TEACHING TECHNOLOGICAL SCIENCES

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TEACHING TECHNOLOGICAL SCIENCES

• FOR THE NON-PHYSICS MAJOR

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Margaret Rodriguez, CST,CFA, BS

• Most definitely NOT a physics major.
• Great believer in common sense, easy to
  conceptualize, methods of teaching difficult
  materials.

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TEACHING TECHNOLOGICAL SCIENCES FOR THE
NON-PHYSICS MAJOR

• OBJECTIVES
• Upon completion of this discussion, the
  participants will be able to
• Discuss the topics outlined in the Core
  Curriculum for Surgical Technology, 5th Edition.

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Objectives, continued

• Discuss the impact of the subject material on the
  comprehension and performance of students in the
  clinical setting and, for the future, the success
  of entry level surgical technologists in the work
  place.

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Objectives, continued

• Explore ideas for teaching lessons in the physics
  of OR equipment including
• Electricity and electrosurgery
• Ionizing and non-ionizing radiation
• Ultrasonic energy
• Minimally invasive procedures
• Robotics and guided imagery

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Objectives, continued

• Network with other instructors
• Identify prizes and pitfalls of subject material
  presentations
• Acquire a reference base for development of
  individualized course content while meeting the
  requirements of the Core Curriculum

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Why teach this type of material?

• If it can harm the patient or kill you as an
  employee, then it might be of benefit to learn
  about the physics behind the devices and gain a
  conceptual grasp of how things work and why.

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Everything old is new again.

• What we knew in high school or college needs to
  be re-visited and re-tooled in order to present a
  fresh face on the subject matter to students
  deeply entrenched in the microwave, cell phone,
  digital age we live in at present.

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Old dogs, new tricks.

• We think we know our subject material well and we
  may..
• Until it changes by way of new technological
  advances in medicine and the supportive
  mechanical devices.

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Resistance is futile.

• We may not want to teach about subjects such as
  robotics because it is not used in our geographic
  areas .
• But, they have built them and they will come.

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Technological Sciences for the Surgical
Technologist

• Catalog description
• Provides in-depth coverage of specialized
  surgical modalities. Areas covered include
  endoscopy, microsurgery, therapeutic surgical
  energies, and other integrated science
  technologies.
• El Paso Community College,
• SRGT 1244, 2 credits

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UNIT TITLES

• Electricity, Electosurgery, and Fire Safety
• Ionizing and Non-ionizing Radiation
• Ultrasonic and Hydrodissection Devices

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UNIT TITLES contd

• Endoscopy and Minimally Invasive Surgery
• Microscopes and Microsurgery
• Robotics and Guided Imagery

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MORE OF A GOOD THING

• When this course was created six years ago, we
  needed enough content to justify a special
  needs course.

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MORE OF A GOOD THING

• The course was created out of a concern by
  hospital directors who wanted students to be
  better prepared with regard to minimally invasive
  procedures
• equipment, techniques, conversions to open,
  modification to room set-ups, and the new
  technologies used in these cases

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CORE CURRICULUM

• BASIC COMPUTER KNOWLEDGE
• ELECTRICITY
• PHYSICS
• ROBOTICS

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BASIC COMPUTER KNOWLEDGE

• Most students now have more computer skills than
  we do.
• Many degree plans incorporate a course on general
  computing skills.
• Many lectures are now presented with computer
  assistance such as Power Point or Internet
  connections.

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BASIC COMPUTER SKILLS

• Do you teach it in your courses?
• Do you have them take a separate course?
• How much classroom time is devoted to computer
  skills?

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BASIC COMPUTER KNOWLEDGE

• Is there anyone who currently has students who
  are completely in the dark about using a
  computer?
• Will there be a large emphasis on specifics on
  the PAE or CST exams?

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ELECTRICITY

• The physics of electricity are good concepts for
  anyone to understand.
• In the OR, it is crucial to be aware of the
  dangers of electrical current to both patients
  and personnel.

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UNIT PRESENTATION

• Power point presentation on electricity and
  electrosurgery

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ALTERNATING CURRENT

• Path of least resistance can be discussed as
  break in insulation of cords.
• Discuss importance of inspecting cords for breaks
  or exposure of wires.

