AIM:To assess where we currently stand in relation to simulator-based training within modern surgical training curricula. METHODS:A systematic literature search was performed in PubMed database using keywords "simulation", "skills assessment" and "surgery". The studies retrieved were examined according to the inclusion and exclusion criteria. Time period reviewed was 2000 to 2013. The methodology of skills assessment was examined. RESULTS:Five hundred and fifteen articles focussed upon simulator based skills assessment. Fifty-two articles were identified that dealt with technical skills assessment in general surgery. Five articles assessed open skills, 37 assessed laparoscopic skills, 4 articles assessed both open and laparoscopic skills and 6 assessed endoscopic skills. Only 12 articles were found to be integrating simulators in the surgical training curricula. Observational assessment tools, in the form of Objective Structured Assessment of Technical Skills (OSATS) dominated the literature. CONCLUSION:Observational tools such as OSATS remain the top assessment instrument in surgical training especially in open technical skills. Unlike the aviation industry, simulation based assessment has only now begun to cross the threshold of incorporation into mainstream skills training. Over the next decade we expect the promise of simulator-based training to finally take flight and begin an exciting voyage of discovery for surgical trainees. Core tip: The nature of surgical training has teetered on the brink of a seismic change in how we can deliver the level of expertise required of a modern surgeon for over a decade. It is evolving from Halstedian's apprenticeship model towards simulation-based training similar to the aviation industry. Since 2000 there have been approximately 173 studies about validation of simulators as assessment tools. As the technology grows, its translation into real changes in curriculum is still unclear. This review is focused upon where we currently stand in relation to the effective integration of simulation-based skills assessment into modern surgical training curricula.Shaharan S, Neary P. Evaluation of surgical training in the era of simulation. World J Gastrointest Endosc 2014; 6(9): 436-447 Available from:

Photoacoustic imaging (PAI) is an emerging biomedical imaging technology, which can potentially be used in the clinic to preoperatively measure melanoma thickness and guide biopsy depth and sample location. We recruited 27 patients with pigmented cutaneous lesions suspicious for melanoma to test the feasibility of a handheld linear-array photoacoustic probe in imaging lesion architecture and measuring tumor depth. The probe was assessed in terms of measurement accuracy, image quality, and ease of application. Photoacoustic scans included single wavelength, spectral unmixing, and three-dimensional (3-D) scans. The photoacoustically measured lesion thickness gave a high correlation with the histological thickness measured from resected surgical samples ([Formula: see text], [Formula: see text] for melanomas, [Formula: see text], [Formula: see text] for nevi). Thickness measurements were possible for 23 of 26 cases for nevi and all (6) cases for melanoma. Our results show that handheld, linear-array PAI is highly reliable in measuring cutaneous lesion thickness , and can potentially be used to inform biopsy procedure and improve patient management.

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surgeons-at-risk-too (accessed April 3 2020,). 2. Pearce C. GPs should assume 'most' patients have Covid-19 and use PPE, says NHS England. Pulse. Available at URL: http://www. pulsetoday.co.uk/clinical/clinical-specialties/respiratory-/ gps-should-assume-most-patients-have-covid-19-and-use-ppesays-nhs-england/20040541.article (accessed April 3 2020,). 3. Ando W, et al. Handling and packaging of medical bags at acute disaster sites under high-temperature conditions. BMC Res Notes 2020; 13 :158 . 4. Wikipedia. Bag. Available at URL: https://en.wikipedia.org/ wiki/Bag (accessed April 3 2020,).