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  1. #1
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    Default Surgery students 'losing dexterity to stitch patients'

    Visit www.inthewoodshop.com for tutorials on constructing handtools, handtool reviews, and my trials and tribulations with furniture builds.

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  3. #2
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    Interesting but not surprising. We will just have to revert to the barbers and carpenters for surgery as they did in yesteryear.
    Tom

    "It's good enough" is low aim

  4. #3
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    I'm also not surprised. My seven year old daughter is expected to do all her maths and reading homework via computer.
    The reading side we just refuse and give her books instead.

    I find it interesting that the Nordic countries which are top of the education tables structure their learning the complete opposite. Minimal screen time, minimal homework, with arts and crafts being as important as the STEM subjects.

  5. #4
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    Practice makes perfect like with everything else. The payoff is that students are generally more technology literate but less handsy.

  6. #5
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    Quote Originally Posted by Fergiz01 View Post
    Practice makes perfect like with everything else. The payoff is that students are generally more technology literate but less handsy.
    Not sure that's even true, they know how to play games, take photos, upload and download stuff but most wouldn't have a clue what's under the hood or how to do stuff at a basic level.

  7. #6
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    Quote Originally Posted by BobL View Post
    Not sure that's even true, they know how to play games, take photos, upload and download stuff but most wouldn't have a clue what's under the hood or how to do stuff at a basic level.
    How true. My daughter did her nursing training in the hospital system and now tells some frightening stories about graduates from the current system - academically great but but little idea practically
    Tom

    "It's good enough" is low aim

  8. #7
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    As a primary school teacher my daughter has noticed an increasing lack of dexterity among the children. You would think by the time children get to school they could, for example, operate scissors and cut paper but often they're learning to do such tasks for the first time while at school. To help improve their dexterity she asked me to make sets of various wooden blocks that could be put together with bolts and nuts.

  9. #8
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    Quote Originally Posted by Fergiz01 View Post
    Practice makes perfect like with everything else. The payoff is that students are generally more technology literate but less handsy.
    Personally,
    I find it a bit disturbing to see a doctor who is “practicing”
    Especially if I’m seeing them without an appointment at accident and emergency department [emoji849][emoji849].

    Cheers Matt,
    (Saying that my last two rounds of stitchers were excellent one being facial and all)

  10. #9
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    Derek,

    What is equally concerning is the feedback coming from the US that new trainees of robotic surgery are failing to learn to use the robots because they can’t engage in the surgery whilst learning. The method means they can’t see and do under guidance.
    The design of the machine means the trainee sits off to the side and can’t ‘get their fingers dirty’ so are learning from you tube vids and from simulators rather than practicing on humans.

    More concerning is that the trainees are graduating but their older peers don’t think they should! Clearly we need a better way to train for robotic surgery..

    (I learnt this after robotic kidney re-plumbing a few weeks ago.. and yes I did intentionally choose a young but experienced robotic surgeon in a capital city. He did a fine job. I now look like I’ve been in a bar fight with what looks like 6 random stab scars across my guts - but the plumbing works really well!)

  11. #10
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    Quote Originally Posted by Fergiz01 View Post
    Practice makes perfect like with everything else. The payoff is that students are generally more technology literate but less handsy.
    I've got to agree with BobL, the kids are just turned into game players and social media consumers - there is no training in web development, programming, cyber-security, or anything productive.

    Heck, there are kids in my daughter's cohort who don't know the whole alphabet, or all the months of the year, and my daughter only knows her times tables because I (and an Aldi poster on the back of the toilet door) taught her.

  12. #11
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    Hmmm, times change, gentlemen! The human race has adapted to many new ways of doing things during its time on earth. Lets face it, if most of us were handed a spear & a spear-thrower & told to go fetch lunch, there would be a few hungry kinder before it appeared!

    I know I've done my share of whinging about students who can't sharpen a knife to cut butter, & seem dangerously clumsy wielding them, but most eventually get there with a bit of help & encouragement. I'd say learning to suture would be among the least of the challenges a young surgeon faces. Funny how they are judged by how neat the external sutures are - it's what's down there beneath them that would concern me more!

