000			12803namaa22004331i 4500
003			OSt
005			20250223033258.0
008			240916b2023 |||a|||f |m|| 000 0 eng d
040			_aEG-GICUC _beng _cEG-GICUC _dEG-GICUC _erda
041	0		_aeng _beng _bara
049			_aDeposite
082	0	4	_a618.14
092			_a618.14 _221
097			_aM.Sc
099			_aCai01.11.15.Ph.D.2023.Ha.R
100	0		_aHagar Ali Mohammed Ali Elnashar, _epreparation.
245	1	0	_aRole of virtual reality simulators in basic hysteroscopy training competence/ _cBy Hagar Ali Mohammed Ali Elnashar ; supervision of Prof. Ahmed Mahmoud Fawzi El-Minawi, Prof. Nadine Alaa Sherif, Asst. Prof. Marwa Fouad saad Sharaf
246	1	5	_a/دور ﻣﺣﺎﻛﺎة اﻟواﻗﻊ اﻻﻓﺗ ارﺿﻲ ﻓﻲ كفاءة اﻟﺗدر ب ﻓﻲ ﻣﻧظﺎر اﻟرﺣم
264		0	_c2023.
300			_a111 pages : _billustrations ; _c25 cm. + _eCD.
336			_atext _2rda content
337			_aUnmediated _2rdamedia
338			_avolume _2rdacarrier
502			_a Thesis (Ph.D)-Cairo University, 2023.
504			_aBibliography: pages 88-111.
520			_aBackground and rationale: Diagnostic or operative hysteroscopy is one of the most common surgical intervention in gynecological surgery. In recent years, it has acquired a central role in diagnosis and treatment of a variety of uterine pathologies like fibroids, polyps and uterine malformations (Gambadauro et al., 2014; Di SpiezioSardo et al., 2008 and Capmas et al., 2016). It is also pivotal in the management of primary or secondary infertility (Lorusso et al., 2008). Biopsy specimens are also sampled with hysteroscopy in the diagnosis of endometrial cancer (Clark et al., 2002). In recent years, the technological advancements such as the use of small diameter (3,5mm) rigid hysteroscopes combined with “no touch” techniques have made hysteroscopy a commonly accepted procedure (Bettocchi et al., 2003 and Mairos and Martino, 2016). As a minimally invasive procedure, hysteroscopy is associated with fewer complications than traditional open surgery (Elessawy et al., 2017). However, it is challenging to gain manual dexterity in hysteroscopy because of the fulcrum effect and the orientation between the two-dimensional screen and the three-dimensional uterine cavity. Other difficulties are the diminished tactile feedback and limited degrees of freedom (Korndorffer et al., 2005). Lack of proficiency in hysteroscopy can compromise patient safety by causing uterine perforation and trauma to neighboring organs. Also, pulmonary air embolisms and pulmonary edema are potential life-threatening complications (McGurgan and McIlwaine, 2015). Today it is generally accepted that the traditional apprentice-tutor model is no longer valid for training all skills necessary in Gynecological surgery and more specifically endoscopic surgery (Campo et al., 2016). This agreement is based on the recognition that, in contrast to open surgery, endoscopic surgery demands surgical skills and psychomotor skills that should not necessarily be trained simultaneously. Increasing evidence strongly suggests that psychomotor skills must be trained earlier and outside the operating room, and several models have been proposed for this aim (Sroka et al., 2010; Diesen et al., 2011; Munro, 2012; Mulla et al., 2012; Escamirosa et al., 2015 and Hofstad et al., 2013). Dawe et al., has shown that participants who reach proficiency in simulation-based training performed with higher global assessment scores and with fewer errors during patient-based encounters than their counterparts who did not receive simulation training (Dawe et al., 2014). Simulation-based training with virtual reality offers a great opportunity to achieve the technical skills of hysteroscopy in a safe and controlled learning environment prior to clinical practice on patients (Cook et al., 2011). So, we aim in this study to evaluate the efficacy of VR hysteroscopy simulation in improving hysteroscopic skills of residents and minimizing surgical errors. 6. Objectives The aim of this prospective comparative study is to evaluate the efficacy of VR simulator training in improving basic gynecological hysteroscopic skills and assess training levels in Ob/Gyn residents, as compared to others with previous hysteroscopic experience.
