Proposal of a synthetic ethylene-vinyl acetate bench model for surgical foundations learning: suture training

Abstract

Due to ethical and legal aspects involved in the handling of cadavers and animals the synthetic simulators are an alternative for learning how to suture technique plus the practice of various procedures such as incision and surgical flap. In this context, this paper describes and propose the use of a synthetic model manufactured from plates of ethylene-vinyl acetate (EVA) to teach primary surgical skills in medical students with no previous exposure to surgery. The model that provides the convenience of being easily reproducible, allowing the students in training can thus improve their skills before applying the technique in clinical practice. Key words: Education, Medical. Students, Medical. Teaching. Surgery. Sutures. RESUMODevido aos aspectos éticos e legais envolvidos no manuseio de cadáveres e animais, os simuladores sintéticos surgem como alternativa para o ensino-aprendizagem de técnicas de sutura e simulação de procedimentos, como a confecção de incisões e retalhos cirúrgicos. Neste âmbito é proposto e descrito um modelo de bancada sintético confeccionado a partir de etileno vinil acetato (EVA) para o ensino de habilidades cirúrgicas básicas, em estudantes de medicina sem exposição prévia a cirurgia. O modelo fornece a praticidade de ser reprodutível, barato e de fácil aquisição, possibilitando que o acadêmico em formação possa, portanto, aperfeiçoar suas habilidades antes de aplicar a técnica na prática clínica. Descritores: Educação Médica. Estudantes de Medicina. Ensino. Cirurgia. Suturas. -Acta Cirúrgica Brasileira -Vol. 26 (2) 2011Bastos EM et al.

Training on synthetic ethylene-vinyl acetate bench model allows novice medical students to acquire suture skills

“…Thus, it was unclear whether it was exactly the training on the EVA model that made this possible; or if, in fact, only the instructions during classes and during the surgical procedure were the main determinants of this performance. Although it seems obvious that the gain of skills through training in any model is superior compared to the non-training, in proposing a new model 11 , this cannot be only in a subjectivity level 20 , because in the teaching of surgical skills, the measurement of gains should be carried out by an objective evaluation method [12][13][14] . Thus, the main focus of this study was to determine whether training on the EVA model, considered as of low-fidelity, can be used/recommended as a tool for teaching sutures during the medical undergraduation, through a comparative analysis with the faculty-directed learning based on didactic materials (video and text about suture training).…”

“…In Group A, students practiced with surgical instruments and suturing by using the EVA bench model (Figure 1) with help of instructors (simultaneous feedback) according to the training described by our group 11 . In group B (control), the students received a faculty-directed training based on visualization of learning materials (textbooks and video-lesson) on the handling of surgical instruments and the manufacture of sutures.…”

“…Recently, we proposed in this context the use of a synthetic ethylene-vinyl acetate (EVA) bench model to teach medical students the fundamental skills (suture techniques) required to assist with cutaneous surgical procedures and feel comfortable in the operating room 11 . In this previous report 11 , we include subjective observations about the acquisition of suture skills; however, in this scenario (simulated surgical training) the evaluation of performance and of this skills' gain should be objective 12 and preferably made by a previously validated test 13,14 .…”

Cryopreserved tracheal segments: a new tool for bench surgical training in thoracic surgery

“…The use of fresh human cadavers and live animal models, which are considered to be of high fidelity or reality are very limited due to availability, high costs, potential of transmitting infectious diseases as well as ethical issues [1][2][3] . Thus, lower fidelity or reality simulators comprise inorganic, virtual reality and synthetic bench models 8,10 , which sacrifice realism for lower cost, portability and potential for repetitive use 7,8,10 . It is well known that cryopreserved trachea maintain smooth muscle, cartilage and epithelium 12 , keeping its "live" anatomical shape and consistency, thus it can be used as a safe and reliable high fidelity simulator.…”

“…However, ethical/legal and economical issues in the use of human cadavers, live laboratory animals and virtual reality simulators have prompted the use of numerous bench models made of organic or synthetic materials [1][2][3][7][8][9][10][11] . Most of these bench models are focused to trainees in general surgery, but few bench models are available for cardiothoracic fellows.…”