Sayra Cristancho

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We have begun development of an interactive, multi-player serious game for the purpose of training cardiac surgeons, fellows, and residents the series of steps comprising the Off-Pump Coronary Artery Bypass grafting (OPCAB) surgical procedure. It is hypothesized that by learning the OPCAB procedure in a "first-person-shooter gaming environment", trainees(More)
Complexity permeates every aspect of contemporary healthcare, challenging the delivery of medical education [1]. Gormley and Fenwick [2] invite us to reflect on how we can help individual learners to see what's in front of them when they face complexity. Instead of saying, 'well, everything is just so chaotic', the authors offer a practical application of(More)
BACKGROUND Simulation-based programs allow trainees to be progressively challenged in a systematic, learner-centered and patient-focused fashion. The design of these programs requires an understanding of the individual steps that comprise the entire surgical procedure and our ability to assess the progress of the learner. We present the results of the(More)
OBJECTIVE Clinical research increasingly acknowledges the existence of significant procedural variation in surgical practice. This study explored surgeons' perspectives regarding the influence of intersurgeon procedural variation on the teaching and learning of surgical residents. DESIGN AND SETTING This qualitative study used a grounded theory-based(More)
BACKGROUND Expert physicians develop their own ways of doing things. The influence of such practice variation in clinical learning is insufficiently understood. Our grounded theory study explored how residents make sense of, and behave in relation to, the procedural variations of faculty surgeons. METHOD We sampled senior postgraduate surgical residents(More)
Despite the benefits associated with virtual learning environments and serious games, there are open, fundamental issues regarding simulation fidelity and multi-modal cue interaction and their effect on immersion, transfer of knowledge, and retention. Here we describe the results of a study that examined the effect of ambient (background) sound on the(More)
BACKGROUND Surgery is an environment in which being an expert requires the ability to manage the unexpected. This feature has necessitated a shift in surgical decision-making research. The present study explores the processes by which surgeons assess and respond to nonroutine challenges in the operating room. METHODS We used a grounded theory methodology(More)
Visual and auditory cues are important facilitators of user engagement in virtual environments and video games. Prior research supports the notion that our perception of visual fidelity (quality) is influenced by auditory stimuli. Understanding exactly how our perception of visual fidelity changes in the presence of multimodal stimuli can potentially impact(More)
PURPOSE In clinical settings, uncertainty is part of everyday practice. However, a lack of insight into how experts approach uncertainty limits the ability to explicitly teach and assess it in training. This study explored how experienced surgeons perceived and handled uncertainty during challenging intraoperative situations, to develop a theoretical(More)