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ALTERNATING CURRENT

• Because it is alternating, it must have a
  completed circuit.
• Discuss what happens at home to the circuit
  breaker when too much power is drawn or
• If you are going to work on the garbage disposal,
  trip that breaker!!

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ALTERNATING CURRENT

• Switches, circuits, rheostats can all be compared
  to everyday things
• Ask for examples from students to encourage
  critical thinking and analogies.

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ALTERNATING CURRENT

• If you have internet connection in your
  classroom
• www.howstuffworks.com
• choose science stuff and then search for
  electricity and terms will be highlighted to link
  to further explanations.

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STATIC ELECTRICITY

• Have students blow up balloons and rub on top of
  heads (if they have hair) and then see if the
  balloon sticks to the wall
• Discuss why we experience shocks more in dry
  weather and correlate that to the OR environment

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ELECTRICAL PLUGS AND GROUNDING

• Show a two-prong plug and have students discuss
  the reason why the hot wire prong is smaller than
  the neutral wire prong.
• Show a three-prong plug and discuss the need for
  grounding, especially in the operating room.

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ELECTROCAUTERY

• Demonstrate a battery operated ELECTROCAUTERY PEN
  to discuss the current, use, and applications.
• http//www.geigermedical.com/index.html for
  example of non-disposable unit

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ELECTROSURGERY

• If you have a working ESU in your lab, practice
  on piece of chicken, deli ham slices placed on
  ground pad.
• Use both cutting and coagulation modes.

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ELECTROSURGERY

• Have students wear surgical gloves and use
  hemostat on tissue and touch ESU electrode to
  instrument to demonstrate transfer of current.

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ELECTROSURGERY

• Change modes to bipolar mode if you have a foot
  pedal and demonstrate delivery of current between
  tines of bipolar forceps.
• Have students wear gloves for safety, just in
  case.

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ELECTROSURGERY

• If you do not have an ESU in your lab/classroom,
  try asking a company sales representative to
  bring in a unit for demonstration and practice.
• Arrange for a field trip to the OR.

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ELECTROSURGERY

• www.valleylab.com/education
• Very good tutorials on electrosurgery
• CE and practice tests available on ESU and fires
  in the OR

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ELECTROSURGERY

• Videos on electrosurgery
• Have students research Harvey Cushing and William
  Bovie and the first Bovie machines used in
  surgery.

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FIRE SAFETY

• Bring in a home ABC fire extinguisher and discuss
  the types of extinguishers
• Check fill gauge
• Discuss PASS and RACE

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FIRE SAFETY

• Discuss evacuation plans for school and operating
  room
• Send students out of classroom to report back
  where fire pull stations are located and practice
  a school evacuation

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FIRE SAFETY

• Videos in class
• Discussion of oxygen enriched environment
• Have students make posters with fire triangle
  with examples of fuel and ignition sources.

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PHYSICS

• VERY BROAD UMBRELLA OF INFORMATION
• Ionizing radiation
• Electromagnetic spectrum
• Radiology
• Radiation therapy/nuclear medicine

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IONIZING RADIATION

• Electromagnetic spectrum
• Wavelengths and what they mean
• Electromagnetic fields
• http//www.colorado.edu/physics/2000/waves_particl
  es/return_el.html
• http//science.howstuffworks.com/
• http//imagers.gsfc.nasa.gov/ems/ems.html

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IONIZING RADIATION

• X-rays
• Show x-ray films and discuss tissue types and
  reactions to x-ray beam
• Show dosimeter badge and discuss hazards of
  exposure
• Have students try on a lead apron

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IONIZING RADIATION

• If you have a radiology technology program,
  invite a faculty member or senior student in to
  discuss radiation safety
• Arrange a tour of a local cancer treatment center

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IONIZING RADIATION

• http//science.howstuffworks.com/x-ray.htm
• http//www.colorado.edu/physics/2000/index.pl
• http//www.osha.gov/SLTC/radiationionizing/

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INTERVENTIONAL RADIOLOGY

• Patient education information
• Gamma Knife for Neurosurgery
• http//www.elekta.com/patientus.nsf
• Need to choose method of download then watch
  video presentation

