Search Results (179)

Radical prostatectomy remains a cornerstone treatment for localized prostate cancer. While oncological control is essential, functional outcomes such as urinary continence and erectile function play a critical role in patient satisfaction and quality of life. Despite the growing emphasis on surgical quality, no standardized intraoperative scoring system has been universally adopted. This narrative review summarizes current approaches to evaluating the technical quality of radical prostatectomy and associated functional outcomes. It focuses on objective intraoperative assessment tools and functional evaluation scales used in clinical research and surgical education. A non-systematic literature search was conducted using the PubMed and Scopus databases to identify relevant intraoperative assessment tools (e.g., GEARS, PACE, and OSATS), functional scales (e.g., IIEF, EPIC, and pad test), and outcome reporting systems. Articles were reviewed for scale structure, clinical applicability, validation status, and limitations. Several tools have been developed to evaluate surgical skills in minimally invasive surgery, yet few are specific to radical prostatectomy. Most rely on subjective surgeon assessment or delayed functional outcomes, limiting their utility for intraoperative feedback. Video-based assessment is promising but underutilized. A gap remains for a prostatectomy-specific, reproducible, and real-time assessment scale. There is a pressing need for validated tools that bridge the gap between surgical technique and functional outcomes. Current methods lack specificity and reproducibility. Development of an objective, intraoperative scoring system may support surgeon feedback, quality improvement, and improved patient counseling. Full article

The modern job market demands soft and future skills from both technical and non-technical professionals. It is often challenging to teach these competencies in a traditional academic setting. This paper presents an effective approach for developing these skills through a short, intensive, joint project. While our case study is an Erasmus+ program, the methodology can be applied within various frameworks. We use problem-based and active learning, along with group work, to teach. The approach also emphasizes diversity by arranging multidisciplinary student groups to work on software development tasks. In our project, less than half of the participants had a computer science background, demonstrating that these tasks are engaging for non-technical students. The multicultural and international environment of the project is crucial in a global working environment, and its brief, intense nature helps simulate real-world stressful situations. This methodology provides a practical way to prepare students for the demands of the modern workplace. The results confirmed the effectiveness of the project in developing certain key skills, though not all competencies showed a measurable increase during the event’s short duration. Full article

In parallel with technical training on knowledge and skills of task-specific medical or surgical procedures, wide arrays of soft skills training would contribute to obstetric safety in the contemporary healthcare setting. This article, as a service evaluation, explored the effect of a specialty-based Crew Resource Management (CRM) training series that transforms the concept of human factors into sustainable measures in fostering clinical safety culture of the Department of Obstetrics and Gynaecology (O&G) in the Queen Elizabeth Hospital. Within the last decade, a tri-phasic programme has been implemented by an inter-professional workgroup which consists of a consultant anaesthesiologist, medical specialists and departmental operations manager from O&G, a nurse simulation specialist, hospital administrators, and a research psychologist. (1) Phase I identified different patterns of attitudinal changes (in assertiveness, communication, leadership, and situational awareness, also known as “ACLS”) between doctors and nurses and between generic and specialty-based sessions for curriculum planning. (2) Phase II evaluated how these specific behaviours changed over 3 months following CRM training tailored for frontline professionals in O&G. (3) Phase III examined the coping style in conflict management and the level of sustainability in self-efficacy over 3 months following specialty-based CRM training. The findings showed the positive impacts of O&G CRM training on healthcare professionals’ increased attitude and behaviour in “ACLS” by 22.7% at a p < 0.05 level, character strengths in conflict management, and non-inferior or sustained level of self-efficacy under tough conditions in the clinical setting up to 3 months after training. As a way forward, incorporating a scenario-based O&G CRM programme into existing skills-based training is expected to change service framework with an innovative approach. In addition, exploring actual clinical outcomes representing a higher level of organisational impacts can be a strategic direction for further studies on the effect of this practical and educational approach on obstetric safety culture. Full article