520			_aﯾﺟـــب ﻋﻠـــﻲ اﻷطـــﺎء ﻓـــﻲ اﻟـــﺳﻧوات اﻷﺧﯾـــرة اﻟﺣﻔـــﺎ ﻋﻠـــﻰ ﻔـــﺎءة اﻟﻣﻬـــﺎ ارت طـــوال ﺣـــﺎﺗﻬم اﻟﻣﻬﻧ"ﺔ ﻋن طر&ã اﻟﺗدر&ب اﻟﻌﻣﻠﻲ اﻟﺟارﺣﻲ. ﻟﻘد أﺻﺢ اﻟﺗدريب اﻟﻌﻣﻠﻲ اﻟﺟارﺣﻲ ﻟﻠﻣﺗدر+ﯾن ﺧـﺎرج ﻏرف اﻟﻌﻣﻠ"ﺎت ﺣﯾث ﻓﺻول اﻟﺗدر&ب وﻏرف اﻟﻣﺣﺎﻛﺎة. ــﺎن اﻟﻐــرض ﻣــن ﻫــذﻩ اﻟد ارﺳــﺔ ﻫــو اﻟﺗﺄﻛــد ﻣــن دور اﻟواﻗــﻊ اﻻﻓﺗ ارﺿــﻲ ﻓــﻲ اﻟﺗــدر&ب ﻋﻠــﻰ اﺳﺗﺋﺻﺎل اﻟﺳﻠﯾﻠﺔ ﺎﻟﻣﻧظـﺎر اﻟرﺣﻣـﻲ ﻣـن ﺧـﻼل ﺗـدر&ب اﻟﻣﺑﺗـدﺋﯾن ﺛـم ﻣﻘﺎرﻧـﺔ ﻧﺗـﺎﺋﺟﻬم ﻣـﻊ ﺗﻠـك اﻟﺗـﻲ ﺣﻘﻘﻬﺎ اﻟﺧﺑ ارء ﺎﺳﺗﺧدام ﺟﻬﺎز ﻣﺣﺎﻛﺎة ﻣﻧظﺎر اﻟرﺣم ﺎﻟواﻗﻊ اﻻﻓﺗ ارﺿﻲ. أﺟر&ت ﻫذﻩ اﻟد ارﺳﺔ ﻓﻲ ﻣﺧﺗﺑر ﻣﺣﺎﻛﺎة اﻟﻣﻧظﺎر ﺎﻟواﻗﻊ اﻻﻓﺗ ارﺿﻲ واﻛﺗﺳﺎب اﻟﻣﻬﺎ ارت ﻓﻲ ﻗﺻر اﻟﻌﯾﻧﻲ، ﻗﺳم أﻣ ارض اﻟﻧﺳﺎء واﻟﺗوﻟﯾد، ﺟﺎﻣﻌﺔ اﻟﻘـﺎﻫرة ﻌـد ﻣواﻓﻘـﺔ ﻟﺟﻧـﺔ أﺧﻼﻗ"ـﺎت اﻟ ﺣـث ﻣـن ﻣﺎﯾو ١٢٠٢ إﻟﻰ أﺑر&ﻞ ٢٢٠٢. ﺷﺎرك ٢٠١ طﺑﯾً ﺎ وﺗم ﺗﻘﺳ ﻣﻬم إﻟﻰ ﻣﺟﻣوﻋﺗﯾن: اﻟﻣﺟﻣوﻋــﺔ أ: ﺿــﻣت ١٥ طﺑﯾ ــﺎً أﺟــروا أﻗــﻞ ﻣــن ٠٥ ﻣﻧظــﺎر رﺣﻣــﻲ ﺗﺷﺧ"ــﺻﻲ واﺳﺗﺋــﺻﺎل ﺳــﻠﯾﻠﺔ اﻟــرﺣم ﺎﻟﻣﻧظــﺎر ﻣــﻧﻬم اﻷط ــﺎء اﻟﻣﻘ"ﻣــﯾن وﻣــﺳﺎﻋدO اﻟﻣﺣﺎﺿــر&ن واﻟﻣﺣﺎﺿــر&ن واﻷﺳــﺎﺗذة اﻟﻣﺳﺎﻋدﯾن ﻓﻲ ﻣﺳﺗﺷﻔﻰ اﻟﻘﺻر اﻟﻌﯾﻧﻲ (ﻣﺑﺗدﺋﯾن). اﻟﻣﺟﻣوﻋـﺔ ب: ﺿـﻣت ١٥ طﺑﯾ ـﺎً أﺟـروا ﻣـﺎ ﻻ "ﻘــﻞ ﻋـن ٠٥ ﻣﻧظـﺎر رﺣﻣـﻲ ﺗﺷﺧ"ـﺻﻲ واﺳﺗﺋــﺻﺎل ﺳــﻠﯾﻠﺔ اﻟــرﺣم ﺎﻟﻣﻧظــﺎر ﻣــﻧﻬم ﻣﺣﺎﺿــر&ن وأﺳــﺎﺗذة ﻣــﺷﺎر ﯾن وأﺳــﺎﺗذة ﻓــﻲ ﻣﺳﺗــﺷﻔﻰ اﻟﻘــﺻر اﻟﻌﯾﻧﻲ و ازﺋر&ن ﻓﻲ اﻟوﺣدات اﻟﻣﺗﺧﺻﺻﺔ ﻣﺳﺗﺷﻔﻰ اﻟﻘﺻر اﻟﻌﯾﻧﻲ (ﺧﺑ ارء). ﺗﻠﻘـــﻰ اﻷط ـــﺎء ﻓـــﻲ اﻟﻣﺟﻣوﻋـــﻪ أ دورة ﺗدر&ﺑ"ـــﺔ ﺎﺳـــﺗﺧدام طر&ﻘـــﺔ اﻟﺗـــدر&ب واﻻﺧﺗ ـــﺎر ﻋﻠـــﻰ VirtaMed وﻣﺣﺎﻛـــﺎة اﻟواﻗـــﻊ اﻻﻓﺗ ارﺿـــﻲ ﻟﺗﻧظﯾـــر اﻟـــرﺣم (HYSTT) ﻣﻬـــﺎ ارت ﺗﻧظﯾـــر اﻟـــرﺣم ™ GynoS ﺗم ﺗﻘﯾ"م ﺟﻣ"ﻊ اﻷط ﺎء ﻋﻠﻰ اﻟﺗﻧﻘﻞ ﺎﻟﻛﺎﻣﯾ ار ﻓﻲ وﻗت ﻣﺣدد وا ازﻟﺔ اﻟﻣـﺳﺎﻣﯾر ﻋﻠـﻰ ﻧﻣـوذج HYSTT. ﺗ ـــﻊ ذﻟـــك ﺗﻘﯾــــ"ﻣﻬم ﺎﺳـــﺗﺧدام اﺧﺗ ـــﺎر&ن ﻓــــﻲ ﺟﻬـــﺎز اﻟﻣﺣﺎﻛـــﺎة VirtaMed "اﻟﺗــــﺷﺧ"ص اﻟــﺳﻬﻞ ٣" و"ﻣﻘــص اﺳﺗﺋــﺻﺎل اﻟزواﺋــد اﻟﻠﺣﻣ"ــﺔ" ﻌــد ﻣــﺷﺎﻫدة اﻟﻌــرض اﻟﺗوﺿــ"ﺣﻲ ﻟﻛــﻞ اﺧﺗ ــﺎر. ﺗــم ﺟﻣﻊ ﻧﺗﺎﺋﺞ اﻷط ﺎء ﻓﻲ ﻼ اﻟﻣﺟﻣوﻋﺗﯾن واﺧﺿﺎﻋﻬم ﻟﻠﺗﺣﻠﯾﻞ اﻹﺣﺻﺎﺋﻲ. ﻓﻲ ﻫذﻩ اﻟد ارﺳﺔ، ﺎن ﻫﻧﺎك ﻓـرق ذو دﻻﻟـﺔ إﺣـﺻﺎﺋ"ﺔ ﺑـﯾن اﻟﻣﺟﻣـوﻋﺗﯾن ﻓ"ﻣـﺎ ﯾﺗﻌﻠـã ﻌﻣـر اﻷط ـــﺎء وﻣــــدة اﻟﻣﻣﺎرﺳــــﺔ ﻣـــﻊ ﻗ"ﻣــــﺔ ٠.١٠٠>P. ﻓ"ﻣــــﺎ ﯾﺗﻌﻠـــã ــــﺎﻟﻧوع، ــــﺎن ﻫﻧـــﺎك ٧٢ أﻧﺛــــﻰ ﻓــــﻲ اﻟﻣﺟﻣوﻋﺔ (أ) (٢٥.٩٪) و٨١ أﻧﺛﻰ ﻓﻘ& ﻓﻲ اﻟﻣﺟﻣوﻋﺔ (ب) (٥٣.