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INTERVENTIONAL RADIOLOGY

• Patient education information
• Stereotactic breast biopsy
• http//www.radiologyinfo.org/content/intervention
  al/breast_biopsy_xr.htm
• Radiation treatment options
• http//www.radiologyinfo.org/content/therapy/radi
  ation_therapy.htm

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NON-IONIZING RADIATION

• LASERS
• Properties of light
• Types of laser media (gas, solid, liquid)
• Tissue effects from laser energy
• Laser safety issues
• http//science.howstuffworks.com/laser.htm

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LASER SAFETY

• http//www.osha.gov/SLTC/laserhazards/
• http//www.colorado.edu/physics/2000/ lasers/

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LASER TRAINING

• If possible, take a field trip to your hospital
  and ask your laser safety officer to prepare a
  hands-on inservice with whichever lasers they
  use.

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LASER TRAINING

• Point out laser signage and security systems
• Review a laser log for types of documentation
  required
• Inspect various wavelength coatings on laser
  goggles.

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LASER TRAINING

• Show a smoke evacuator and discuss need for
  control of smoke plume
• http//www.osha.gov/SLTC/laserelectrosurgeryplume/
  

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LASER TRAINING

• Borrow or open an instrument tray with ebonized
  instruments and discuss rationale behind use
• Point a flashlight at the wall or ceiling and
  then a laser pointer then both together to
  demonstrate light properties

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LASER TRAINING

• Videos on lasers in the OR
• Review of AORN Standards and Recommended Practices

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SOUND, VIBRATIONS,WAVES

• Ultrasonic scalpel
• Harmonic scalpel/Ultracision
• http//www.jnjgateway.com then link to various
  surgical procedures, product specifications,
  general information and online videos of
  technology and surgical procedures

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http//hyperphysics.phy-astr.gsu.edu/hbase/waves/s
tring.html
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ULTRASONIC SCALPEL

• If your hospitals use Harmonic scalpel or other
  version, ask sales rep to bring in a unit for
  demonstration and practice.
• Chicken works nicely

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ULTRASONIC SCALPEL

• If rep cannot bring unit to you, try trip to OR
  and ask a staff member to demonstrate as part of
  peer teaching credit
• Ask a surgeon who uses the Harmonic scalpel to
  explain the benefits over use of ESU or lasers

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ULTRASONIC SCALPEL

• Have students research to compare and contrast
  between ESU and ultrasonic scalpel regarding
  tissue effects, mechanism of action
• Tissue welding, denaturing of proteins, no char,
  no plume, no electrical current through patient,
  no grounding, slower, but generally safer,
  surgical procedures, types of tips, hand pieces,
  55,500 cycles/sec

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CUSA

• Cavitronic Ultrasonic Suction Aspirator
• Have students research difference between CUSA
  and Harmonic Scalpel
• Surgical applications of CUSA

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ULTRASONIC ENERGY

• See if anyone has a portable home jewelry
  ultrasonic cleaner and fill and demonstrate.
• Ask an ultrasound tech to visit and explain the
  mechanism of action used for imaging internal
  structures without radiation.

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VIBRATIONS

• http//hyperphysics.phy-astr.gsu.edu/hbase/waves/s
  tring.html
• String theory
• http//www.pbs.org/wgbh/nova/elegant/resonance.htm
  l

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Impact on surgery??
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MECHANICS

• Motion and Newtons Laws
• http//www.grc.nasa.gov/WWW/K-12/airplane/newton.h
  tml
• http//www.physicsclassroom.com/Class/newtlaws/new
  tltoc.html

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Newtons First Law
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Newtons Second Law
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Newtons Third Law
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MINIMALLY INVASIVE SURGERY

• Videos
• Practice with trainers for holding the camera
• Visit an endoscopy suite
• Assign research items from
• www.laparoscopy.com

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MINIMALLY INVASIVE SURGERY

• Discuss variations on room set-up for different
  procedures
• Outline steps for placement of Veress needle and
  for open laparoscopy

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MINIMALLY INVASIVE SURGERY

• Power point presentation on Laparoscopy

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STATES OF MATTER

• SOLIDS, LIQUIDS, GASES, PLASMA
• http//www.chemtutor.com/sta.htm
• http//www.visionlearning.com/library/module_viewe
  r.php?mid49lc3

