SCAPEL

Team Leader

Joy Etike

Project Overview

Project Name:

SCAPEL

One-line project summary:

Allow Gynaecological & General Surgeons to become confident in performing Abdominal Hysterectomy as part of the Surgical management for PPH

Pitch your project.

SCAPEL an educational online platform that consists of video-based contents for lectures and necessary "know-how" for building a bench simulation-training model to provide knowledge, skills, self-assessment and peer review for improved surgical skills on abdominal hysterectomy targeted towards resident gynecologists' and general surgeons in order to allow gradual transition of the users from their theoretical experience to a practical setting.

Its key features includes Video-based content for training, Self Review using checklist, Interactive community of surgeons for peer review and Case Based Quiz (CBQ).

We also propose using Kirk Patrick Model to evaluate our training and assessment tools. Developed originally in 1959, this model is very simple to use, with clear and measurable metrics. It is a useful and validated model for evaluating the effectiveness of training models in several sectors

What is your surgical training module?

SCAPEL Is an educational online platform that consists of video-based contents for lectures and necessary "know-how" for building a bench simulation-training model to provide knowledge, skills, self-assessment and peer review for improved surgical skills on abdominal hysterectomy targeted towards resident gynaecologists' and general surgeons.

We have envisioned SCAPEL to have 4 core features
1. Video-based content for trainings
2. Self Review of simulation using checklist
3. Interactive community of surgeons for peer reviews
4. Case Based Quiz games(CBQ)

During the "practice mode", i.e. when learners are simulating the procedure on bench model, they are simultaneously videoing themselves with their phones either hung on a tripod stand or using a head strap to hold the phone.

After recording, users review their videos using the associated task-specific checklist and rate themselves on a scale of 1-5 (5 represents "Confidently done" and 1 represents "Not done"). One of the major known problem of self-assessment is the fact that junior or less experienced learners tend to over-rate themselves and vice versa which is why we also introduced a peer review feature.

After self assessment with the checklist, learners can post the recorded practice video on SCAPEL online community. This community gives learners the opportunity to get feedbacks and also provide feedbacks to other learners. Just as with other learning community, users can react to a posted video by upVoting, downVoting and making comments directly on the video timelines.

Finally, SCAPEL provides users with a Case-Based Quiz (CBQ) game feature. This quiz assesses the cognitive, theoretical and decision making skills of a learner using descriptive real-life scenario questions.

What specific surgical skills are you teaching?

In 2015, WHO reported 800/100,000 Post-Partum Heamorrage (PPH) related maternal mortality with a total of over 58,000 deaths that same year in Nigeria. While PPH has become treatable and manageable in developed countries, Nigeria still remains far behind especially when emergency surgical intervention becomes necessary. Some of the surgical skills needed to perform certain emergency obstetrics procedures are scarce especially in smaller hospitals, primary health centres and among young surgeons. Since, PPH can be managed effectively with alternatives approaches that have fewer risks than open surgery, abdominal hysterectomy is only appropriate in severe cases, such as placenta accreta/increta/percreta, uterine rupture or when other fertility-preserving procedures proves abortive. This makes residents have less exposure to the procedure, with the largest impact occurring in early learners. Infact, with the advent of Minimal Invasive Surgeries (MIS), most resident surgeons may get more exposure in laparoscopic and vaginal hysterectomy than Abdominal hysterectomy. Thus, there is an inevitable need for a simulation training to complement operating room experience for AH before it becomes a surgical skill decay.

Who does your project serve, and in what ways will the project improve their skills?

The target users for SCAPEL are resident obstetricians, gynecologists and general surgeons in Nigeria. We have included general surgeons because in many small hospitals, especially in the rural areas, general surgeons will most likely be the only available surgeon during childbirth. They should be able to manage a severe PPH situation if the need arises.

Generally, the needs of resident surgeons in Nigeria is more practice and less service provision. Surgical challenges now comprise a huge burden of disease in Nigeria, hence, due to a high demand of surgical procedures, residency in Nigeria is now perceived to provide more of service than learning experience for the junior surgeons. As such, surgeons may be involve in procedures outside their domain or be performing a procedure for the first time directly on a patient.

Even in obstetrics and gynaecology, where quick surgical procedure may be needed to prevent mortality or severe morbidity, we still have not paid required attention to the level of surgical training for residents before OR experience. Hysterectomy for instance is only done by experts surgeons and mostly during a begnin diagonsis. Performing this same procedure for PPH management puts a surgeon under a different kind of pressure.

In what city, town, or region is your project team headquartered?

Lagos, Nigeria

What is your project's stage of development?