٣٪) وﻟﻛن ﺎن اﻟﻔـﺎرق ﺿـﺋ" ًﻼ .P إﺣﺻﺎﺋً"ﺎ ﻘ"ﻣﺔ ٠.٥٥٠ ãأظﻬـرت اﻟﻧﺗــﺎﺋﺞ أﻧـﻪ ﻟــم " ـن ﻫﻧــﺎك ﻓـرق ذو دﻻﻟــﺔ إﺣـﺻﺎﺋ"ﺔ ﺑــﯾن اﻟﻣﺟﻣـوﻋﺗﯾن ﻓ"ﻣــﺎ ﯾﺗﻌﻠــ ﺎﻟﺗﻧﻘـــﻞ ﺎﻟﻛـــﺎﻣﯾ ار ﺑوﻗـــت ﻣﺣـــدد وا ازﻟـــﺔ اﻟﻣـــﺳﺎﻣﯾر ﺎﺳـــﺗﺧدام ﻧﻣـــﺎذج HYSTT. ـــﺎن ﻣﺗوﺳـــ& وﻗـــت اﻟﺗﻧﻘﻞ ﻓﻲ اﻟﻣﺟﻣوﻋﺔ أ ٠.٤٤±١.٤٩ دﻗ"ﻘـﺔ ﻣﻘﺎﺑـﻞ ٢.٣١±٠.٥٣ دﻗ"ﻘـﺔ ﻓـﻲ اﻟﻣﺟﻣوﻋـﺔ ب ﻘ"ﻣـﺔ P٠.١١. ـــــــﺎن ﻣﺗوﺳـــــــ& اﻟوﻗـــــــت ﻹ ازﻟـــــــﺔ اﻟﻣـــــــﺳﺎﻣﯾر ﻓـــــــﻲ اﻟﻣﺟﻣوﻋـــــــﺔ أ وب ٠.٣±٣.٥٢ دﻗ"ﻘـــــــﺔ .P و٣.٤٢±٠.١٣ دﻗ"ﻘﺔ ﻋﻠﻰ اﻟﺗواﻟﻲ ﻣﻊ ﻗ"ﻣﺔ ٠.٨٦ ﻓــﻲ د ارﺳــﺗﻧﺎ، ﻟــم " ــن ﻫﻧــﺎك ﻓــرق ذو دﻻﻟــﺔ إﺣــﺻﺎﺋ"ﺔ ﺑــﯾن اﻟﻣﺟﻣــوﻋﺗﯾن ﻓ"ﻣــﺎ ﯾﺗﻌﻠــã ﺑﻧــﺳ ﺔ ﺗﺟو&ﻒ اﻟرﺣم اﻟﻣرﺋﻲ وﻣﺣـﺎذاة اﻟﻛـﺎﻣﯾ ار و وﻗـت اﻟرؤ"ـﺔ اﻟﻣـﺷوﺷﺔ وﺗـﺻو&ر اﻟﻔـوﻫﺗﯾن وطـول اﻟﻣـﺳﺎر اﻟﺗ ارﻛﻣـــﻲ وﺗﻼﻣـــس اﻟﻣﻧظـــﺎر ﻣـــﻊ ﻋﻧـــã اﻟـــرﺣم وﺗﺟو&ـــﻒ اﻟـــرﺣم ﻓـــﻲ اﺧﺗ ـــﺎر اﻟﺗـــﺷﺧ"ص واﺳﺗﺋـــﺻﺎل اﻟزواﺋد اﻟﻠﺣﻣ"ﺔ. ﻓــﻲ اﻟد ارﺳــﺔ اﻟﺣﺎﻟ"ــﺔ ــﺎن ﻫﻧــﺎك ﻓــرق ذو دﻻﻟــﺔ أﺣــﺻﺎﺋ"ﺔ ﺑــﯾن اﻟﻣﺟﻣــوﻋﺗﯾن ﻓــﻲ اﻻﺧﺗ ــﺎر اﻟﺗﺷﺧ"ــﺻﻲ ﻓ"ﻣــﺎ ﯾﺗﻌﻠــã ﺎﻟــدرﺟﺎت اﻹﺟﻣﺎﻟ"ــﺔ و درﺟــﺔ ﺗــﺻو&ر اﻟــرﺣم و درﺟــﺔ اﻟــﺳﻼﻣﺔ واﺳــﺗﻌﻣﺎل اﻟﺳواﺋﻞ و