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ROBOTICS AND GUIDED IMAGERY

• Currently, mainly large research/teaching
  hospitals are using robotics
• Nearly every hospital has some sort of guided
  imagery for various specialties, i.e. neuro, ENT

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Guided Imagery

• Electromagnetic navigation technology
• http//www.gehealthcare.com/rad/savi/education/edu
  cation_index2.htmlgallery

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Guided Imagery

• 21st Century Medicine 3-D imaging and
  Cyberspace
• http//www.pbs.org/safarchive/4_class/45_pguides/p
  guide_605/4565_cyber.html

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Guided Imagery

• Explanations of building 3 dimensional images for
  surgical planning
• http//groups.csail.mit.edu/vision/medical-vision/
  surgery/surgical_navigation.html

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Guided Imagery

• Archived internet broadcast treating chronic
  sinus problems with guided imagery Thomas
  Jefferson University Hospital
• http//slp3d2.com/thj_1004/broadcast.html

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Guided Imagery

• Stereotaxis and 3 dimensions in space
• Surgical planning lab Brigham and Womens
  Hospital
• http//splweb.bwh.harvard.edu8000

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Guided Imagery

• Spinal procedure articles online
• http//www.spineuniverse.com/displayarticle.php/ar
  ticle105.html
• UfluoroNav Virtual Fluoroscopy System

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Guided Imagery

• Image-Guided Surgery Space Age Technology
  Enters the Operating Room
• http//www.spineuniverse.com/displayarticle.php/ar
  ticle756.html

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Guided Imagery

• Institute for Biomedical Engineering The George
  Washington University
• Topics include surgical simulation, guided
  imagery techniques for breast cancer diagnosis,
  and Informatics for Disasters
• http//www.ibe.gwu.edu/sub7.html

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ROBOTICS

• Solving Theoretical and Practical Problems in
  Robotics Robotics, Dynamics, and Control
• Research group of Boston University
• http//robotics.bu.edu/dupont/research.htm

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ROBOTICS

• Robotics and Computers in Minimally Invasive
  Spine Surgery
• http//www.spineuniverse.com/displayarticle.php/ar
  ticle1511.html

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TELESURGERY

• Distance delivery of surgical care by use of
  robotics, computers, and satellite communications
• Have students discuss implications of technology
  in war, disaster areas, and eventually deep space

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TELEPRESENCE distance consultation
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ROBOTICS

• Ability to move in more degrees of freedom than
  human extremities
• Elimination of tremor and/or fatigue
• Future capabilities for tactile feedback

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ROBOTICS - Training
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ROBODOC?
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RESOURCES

• VARIOUS OPTIONS
• Utilize those on the reference list for the
  LCC-ST CST exam
• Dont be afraid to use as many visual aides as
  possible
• Satisfy as many learning styles as you can, i.e.
  auditory, visual, kinesthetic, etc

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RESOURCES

• Show and Tell with everything available
• Utilize the industry representatives
• Get hospital staff (former students) involved in
  teaching

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RESOURCES

• Request mini-lectures or hands-on demonstrations
  from local surgeons giving them a sense of
  ownership of your program
• Share expertise between other allied health
  programs by inviting speakers or senior students

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RESOURCES

• Distribute copies of articles from The Surgical
  Technologist journal on relevant subjects
• Check out teacher stores for charts, posters,
  or other learning aids.

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RESOURCES

• Of course, surf the world wide web to your
  hearts content
• Google.com is an enormous search engine
• Whats your preference?

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WHEN IS IT ENOUGH ?

• There is almost TOO much information available to
  demonstrate concepts, ideas, procedures, and
  technology.
• We must sift through and find what is most
  relevant to our students currently and what they
  will need in the near future.

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WHEN IS IT ENOUGH ?

• We, as instructors however, do not have the
  luxury of resting on our laurels
• When the technology changes we must reflect it
  in our lesson plans

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WHEN IS IT ENOUGH ?

• Remaining current in the future is the
  responsibility of graduates as they become more
  seasoned professionals
• We all need to continue learning

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THE ONLY CONSTANT IS CHANGE
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Thank you so much

• I wish you great luck and happy hunting!