Online Vocational Training course on Ergonomics for Orthopaedic Minimally Invasive Surgery

 

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TRAIN4ORTHOMIS

 

The main objective of this project was the development of the contents and the implementation of an online course to assure surgeons a worthy education and training along their professional career regarding ergonomics and usability applied to orthopaedic Minimally Invasive Surgery of hip and spine, matching product innovation with the needs of orthopaedic surgeons and the latter with their working environment. The e-learning tool resulting from the project is available online in 4 European languages (English, Spanish, Polish and German).

Train4OrthoMIS project cover the lack of training of MIS surgeons, improves the knowledge/capacities of the European professionals and provides new skills for emergent activities that these of workers should carry out in their work.

This project aimed to create, implemented and set the basis for a pan-European exploitation of a new online VET course focused on ergonomic criteria in the design of working tools and of suitable operating room environments for MIS surgeons and assistants. In addition, of course, this course is also intended for medical students interested in acquiring ergonomic and usability skills associated with MIS techniques as a formative process.

In conclusion, this project was intended to achieve the following specific objectives set by the Erasmus+ Programme:

  • To foster the provision and the assessment of key-competences related with ergonomics and usability, applied to orthopaedic Minimally Invasive Surgery of hip and spine.

  • To enhance the quality and the relevance of the learning offer and to improve the level of key competences and skills by means of a new and innovative approach that will let to orthopaedic surgeons and assistants to acquire ergonomic knowledge.

Start Date: 01-09-2014

Finish Date: 31-08-2017

Project Reference: 2014-1-ES01-KA202-004533

 

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TRAIN4ORTHOMIS

From the perspective of training provision, PARTICIPANTS such as IBV, BGU-MURNAU and CCMIJU will take profit from the developed materials through (i) improving and/or supplementing their existing training services; (ii) increasing their expertise in the domain of orthopaedic MIS applied to professional training; and (iii) achieving the status of being a reference in ergonomics and usability for hip and spine surgery specialists.

KOMAG and SUT, as experts in virtual modelling ergonomics and related interactive training solutions, will obtain (i) the progress of their specific software in medical ergonomics, by creating new functionalities and optimizing key parameters analyses. In addition, both partners will be also (ii) capable to take advantage of the knowledge derived from the project by using it as a basis to generate new software-based training solutions in other close medical disciplines (e.g. abdominal or different joint surgery).

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The measurement body position recording sensors

Apart from the benefits related to the training offer provided by consortium partners, each of them expect other of its commercial services to be boosted. In this regard, IBV and BGU-MURNAU foreseen to provide advising in re-designing hip and spine (respectively) surgical instruments to trained surgeons from the Train4OrthoMIS course, whereas CCMIJU will intend to attract an increased number of attendants to their existing capacitation services. Concurrently, KOMAG and SUT will count on the suitable input to give consultancy services linked to the enhancement of operating MIS environments, which will enable orthopaedic surgery teams to improve their performance on patient interventions.

TARGET GROUPS in the project are: (i) orthopaedic MIS surgeons and assistants (e.g. nurses); and (ii) medical students interested in acquiring ergonomic and usability skills associated with MIS techniques as a formative process.

On the one hand, the new developed materials will provide orthopaedic MIS surgeons and assistants with in-depth knowledge of the interaction with the working environment and surgical instruments, as well as postural hygiene during different kinds of surgery, thus (i) avoiding musculoskeletal diseases that currently affect them, and (ii) increasing at the same time their labour efficiency by reducing aches/fatigue and operating times. Moreover, these specialized training contents will lead them to (iii) upgrade their professional curriculum -facilitating promotion/advancement in their labour career- and (iv) be positioned as prescribers of ergonomics and usability.

On the other hand, medical students will have (i) direct access to a unique specialization in a methodology which offers high future expectations, allowing a clear academic differentiation in the current highly competitive labour market. At the same time, students will be also (ii) rewarded by means of an academic accreditation, this way obtaining a key recognition and pushin their learning.