اﻟﺗوﻗﯾت اﻟذO ﺎن ﻓ"ـﻪ اﻟـرﺣم ﻏﯾـر ﻣﻧـﺗﻔﺦ ﻟـﺻﺎﻟﺢ اﻟﻣﺟﻣوﻋـﺔ (أ). ﻣـﺎ ـﺎن ﻫﻧـﺎك ﻓـرق ﻣﻌﺗــد ــﻪ إﺣــﺻﺎﺋً"ﺎ ﺑــﯾن اﻟﻣﺟﻣــوﻋﺗﯾن ﻓ"ﻣــﺎ ﯾﺗﻌﻠــã ﺎﻻﻗﺗــﺻﺎد ﻓــﻲ اﺧﺗ ــﺎر اﺳﺗﺋــﺻﺎل اﻟــﺳﻠﯾﻠﺔ وﺗوﻗﯾــت اﺳﺗﺋـــــــــــﺻﺎﻟﻬﺎ ﻟـــــــــــﺻﺎﻟﺢ اﻟﻣﺟﻣوﻋـــــــــــﺔ (أ). ـــــــــــﺎن ﻣﺗوﺳـــــــــــ& وﻗـــــــــــت اﻹﺟـــــــــــ ارء ﻓـــــــــــﻲ اﻟﻣﺟﻣوﻋـــــــــــﺔ أ .P وب٠.٥٤٦±٢.٦٤٥ دﻗ"ﻘﺔ و٣.٢٣١±١.٦١ دﻗ"ﻘﺔ ﻋﻠﻰ اﻟﺗواﻟﻲ ﻣﻊ ﻗ"ﻣﺔ ٠.٢٠٠
530			_aIssues also as CD.
546			_aText in English and abstract in Arabic & English.
650		7	_aUterine diseases _2qrmak
653		0	_aSimulation training _a Hysteroscopic skills _aVirtual reality _aHysteroscopy simulator
700	0		_aAhmed Mahmoud Fawzi El-Minawi _ethesis advisor.
700	0		_aNadine Alaa Sherif _ethesis advisor.
700	0		_aMarwa Fouad saad Sharaf _ethesis advisor.
900			_b01-01-2023 _cAhmed Mahmoud Fawzi El-Minawi _cNadine Alaa Sherif _cMarwa Fouad saad Sharaf _U Cairo University _FFaculty of Medicine _DDepartment of Obstetrics and Gynecology
905			_aShimaa _eHuda
942			_2ddc _n0 _cTH _e21
999			_c167879