Background: Failure to rescue (FTR), defined as death after major postoperative complications, is a critical quality indicator in pancreatic cancer surgery. Despite advances in surgical techniques and perioperative care, FTR rates remain high and vary across institutions. Methods: This systematic review uses a narrative synthesis followed by PRISMA 2020. A PubMed search (1992–2025) identified 83 studies; after screening, 52 studies (2010–2025) were included. Eligible designs were registry-based, multicenter, single-center, or prospective audits. Given substantial heterogeneity in study designs, FTR definitions, and outcome measures, a narrative synthesis was performed; no formal risk-of-bias assessment or meta-analysis was conducted. Results: Definitions of FTR varied (in-hospital, 30-day, 90-day, severity-based, and complication-specific cases). Reported rates differed by definition: average reported rates were 13.2% for 90-day CD ≥ III (G1); 10.3% for in-hospital/30-day CD ≥ III (G3); and 7.4% for 30-day “serious/major” morbidity (G8). Absolute differences were +3.0 and +2.9 percentage points (exploratory, descriptive comparisons). Five domains were consistently associated with lower FTR: (i) centralization to high-volume centers; (ii) safe adoption/refinement of surgical techniques; (iii) optimized perioperative management including early imaging and structured escalation pathways; (iv) patient-level risk stratification and prehabilitation; and (v) non-technical skills (NTSs) such as decision-making, situational awareness, communication, teamwork, and leadership. Among NTS domains, stress and fatigue management were not addressed in any included study. Limitations: Evidence is predominantly observational with substantial heterogeneity in study designs and FTR definitions; the search was limited to PubMed; and no formal risk-of-bias, publication-bias assessment, or meta-analysis was performed. Consequently, estimates and associations are descriptive/associative with limited certainty and generalizability. Conclusions: NTSs were rarely used or measured across the included studies, with validated instruments; quantitative assessment was uncommon, and no study evaluated stress or fatigue management. Reducing the FTR after pancreatic surgery will require standardized, pancreas-specific definitions of FTR, process-level rescue metrics, and deliberate strengthening of NTS. We recommend a pancreas-specific operational definition with an explicit numerator/denominator: numerator = all-cause mortality within 90 days of surgery; denominator = patients who experience major complications (Clavien–Dindo grade III–V, often labeled “CD ≥ 3”). Addressing the gaps in stress and fatigue management and embedding behavioral metrics into quality improvement programs are critical next steps to reduce preventable mortality after complex pancreatic cancer procedures. Full article

Service or community engaged learning has gained momentum as a strategy for developing engineering students’ professional skills while facilitating engagement with the real-world complexities of engineering problem-solving. Along with other critical scholars of engineering education, we argue that embedding social justice frameworks into engineering education, including sensibility around difference, power, and privilege, is required in order for engineering to meet the great sustainability and equity challenges of our time. This paper investigates how social justice course content and community engaged learning experiences can change engineering student attitudes toward civic engagement and social responsibility. We also explore how such content increases interest in engineering among students underrepresented in the field. Using pre-/post-survey data and focus group discussions, we conducted a quantitative and qualitative evaluation of student experience in an advanced undergraduate engineering course at a public research university that integrated social justice content with hands-on community engaged projects. Our analysis of survey results show that (1) students placed greater importance on justice-oriented civic engagement and socially responsible engineering after completing the course; (2) women and underrepresented racial/ethnic groups demonstrated greater interest in community engaged projects, and women indicated a greater interest in engineering at the end of the course than men; and (3) participation in a community engaged project also increased students’ interest in engineering, humanized problems that might have traditionally been construed as technological, and deepened the value students placed on non-technical forms of knowledge and their sense of moral and ethical responsibilities. Full article

The rapid proliferation of generative artificial intelligence (GenAI) in educational settings has created unprecedented opportunities for language instruction, yet empirical evidence regarding its efficacy in primary-level English as a Foreign Language contexts remains scarce, particularly concerning pre-service teachers’ implementation experiences during formative practicum periods. This investigation, conducted in a public school in a non-Anglophone country during the Spring of 2025, examined the impact of GenAI-driven gamified activities on elementary pupils’ English language competencies while exploring novice educators’ professional development trajectories through a mixed-methods quasi-experimental approach with comparison groups. Four third-grade classes (n = 119 individuals aged 8–9) in a public school were assigned to either ChatGPT-mediated voice-interaction games (n = 58) or conventional non-digital activities (n = 61) across six 45 min lessons spanning three weeks, with four female student-teachers serving as instructors during their culminating practicum. Quantitative assessments of grammar, listening comprehension, and pronunciation occurred at baseline, post-intervention, and one-month follow-up intervals, while reflective journals captured instructors’ evolving perceptions. Linear mixed-effects modeling revealed differential outcomes across linguistic domains: pronunciation demonstrated substantial advantages for GenAI-assisted learners at both immediate and delayed assessments, listening comprehension showed moderate benefits with superior overall performance in the experimental condition, while grammar improvements remained statistically equivalent between groups. Thematic analysis uncovered pre-service teachers’ progression from technical preoccupations toward sophisticated pedagogical reconceptualization, identifying connectivity challenges and assessment complexities as primary barriers alongside reduced performance anxiety and individualized pacing as key facilitators. These findings suggest selective efficacy of GenAI across language skills while highlighting the transformative potential and implementation challenges inherent in technology-enhanced elementary language education. Full article