In addition, OTHER RELEVANT STAKEHOLDERS will benefit from Train4OrthoMIS course:

  • Patients, since the increase in the efficiency and safety in surgical interventions will have a bearing on a greater success rate and in reduction of the post-operative period.

  • The European Health System, since it offers the opportunity of optimizing health care by increasing the level of efficiency and quality of its services. Namely, the increase of labour productivity through decreasing likelihood of sick leaves related to surgeons and assistants, as well as through time reduction in operating performance, are two of the most important advantages.

  • Clinical product companies that develop surgical prosthesis and tools could be benefited from the project as a way to promote and recommend certain categories of their advanced products (i.e. ergonomical MIS products), acting the course as a sales driver and disseminator of commercial items from this sector.

 

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Example of forced position during positioning of the femoral head to the acetabular

 

Furthermore, contents of Train4OrthoMIS even have direct application to technical professionals (e.g. designers) working in these companies, who might use this knowledge to develop other new and innovative orthopaedic MIS solutions based on ergonomics and usability criteria from a user-centred approach.

  • Other clinicians might learn from these cutting-edge contents, as well as using them as a basis to encourage developments about ergonomics and/or usability in other surgical disciplines (e.g. maxillofacial, neurosurgery).

In order to guarantee the quality of results and a wide impact, representative end-users covering the targeted groups are involved from the conception (Intellectual Output O1) to the validation of the Train4OrthoMIS course (Intellectual Output O5), which will be also tested and validated through a pan-European pilot course deployment. Moreover, consortium partners have direct and fluent relationship with the targeted groups in their daily activities, enabling the success of the proposed training through the involvement of these audiences.

 

LogoAcronymParticipant
 BGU Logo
BGU-MURNAU
http://www.bgu-murnau.de
 logo-ccmi
CCMIJU
 ibv
IBV
 komag
KOMAG
 sut
SUT

TRAIN4ORTHOMIS

Train4OrthoMIS project proposes to develop in a unique e-learning course all the training materials needed for improving the working conditions of orthopaedic MIS surgeons in the operating room under pinned by key methodologies about user-centred design, ergonomics and usability.

First of all, the consortium did a previous research in order to confirm that there is no training tool in the field of MIS surgery similar to the compendium offered in Train4OrthoMIS. Many works have been published analyzing different aspects of the working environment in MIS surgery and some other studies analyzing the ergonomics of the instruments’ handling. These studies are the first step to understand surgeons interaction in their workplace and thus to achieve optimum products design that satisfies surgeon needs. However, surgeons are not aware of ergonomic guidelines and besides the existing information must be converted to design criteria and to criteria on how to use the equipments.

Nevertheless, this information is in research centres and university’s departments. It is possible to find some training courses focused on workplace ergonomics or on design of ergonomic instrumental, but these courses are mainly focused on laparoscopic surgery and not in the orthopaedic MIS field, which is much more demanding in some aspects like impacts-level and vibrations.

A background is the German project ORTHOMIT that provided an integrated platform for smart interventional therapy of bone and joint diseases in orthopaedic surgery and traumatology, as well as to demonstrate its clinical usability and cost efficiency.

All these works come from disperse sources on different research fields, being not applied to design of MIS instruments in a usercentred approach.

Hence, the results and expertise that make up the basis for the development of contents of Train4OrthoMIS course will overcome existing limitations and will target at the same time complementary profiles for a faster impact of the project outcomes.

 

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The simplified diagram of working conditions registration in the operating theater

Some projects carried out by the partners of this proposal may provide useful information:

  • Knowledge-based improvement of working conditions in healthcare organizations (VI Contest of Research and Development Projects of Polish Ministry of Science and Higher Education Ref. Number: N R11 0026 06/2009). The objective of this project,coordinated by SUT, was to create an IT platform with resources of knowledge needed for effective forming working conditions including ergonomic work methods and management in surgical orthopaedic wards. The platform integrates modern ICT technologies and methods such as human body modeling, including ergonomic assessments.The project was financed by national recourses.

