Simulated laparoscopic operating room crisis: An approach to enhance the surgical team performance

Powers, Kinga A.; Rehrig, Scott T.; Irias, Noel; Albano, Hedwig A.; Malinow, Andrew M.; Jones, Stephanie B.; Moorman, Donald W.; Pawlowski, John; Jones, Daniel B.

doi:10.1007/s00464-007-9678-x

Cited by 78 publications

(48 citation statements)

References 37 publications

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“…Still, the FLS combination of didactic and psychomotor training in concert with an extensively validated high-stake exam is unique in minimally invasive surgery. Finally, FLS was shown to be very helpful as stratification criteria and as a technical element in submersive multidisciplinary training and MIS crisis resource management [27,34].…”

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confidence: 99%

“…The format and content of the MISTELS/FLS metrics were evaluated by a series of studies for their reliability [19,39], validity [2,4,5,11,14,17,20,26,27,39], feasibility of administration [11,27], and appropriateness of a passing score for the test [4, 5, 7-11, 18, 23-26, 31]. Exceeding the reliability threshold of 0.8 [19], the program meets the standards for high-stakes examination [11,19,39].…”

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Malpractice carrier underwrites Fundamentals of Laparoscopic Surgery training and testing: a benchmark for patient safety

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Malpractice carrier underwrites Fundamentals of Laparoscopic Surgery training and testing: a benchmark for patient safety

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“…Construct validity (i.e., ability to distinguish between experts and novices) was similarly demonstrated for a laparoscopic-crisis scenario in a simulated operating room. 21 The results are ambiguous, however, with respect to using these simulated environments to specifically teach complex non-technical skills. While simulated operating rooms are generally thought to be useful for training members of the operating-room team, they are complex, and expensive to maintain.…”

Section: Effectiveness In Teaching Non-technical Skillsmentioning

confidence: 99%

“…To both teach and assess non-technical and technical aspects of performance, virtual operating rooms have been developed. 4,[20][21][22] These rooms consist of an operating table, lights, suction equipment and an anesthesia machine. They contain a simulator (either synthetic or virtual reality) and a control room, which is separated from the operating room by a one-way mirror.…”

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Simulation in surgical education

Palter

Grantcharov²

2010

Canadian Medical Association Journal

121

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Key points• Both technical and non-technical skills are essential for surgeons in training.• Technical skills learned on low-fidelity benchtop models, video-based trainers and virtual-reality models are transferable to the operating room.• Current evidence does not show a clear advantage of either virtual reality or synthetic models in teaching technical skills.• Evidence is lacking on how best to integrate each type of simulator into a holistic, proficiency-based curriculum. Simulation in surgical educationVanessa N. Palter MD, Teodor P. Grantcharov MD PhDPreviously published at www.cmaj.caReview those used for teaching minimally invasive procedures (referred to as tower trainers or video-box trainers). Numerous benchtop models are available for the simulation of a variety of procedures, including knot-tying, fascial closure, and suturing 14 (Figure 1). The most obvious limitation of such models is that they teach only one surgical technique rather than an entire operation. 5 Their use requires the presence of an expert to demonstrate the procedure and provide feedback on performance. 1,5 Tower trainers include a box with slits on the superior surface for trocar insertion. Real laparoscopic instruments are inserted through the trocars into the box, where the procedure is simulated. A camera inside the box provides video output to a monitor on which trainees can watch their own movements. These models can simulate a variety of techniques, including laparoscopic suturing, knot-tying, clip-applying and coordination drills.14 One of the most well-described tower trainers is the physical laparoscopy trainer known as the McGill Inanimate System for Training and Evaluation of Laparoscopic Skills. This system consists of five tasks performed on an endotrainer box. 16 The tasks include peg transfer, cutting, placing a ligating loop and intracorporeal suturing. Virtual-reality simulationTraining by virtual-reality simulation encompasses systems designed to teach laparoscopic, endoscopic and percutaneous interventions. 13 The fidelity of virtual-reality simulators ranges widely, from the Minimally Invasive Surgical Trainer -Virtual Reality (MIST-VR) system, which is a low-fidelity system designed to teach general laparoscopic proficiency, to systems that teach component procedural skills and other systems that replicate entire operations 17 ( Figure 2 and Videos 1 and 2, available at www .cmaj .ca /cgi /content /full /cmaj .091743 /DC1). Unlike bench-model learning, the presence of an expert is not necessary when virtual-reality simulation is used. Such models allow for practice at varying levels of difficulty, can simulate complications and automatically provide objective measures of assessment, allowing for both formative and summative trainee assessment.18 Virtual-reality models have been criticized, however, for high initial cost of system acquisition, limited force-feedback with use of surgical instruments and lack of realism of graphics. 14,19The virtual operating room Benchtop models, virtual-reality models, and an...

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“…Mock operating room suites are often used to recreate crisis scenarios that both assess and improve communication, team skills, and the ability to react under stress, providing the opportunity to practice and develop a variety of skills in a controlled, risk-free environment at the learner's pace [5][6][7][8][9]. Skills required for technically challenging procedures are acquired in the simulated environment and hopefully transferred to the operating room, thus decreasing potential injury to the patient [5,6].…”

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Framing family conversation after early diagnosis of iatrogenic injury and incidental findings

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Simulated laparoscopic operating room crisis: An approach to enhance the surgical team performance

Cited by 78 publications

References 37 publications

Malpractice carrier underwrites Fundamentals of Laparoscopic Surgery training and testing: a benchmark for patient safety

Malpractice carrier underwrites Fundamentals of Laparoscopic Surgery training and testing: a benchmark for patient safety

Simulation in surgical education

Framing family conversation after early diagnosis of iatrogenic injury and incidental findings

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