This study examines patterns of artificial intelligence (AI) adoption in Ecuadorian micro and small enterprises (MSEs), with an emphasis on functional diversity across value chain activities. Based on a cross-sectional dataset of 781 enterprises and an entropy-based model, it assesses internal variability in AI use and explores its relationship with strategic perception and dynamic capabilities. The findings reveal predominant partial adoption, alongside high functional entropy in sectors such as mining and services, suggesting an ongoing phase of technological experimentation. However, a significant gap emerges between perceived strategic use and actual functional configurations—especially among microenterprises—indicating a misalignment between intent and organizational capacity. Barriers to adoption include limited technical skills, high costs, infrastructure constraints, and cultural resistance, yet over 70% of non-adopters express future adoption intentions. Regional analysis identifies both the Andean Highlands and Coastal regions as “innovative,” although with distinct profiles of digital maturity. While microenterprises focus on accessible tools (e.g., chatbots), small enterprises engage in data analytics and automation. Correlation analyses reveal no significant relationship between functional diversity and strategic value or capability development, underscoring the importance of qualitative organizational factors. While primarily descriptive, the entropy-based approach provides a robust diagnostic baseline that can be complemented by multivariate or qualitative methods to uncover causal mechanisms and strengthen policy implications. The proposed framework offers a replicable and adaptable tool for characterizing AI integration and informing differentiated support policies, with relevance for Ecuador and other emerging economies facing fragmented digital transformation. Full article

This study aimed to identify and analyse the main difficulties faced by family farmers in producing and supplying vegetables through short food supply chains. Semi-structured interviews were conducted with seven family farmers in a large city in southern Brazil. We sought to include at least one farmer supplying each of the main identified outlets: schools, restaurants, supermarkets, street markets, and consumer groups. Contacts were obtained through rural producer organisations. Data were recorded, transcribed, and analysed using thematic analysis. Three groups of difficulties emerged: (i) production—including seasonality, pest, and disease management, climate-related losses, and limited technical support; (ii) sales—such as price competition, logistical challenges, and inconsistent demand; and (iii) consumption—particularly low consumer habits regarding vegetable purchase and preparation, and preference for non-seasonal products. The study concludes that the main challenges to strengthening short food supply chains are the limited engagement of young people in farming, lack of specialised technical assistance, climate-related risks, bureaucratic barriers, and the high costs of organic certification. Farmers also reported logistic difficulties and constraints in supplying restaurants due to demand for a narrow range of products disregarding seasonality. At the consumer level, habits shaped by conventional food systems emerged as obstacles. Strategies such as alternative markets, farmer organisations, supportive public policies, and initiatives to promote cooking skills and consumer awareness are key to enhancing resilience and expanding the supply of healthy foods. Full article

Hand hygiene is a key measure to prevent healthcare-associated infections (HAIs), yet compliance remains low in Sub-Saharan Africa (SSA), due to limited resources, insufficient training, and behavioral challenges. Simulation-based education offers a promising approach to enhance technical and non-technical skills in safe learning environments, promoting behavioral change and patient safety. This study aimed to develop and pilot a contextually adapted hand hygiene simulation-based learning scenario for nursing students in SSA. Grounded in the Medical Research Council (MRC) Framework and Design-Based Research principles, a multidisciplinary team from European and African higher education institutions (HEIs) co-created this scenario, integrating international and regional hand hygiene guidelines. Two iterative pilot cycles were conducted with expert panels, educators, and students. Data from structured observation and post-simulation questionnaires were analyzed using descriptive statistics. The results confirm the scenario’s feasibility, relevance, and educational value. The participants rated highly the clarity of learning objectives (M = 5.0, SD = 0.0) and preparatory materials (M = 4.6, SD = 0.548), reporting increased knowledge/skills and confidence and emphasizing the importance of clear roles, structured facilitation, and real-time feedback. These findings suggest that integrating simulation in health curricula could strengthen HAI prevention and control in SSA. Further research is needed to evaluate long-term outcomes and the potential for wider implementation. Full article