  • Ergonomic criteria generation to the design of surgical instrumental (National Program of Industrial Design and Production. Ref. Number: DPI2004-08196-CO2-01). The aim of this project, coordinated by IBV, was the generation of design criteria to improve the surgical instruments from an ergonomic point of view, respecting all the durability and security criteria, then current and indicated in the international standards. The generated criteria allowed improving the surgeons’ working conditions minimizing the physical efforts than they have to suffer during the operation.

  • Ergonomic Instruments Development for Hip Surgery. An Innovative Approach on Orthopaedic Implants Design. (Sixth Framework Programme (Co-operative Research). Ref Number: COOP-CT-2005-017806). ENHIP was a research project coordinated by IBV, with the participation of KOMAG and SUT. As a result of the Enhip project was obtained new instruments and knowledge.

TRAIN4ORTHOMIS

 

The main objective of this project is the development of the contents and the implementation of an online course to assure surgeons a worthy education and training along their professional career regarding ergonomics and usability applied to orthopaedic Minimally Invasive Surgery of hip and spine, matching product innovation with the needs of orthopaedic surgeons and the latter with their working environment. The e-learning tool resulting from the project will be available online in 4 European languages (English, Spanish, Polish and German) in order to increase acceptance of the course.

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The importance of minimally invasive surgery (MIS) has constantly increased, and it has been routinely used in orthopaedic surgery for more than 40 years, because of its main advantages [1]: reduced trauma to soft tissues; decreased blood loss, less pain and faster recovery; better stability of the prosthese's components as well as better cosmetic results. In recent years there has been a progressive increase in the number of services and professionals worldwide who use MIS techniques. For these reasons, MIS surgery has offered a step change in quality of care, patient satisfaction and efficiency in use of health service resources.

MIS surgery is a task with high physical and mental demands and involves a series or risks for the surgeon. The intraoperative surgical workplace is affected by stressing environmental factors and, additionally, surgeons have to perform high-force as well as high-precision tasks in combination with multimodal information processing. This leads to increased stress and strain, resulting in muscle overload, fatigue of surgeons and higher risk for human error [2] and for inefficiencies in operations, causing that surgeons suffer from severe musculoskeletal disorders with progressing working life [3,4,5]. Therefore, the implementation of ergonomic criteria in the design of working tools and of suitable operating room environments is essential to improve efficiency, safety, and comfort for the operating team, while reducing physical strains on surgeons.

laparoscopia instrumental 01

The advancement of MIS techniques has changed the practice of general surgery. While maintaining the goal of safely and effectively offering new procedures to their patients, practicing general surgeons are actively adopting new techniques. “Yet, even though the benefits of MIS are now plain for all to see, it is increasingly apparent in this success story that a considerable unforeseen cost is borne by one key stakeholder – the surgeon”. Moreover, there exist barriers such as new technology or inadequate training availability, while there is an increasing demand in hospitals of surgeons for minimally invasive surgeries.

Proper training on ergonomic improvements in the surgical instruments and on user-driven methodologies for usability enhancement will synergistically expand the application of MIS surgery, with the associated benefits for patients and for surgeons.

Train4OrthoMIS project will cover the mentioned lack of training of MIS surgeons, will improve the knowledge/capacities of the European professionals and will provide new skills for emergent activities that these of workers should carry out in their work.

Train4OrthoMIS project aims to create, implement and set the basis for a pan-European exploitation of a new online VET course focused on ergonomic criteria in the design of working tools and of suitable operating room environments for MIS surgeons and assistants. In addition, of course, this course is also intended for medical students interested in acquiring ergonomic and usability skills associated with MIS techniques as a formative process.

In conclusion, this project is intended to achieve the following specific objectives set by the Erasmus+ Programme:

  • To foster the provision and the assessment of key-competences related with ergonomics and usability, applied to orthopaedic Minimally Invasive Surgery of hip and spine.
  • To enhance the quality and the relevance of the learning offer and to improve the level of key competences and skills by means of a new and innovative approach that will let to orthopaedic surgeons and assistants to acquire ergonomic knowledge.