    It's not just the manual dexterity, which the average person will manage to acquire without too much pain (to either party), it's all the knowledge that needs to go with it that has to be acquired. Spare a thought for the folks who have to design courses that jam enough into the time allowed to cover what's required to become even marginally competent. Then there are 'ethics committees' to deal with, unheard of in my student days, that make rules forbidding a student from 'practising' on a live animal. How are you supposed to learn to swim without getting wet??

    During my lifetime, human & veterinary medicine has changed dramatically. I have often, like most "Old Hands" shaken my head at the younger generation and their seeming lack of abilities I took for granted. But take heart, the treatment you get today for serious conditions is likely to be far better & more efficacious than anything you might have received in 1930. Progress happens in spite of ourselves....

    Cheers,
    IW

  13. #12
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    Quote Originally Posted by IanW View Post
    It's not just the manual dexterity, which the average person will manage to acquire without too much pain (to either party), it's all the knowledge that needs to go with it that has to be acquired. Spare a thought for the folks who have to design courses that jam enough into the time allowed to cover what's required to become even marginally competent. Then there are 'ethics committees' to deal with, unheard of in my student days, that make rules forbidding a student from 'practising' on a live animal. How are you supposed to learn to swim without getting wet?? ,
    My experience was that there is plenty of time in a students week to learn more, it's just that the bean counters have cut the $ to fund hands on lab work. Over my time working at Uni, supervised first year lab work in the subjects I taught was cut from 84 hours a year to 48 hours a year. 3rd year was cut from 168 hours a year to 72 hours a year and for students in certain streams the lab work was "optional". Result was some students would arrive in Honours and attempt to undertake research and could barely use basic instrumentation like an oscilloscope. In first year we had to swap solid subjects in programming and data processing for a dumbest common denominator compulsory subject on word processing and presentation skills. We used to open up labs for senior students to practice working on experiments by themselves (there was always an on duty supervisor that they could call on for help but that supervisor had to cover a number of rooms) but that got canned by the OHS people.

  14. #13
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    Quote Originally Posted by arose62 View Post
    Heck, there are kids in my daughter's cohort who don't know the whole alphabet, or all the months of the year, and my daughter only knows her times tables because I (and an Aldi poster on the back of the toilet door) taught her.
    Quote Originally Posted by IanW View Post
    Hmmm, times change, gentlemen! The human race has adapted to many new ways of doing things during its time on earth. Lets face it, if most of us were handed a spear & a spear-thrower & told to go fetch lunch, there would be a few hungry kinder before it appeared!
    with respect Ian, arose is more perspective than he knows.
    Come the middle years of high school, and I'll wager that his daughter will be the only one in her cohort who is capable of continuing with the STEM subjects.

    Been there seen that. Kids without a solid grounding in their times tables really struggle when it comes to balancing chemical equations where inherent knowledge of times tables, lowest common multiples and highest common divisors is essential.
    You can't balance 6 equations in the time allotted if you have to use a calculator to divide 6 by 3 or multiple 5 by 4.


    I know I've done my share of whinging about students who can't sharpen a knife to cut butter, & seem dangerously clumsy wielding them, but most eventually get there with a bit of help & encouragement. I'd say learning to suture would be among the least of the challenges a young surgeon faces. Funny how they are judged by how neat the external sutures are - it's what's down there beneath them that would concern me more!
    if they can't suture neatly how could you responsibly let them sew up an aorta or bowel?
    regards from Alberta, Canada

    ian

  15. #14
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    These kinds of stories are popular, but meaningless. The standard of care in the last 50 years has increased several fold. At the same time, there will always be retiring physicians who decry students who can't do what they could do (but do, in fact in the context of a system provide a standard of care and with consistency they couldn't have dreamed of. It may be with the aid of less "gut feeling" and more data and analysis based tools, but I seriously doubt people will be walking from hospital facilities laid open or with giant gloms of folded scar tissue because students couldn't make stitches. )

    Each generation is there to tell us how the next generation can't do what they did and how the end is near for all of us.

    Nobody caught the professor's name? Dr. Kneebone?

  16. #15
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    I can believe that the internal stitching is sloppy. I've seen it.
    Surface closures are OK with staples, probably less tissue insult in the long term (once again, no skill suturing.)

    Real practice is no more complicated than suturing cuts in a strength of gelatin or agar in a Petri dish.
    It's the repetition that makes the result. It's pride in craftsmanship.

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