Background: The rapid shift from open to endovascular techniques in vascular surgery has significantly decreased trainee exposure to high-stakes open procedures. Simulation-based training, especially that incorporating virtual reality (VR) and artificial intelligence (AI), provides a promising way to bridge this skill gap. Objective: This narrative review aims to assess the current evidence on the integration of extended reality (XR) and AI into vascular surgeon training, focusing on technical skill development, performance evaluation, and educational results. Methods: We reviewed the literature on AI- and XR-enhanced surgical education across various specialties, focusing on validated cognitive learning theories, simulation methods, and procedure-specific training. This review covered studies on general, neurosurgical, orthopedic, and vascular procedures, along with recent systematic reviews and consensus statements. Results: VR-based training speeds up skill learning, reduces procedural mistakes, and enhances both technical and non-technical skills. AI-powered platforms provide real-time feedback, performance benchmarking, and objective skill evaluations. In vascular surgery, high-fidelity simulations have proven effective for training in carotid artery stenting, EVAR, rAAA management, and peripheral interventions. Patient-specific rehearsal, haptic feedback, and mixed-reality tools further improve realism and readiness. However, challenges like cost, data security, algorithmic bias, and the absence of long-term outcome data remain. Conclusions: XR and AI technologies are transforming vascular surgical education by providing scalable, evidence-based alternatives to traditional training methods. Future integration into curricula should focus on ethical use, thorough validation, and alignment with cognitive learning frameworks. A structured approach that combines VR, simulation, cadaver labs, and supervised practice may be the safest and most effective way to train the next generation of vascular surgeons. Full article

Background/Objectives: Effective teamwork is crucial for minimizing human error in healthcare settings. Medical teams, typically composed of physicians and nurses, supported by auxiliary professionals, achieve better outcomes when they possess strong collaborative competencies. High-quality teamwork is associated with fewer adverse events and complications and lower mortality rates. Based on this background, the objective of this study is to analyze the perception of non-technical skills and immediate learning outcomes in interprofessional simulation settings based on E-CRM items. Methods: A cross-sectional observational study was conducted involving participants from the official postgraduate Medicine and Nursing programs at the Catholic University of Murcia (UCAM) during the 2024–2025 academic year. Four interprofessional E-CRM simulation sessions were planned, involving randomly assigned groups with proportional representation of medical and nursing students. Teams worked consistently throughout the training and participated in clinical scenarios observed via video transmission by their peers. Post-scenario debriefings followed INACSL guidelines and employed the PEARLS method. Results: Findings indicate that 48.3% of participants had no difficulty identifying the team leader, while 51.7% reported minor difficulty. Role assignment posed moderate-to-high difficulty for 24.1% of respondents. Communication, situation awareness, and early help-seeking were generally managed with ease, though mobilizing resources remained a challenge for 27.5% of participants. Conclusions: This study supports the value of interprofessional education in developing essential competencies for handling urgent, emergency, and high-complexity clinical situations. Strengthening interdisciplinary collaboration contributes to safer, more effective patient care. Full article

Background: Intermediate care units face growing complexity due to aging populations and chronic illnesses. Non-technical skills such as empathy and communication are crucial for quality care. We aimed to examine the relationship between communication skills, self-efficacy, and sense of coherence among intermediate care nurses. Methods: We conducted an observational, cross-sectional study with 60 intermediate care nurses from three units in a Catalan hospital, Spain. Participants engaged in high-fidelity simulation using geriatric end-of-life scenarios with an ultra-realistic manikin representing a geriatric patient at the end of life. NTSs were measured using validated tools: the Health Professionals Communication Skills Scale (HP-CSS), the General Self-Efficacy Scale, and the Sense of Coherence Questionnaire (OLQ-13). Sessions followed INACSL standards, including prebriefing, simulation, and debriefing phases. Results: Post-simulation outcomes revealed significant gains in interpersonal competencies, with men reporting higher assertiveness (p = 0.015) and greater satisfaction with both the simulation experience (p = 0.003) and the instructor (p = 0.008), underscoring gender-related perceptions in immersive training. Conclusions: Ultra-realistic clinical simulation is effective in enhancing NTS among intermediate care nurses, contributing to improved care quality and clearer professional profiles in geriatric nursing. Full article

