|Tipo di tesi||Tesi di laurea magistrale|
|Titolo||COME SUPERARE IL GAP FORMATIVO DEI GIOVANI CHIRURGHI DOVUTO ALLA PANDEMIA DI COVID-19. CONCEZIONE DI UN PROGRAMMA SPERIMENTALE DI FORMAZIONE IN CHIRURGIA ROBOTICA: DALLE COMPETENZE DI BASE ALLE PROCEDURE A BASSA COMPLESSITÀ.|
|Titolo in inglese||HOW TO OVERCOME YOUNG SURGEONS TRAINING-GAP DUE TO THE COVID-19 PANDEMIC. CONCEPTION OF AN EXPERIMENTAL TRAINING PROGRAM IN ROBOTIC SURGERY: FROM BASIC SKILLS TO LOW COMPLEXITY PROCEDURES.|
|Struttura||Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze|
|Corso di studi||MEDICINA E CHIRURGIA (D.M.270/04)|
|Data inizio appello||2022-07-14|
|Disponibilità||Accesso limitato: si può decidere quali file della tesi rendere accessibili. Disponibilità mixed (scegli questa opzione se vuoi rendere inaccessibili tutti i file della tesi o parte di essi)|
|Data di rilascio||2062-07-14|
La chirurgia robotica rappresenta la più grande rivoluzione in campo chirurgico degli ultimi 20 anni, tuttavia la formazione dei giovani chirurghi in questo campo è ancora ostacolata da diversi fattori. La pandemia COVID-19 ha ulteriormente aggravato il problema della formazione chirurgica con una grave riduzione del numero di interventi. Ciò ha creato una situazione in cui solo pochi chirurghi erano coinvolti, poiché non tutti gli operatori sono soliti eseguire procedure robotiche e i chirurghi junior non erano pronti a utilizzare la piattaforma robotica in modo autonomo. Inoltre, molti chirurghi sono stati impiegati in unità COVID-19 dedicate, causando così una completa interruzione della formazione chirurgica. La situazione sopra descritta ha avuto un impatto negativo anche sulla salute mentale e sul benessere dei chirurghi, che hanno mostrato un aumento dello stress e delle preoccupazioni per il loro futuro.
Robotic surgery represents the greatest revolution in surgery of the last 20 years, however there are still challenges to young surgeons' training in this field due to different obstacles. The COVID-19 pandemic had further exacerbated the problem of surgical education with a severe reduction of the number of surgeries. This created a situation in which only few surgeons were involved in surgical practice, since not every attending usually performs robotic procedures and junior surgeons weren't ready to use the robotic platform autonomously. Moreover, many surgeons were deployed in dedicated COVID-19 units, thus causing a complete disruption of surgical education. The above-mentioned situation made the negative impact also on mental health and wellbeing of the surgeons, who showed increased stress and concerns for their future. The UO of Surgery at Ospedale Civile di Baggiovara designed an experimental robotic training program divided in three Phases: Preclinical, Bedside, and Console step. Every member of the surgical team was included in a training group based on previous experience in robotic surgery. In this study we specifically took under consideration the group with few or no previous experience who took part in the Preclinical step. Trainees participated to theorical lessons and then went through practical training every other Saturday for two months. The Preclinical step included 13 exercises performed at the DaVinci® simulator, as well as dry lab training. To evaluate the impact of Covid-19 on the wellbeing of the trainees and the possible benefits of the training program on this aspect two questionnaires were administrated to all participants (Entry and Exit questionnaire). 16 Residents and 14 Attendings took part in the Preclinical Step. Camera 0, Clutch and Energy Pedals were taken under consideration at the simulator. For every exercise there was an improvement of the results from the first to the last attempt. Attendings had lower starting scores with a steeper implementation trend and they couldn’t exceed resident’s scores in the Energy Pedal exercise. While before the pandemic 80% of trainee performed more than 10 surgeries per month, after the pandemic 67% performed less than 10 procedures per month. 100% of the attendings reported to feel more stressed during the pandemic. At the end of the course 100% of participants found the course useful for their educational growth and a powerful tool to enforce team spirit and collaboration between different departments. All participants expressed in favor of introducing the course as a permanent part of the clinical practice. 67% of trainees declared that the training program could fill the educational gap created by the pandemic. 33% of participants experienced a beneficial effect of the program on personal wellbeing. The pandemic drastically reduced both work and teaching activities of surgeons thus leading to a gap in surgical training. The negative impact of the pandemic shifted from technical skills to personal wellbeing and perceived stress. The introduction of a structured training program proved to be effective on both aspects. Attendings started from lower scores at the simulator with a steeper learning curve but reached better final results than the residents, except in the Energy Pedal. Thus, previous laparoscopic experience does not impact on robotic skills, especially for simple tasks. The robotic platform is a complex machine that requires several degrees of training, and a direct passage from laparoscopy to robotics, without adequate training seems to be challenging. The structured training program not only improved technical skills but also team spirit and had a positive impact on participants wellbeing. Having a structured and well-organized didactic program could allow for more surgeons to be trained more quickly.