MEDICAL UNIVERSITY PLOVDIV

PROJECT 2008-1-BG1-LEO05-00454/LLP Leonardo da Vinci Transfer of Innovation.

ENDOSCOPIC CARPAL TUNNEL RELEASE

PROJECT OBJECTIVES:

Need analysis - identifying and analyzing requirements of orthopaedic surgeons, anesthesiologists, medical and technical stuff in Bulgaria, Ireland and Greece

Selecting and analyzing innovative content to meet these requirements

Transferring the PSS approach in medical training and developing an intelligent medical performance support environment for surgery training

Pilot test of the system

WORK PROGRAMME OF MEDICAL UNIVERSITY PLOVDIV: Need analysis Selection and adaptation of course content Development of a course on ENDOSCOPIC

CARPAL TUNNEL RELEASE Pilot test of the system including usability tests Dissemination of project results Exploitation – implementation of the course in the

regular training and teaching activities of Medical University Plovdiv and in long term in the lifelong learning e-health national environment.

NEED ANALYSIS

PURPOSES OF NEED ANALYSIS Identify and analyse user requirements and

training needs on innovative eLearning materials and problem-based learning skills in endoscopic carpal tunnel release

Collect information directly related to the nature of the interactive multimedia products

INSTRUMENTATION OF NEED ANALYSIS

Questionnairies The questionnaires were published on the

Web site of SurveyMonkey.com, printed versions were distributed to orthopaedic surgeons and residents on daily morning conferences. Partners from the University of Cork and Vita Hospital were asked to make the survey. 34 people made the survey and 31 finished it.

NEED ANALYSIS RECOMMENDATIONS Specify clearly defined objectives before the

training begins Follow a series of defined steps to reach the

level of competence Base training of medical skills on problem

based learning approach and real time feedback

Assessment criteria should be specified as part of the training process

RESULTS OF NEED ANALYSIS Medical University – Plovdiv, Bulgaria

presented the analysis of specific requirements of orthopaedic surgeons with regard to the content and techniques for delivery of training materials in the OnLineOrtho system in Bulgaria

Surgeons need courses providing knowledge about new surgical techniques that are used in daily practice

COURSE CONTENT

MODULES

Module 1: CARPAL TUNNEL SYNDROME - TREATMENT METHOD CHOICE

Module 2: ENDOSCOPIC CARPAL TUNNEL RELEASE TECHNIQUE

Module 1 Task 1: DISCUSS FUNDAMENTALS OF CARPAL TUNNEL SYNDROME

Task description: Discuss etiology, natural history, and complications

of carpal tunnel syndrome - the most common entrapment neuropathy.

Instructions: 1. Define carpal tunnel syndrome

2. Identify causes and associated disorders3. Describe clinical symptoms and signs4. Describe diagnostic tests5. Discuss carpal tunnel anatomy6. Describe median nerve within the carpal tunnel

Module 1 Task 2: COMPARE METHODS OF CARPAL TUNNEL RELEASE Task description: Identify the treatment methods of carpal tunnel

syndrome, and compare surgical release procedures.

Instructions: 1. Discuss conservative treatment.

2. Discuss conventional carpal tunnel release.3. Discuss endoscopic carpal tunnel release with 2 incisions.4. Discuss single portal endoscopic carpal tunnel release.5. Compare endoscopic vs open surgery.

Module 2 Task 1: DISCUSS FUNDAMENTALS OF THE SINGLE PORTAL ENDOSCOPIC

CARPAL TUNNEL RELEASE TECHNIQUE Task description: Describe the fundamentals and define the steps of the single

portal endoscopic carpal tunnel release technique. Instructions: 1. Define the steps of the single portal endoscopic carpal tunnel

release technique. 2. Identify major superficial anatomical landmarks. 3. Identify major endoscopic landmarks. 4. Watch the video and define the steps of the technique. 5. Define the instrumentation necessary for the endoscopic

surgical procedure.