Background/Objectives: The use of simulation has become more popular in healthcare settings, and simulation is also very popular in ultrasound training, allowing the learners to virtually practice and improve clinical skills. Obstetric pathology and gynecologic lesions can have a large range of sonographic features, and the detection rates for these can be increased by using ultrasound simulation systems to train users. In the following paper, we provide insight into the application of simulation tools in obstetric and gynecologic ultrasound training. Methods: We present different ultrasound models for GYN/OB ultrasound training. Results: Ultrasound simulation is a key component of obstetrics and gynecology (OB/Gyn) ultrasound education. Conclusions: By examining the best practices, we highlight the diverse simulation options available to help learners technical and non-technical skills in a controlled learning environment. Full article

As we move toward a more digitalized and interconnected world, new cybersecurity challenges emerge. While most related research has focused on large companies, this study aims to fill a gap in the literature by exploring cybersecurity issues in small and medium-sized enterprises (SMEs), particularly in relation to nontechnical, soft-skill, and intellectual capital aspects. This study examines the interplay between cybersecurity awareness and perception and ownership structure in SMEs in the Silesian region of Poland. Unlike the majority of cybersecurity literature, our focus is on how ownership structure influences cybersecurity perception. We surveyed 200 SMEs at random within the respective region and utilized hierarchical and simple linear regression analyses to assess the relationships between these factors and financial performance. Our results indicate that larger enterprises and those without a family-owned structure exhibit significantly greater levels of cybersecurity. Additionally, we found a positive correlation between cybersecurity and a firm’s financial performance and overall health. These findings underscore the importance of cybersecurity awareness and practices for the growth and stability of SMEs. Full article

The continuous evolution of technology compels higher education leaders to adapt to VUCA (volatile, uncertain, complex, and ambiguous) and BANI (brittle, anxious, non-linear, and incomprehensible) environments through innovative strategies that ensure institutional relevance. While VUCA emphasizes the challenges posed by rapid change and uncertain decision-making, BANI underscores the fragility of systems, heightened anxiety, unpredictable causality, and the collapse of established patterns. Navigating these complexities requires agility, resilience, and visionary leadership to ensure that institutions remain adaptable and future ready. This study presents a bibliometric analysis of digital academic leadership in higher education transformation, examining empirical studies, reviews, book chapters, and proceeding papers published from 2014 to 2024 (11-year period) in the Web of Science—Science Citation Index Expanded (SCIE) and Social Science Citation Index (SSCI). Using CiteSpace software (version 6.3. R1-64 bit), we analyzed 5837 documents, identifying 24 key publications that formed a network of 90 nodes and 256 links. The reduction to 24 publications occurred as part of a structured bibliometric analysis using CiteSpace, which employs algorithmic thresholds to identify the most influential and structurally significant publications within a large corpus. These 24 documents form the core co-citation network, which serves as a conceptual backbone for further thematic interpretation. This was the result of a multi-step refinement process using CiteSpace’s default thresholds and clustering algorithms to detect the most influential nodes based on centrality, citation burst, and network clustering. Our findings reveal six primary research clusters: “Enhancing Academic Performance”, “Digital Leadership Scale Adaptation”, “Construction Industry”, “Innovative Work Behavior”, “Development Business Strategy”, and “Education.” The analysis demonstrates a significant increase in publications over the decade, with the highest concentration in 2024, reflecting growing scholarly interest in this field. Keywords analysis shows “digital leadership”, “digital transformation”, “performance”, and “innovation” as dominant terms, highlighting the field’s evolution from technology-focused approaches to holistic leadership frameworks. Geographical analysis reveals significant contributions from Pakistan, Ireland, and India, indicating valuable insights emerging from diverse global contexts. These findings suggest that effective digital academic leadership requires not only technical competencies but also transformational capabilities, communication skills, and innovation management to enhance student outcomes and institutional performance in an increasingly digitalized educational landscape. Full article