低;观察组肺部感染发生率低于对照组;两组患者治疗后动脉血氧分压(PaO₂)和动脉血氧饱和度(SaO₂)水平均较治疗前升高,且观察组较对照组高;治疗后,两组患者误吸程度均较治疗前减轻,且观察组优于对照组;治疗后,两组患者吞咽功能均较治疗前改善,且观察组优于对照组,差异有统计学意义(P <0.05)。结论 脑卒中吞...