Module 2 Task 2: CHOICE OF METHOD OF TREATMENT FOR CARPAL TUNNEL SYNDROME Task description: Describe the objectives of choice of method of

treatment of carpal tunnel syndrome. Instructions: 1. Discuss options for conservative treatment. 2. Describe surgical treatment fundamentals,

regardless of the specific surgical technique. 3. Discuss perioperative treatment. 4. Describe outcome options based on choice of

method of treatment.

PILOT TEST

AIM OF THE PILOT TEST

To examine the functionality and usability of: IPSS e-learning material

To elicit the attitudes of the users To explore satisfaction of the organizations

involved To identify relevant information from existing

and new resources that can provide further feedback to developers to improve the system

PARTICIPANTS IN THE PILOT TEST 7 RESIDENTS IN ORTHOPAEDIC SURGERY 7 ORTHOPAEDIC SURGEONS PLACE: MEDICAL UNIVERSITY PLOVDIV,

DEPARTMENT OF ORTHOPAEDICS AND TRAUMATOLOGY

PILOT TEST ORGANISED BY: Dr. Keti Tokmakova and Dr. Petar Molchovski

QUESTIONAIRE CREATED BY: Dr. Gabrielle Iohom

EVALUATION OF PILOT TEST Measurement Instrument: developed and elaborated by Cork

University Hospital, Ireland in collaboration with the coordinators of the program (University of Thessalia, Greece,BIOMED, Greece, DIPSEIL group, Bulgaria)

Evaluation of the following elements: performance support and its aspects usability of the system attitudes of the users regarding the online learning environment organization of the learning tasks the overall performance support environment considering the

individual learning and practicing process

RESULTS OF PILOT TEST

Users were satisfied with the

Simplicity

Efficiency and

Usability of the system

RESULTS OF PILOT TEST

System was considered

well-organized

user-friendly

substantially supportive and

well-defined in its contents and procedures

CONCLUSIONS OF PILOT TEST Respondents seemed to favor the internet-based learning

approach

Users were satisfied with how information and images were presented on screen, and the whole configuration of the system

System provides adequate, clear and precise information

Incorporating different aspects in the process of exploring and studying the particular subject matter with inclusive and easy to find information was highly acknowledged

DISSEMINATION

UNIVERSITY OF THESSALY, BIOMED AND MEDICAL UNIVERSITY PLOVDIVDISSEMINATION OF PROJECT RESULTS 11th EFORT Congress 2010, 2-5 June 2010,

Madrid, Spain

Intra-articular distal radius fractures: importance of different tools for minimally invasive surgical treatment – Dailiana Z., Besdekis G., Vartimidis S., Karamanis N., Kazantzi V., Rizos P., Fotiadis D., Iohom G., Tokmakova K., Molchovski P., Malizos K.

UNIVERSITY OF THESSALY, BIOMED AND MEDICAL UNIVERSITY PLOVDIVDISSEMINATION OF PROJECT RESULTS 11th EFORT Congress 2010, 2-5 June 2010,

Madrid, Spain

Minimally invasive surgical treatment of scaphoid fractures – Daliana Z., Vartimidis S., Giannakos R., Kazantzi V., Rizos P., Fotiadis D., Iohom G., Tokmakova K., Mileva N., Malizos K.

MEDICAL UNIVERSITY PLOVDIVDISSEMINATION OF PROJECT RESULTS 15th Congress of FESSH, 23-26 June, 2010,

Bucharest, Romania

Endoscopic carpal tunnel release – an on-line training course – Tokmakova K., Molchovski P., Atanassov A., Atanassova P., Mileva N., Stoyanova S.

MEDICAL UNIVERSITY PLOVDIVDISSEMINATION OF PROJECT RESULTS 7th SICOT/SIROT Annual International

Conference, 30 August – 3 September, 2010, Gothenburg, Sweden

Endoscopic carpal tunnel syndrome treatment – an on-line training course – Tokmakova K., Molchovski P.

EXPLOITATION

XI National Congress of the Bulgarian Orthopaedic and Traumatologic Association (BOTA). 06 -10.10.2010, Golden Sands, Varna, Bulgaria

Exploitation - Project presentation and discussion on implementation of the course in the regular training and teaching activities of Medical University Plovdiv, BOTA and in long term in the lifelong learning e-health national environment.