Validation and implementation of surgical simulators: a critical review of present, past, and future

Schout, Barbara M.A.; Hendrikx, Ad J.M.; Scheele, Fedde; Bemelmans, Bart L.H.; Scherpbier, A. J. J. A.

doi:10.1007/s00464-009-0634-9

Cited by 202 publications

(172 citation statements)

References 74 publications

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“…Simulator-based training has recently evolved as an effective method in the training of surgeons (1). Developing the necessary eye-hand coordination before hands-on surgical practice may not only shorten the learning curve but also improve patient safety (2).…”

Section: Introductionmentioning

confidence: 99%

The impact of a simulation-based training lab on outcomes of hysterectomy

Asoğlu¹,

Achjian²,

Akbilgiç³

et al. 2016

J Turkish German Gynecol Assoc

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Results:The average estimated blood loss before and after simulation-based training was significantly different in TAH and RAH groups (317±170 mL versus 257±146 mL, p=0.003 and 154±107 mL versus 102±88 mL, p=0.004, respectively), but no difference was found for TLH and VH. The mean of length of hospital stay was significantly different before and after simulation-based training for each technique: 3.7±2.3 versus 2.9±2.2 days for TAH, 2.0±1.2 versus 1.3±0.9 days for VH, 2.4±1.3 versus 1.9±2.5 days for TLH, and 2.0±1.3 versus 1.4±1.7 days for RAH (p<0.01). Conclusion:Based on our data, simulator-based training may play an integrative role in developing the residents' surgical skills and thus improving the surgical outcomes of hysterectomy. (J Turk Ger Gynecol Assoc 2016; 17: 60-4)

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Section: Introductionmentioning

confidence: 99%

The impact of a simulation-based training lab on outcomes of hysterectomy

Asoğlu¹,

Achjian²,

Akbilgiç³

et al. 2016

J Turkish German Gynecol Assoc

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“…Las pautas OSATS utilizadas han sido validadas ampliamente en la literatura internacional 22 , principalmente en profesionales titulados con algún grado de formación en habilidades quirúrgicas (residentes, médicos, cirujanos). Su aplicación en pregrado, con alumnos que no cuentan con un basal de destrezas quirúrgicas, no está ampliamente difundido y, en este estudio, se demostró que su aplicación en este contexto también permite discriminar grados de habilidades (validez de contenido).…”

Section: Discussionunclassified

“…no se logró recopilar todas las encuestas de apreciación debido a dificultades con el seguimiento, considerando que el curso se realizó en horario extracurricular. Pudo haberse logrado un mayor grado de validez, ya que en esta experiencia no se logró diferenciar a expertos de novatos en el modelo de caja propuesto; validez de constructo 22 . Además, dado que no se evaluó las demás tareas incluidas en el entrenamiento por dificultades técnicas, sería interesante evaluar en futuros estudios los cambios de destrezas en éstas, teniendo en cuenta que el punto simple es la tarea más representativa en términos de sutura.…”

Section: Discussionunclassified

Programa Pionero De Simulación en Sutura Para Estudiantes De Medicina De Pregrado

Alvarado

et al. 2015

Rev Chil Cir

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a pioneer simulation curriculum of suture technique training for medical students introduction: Simulation has demonstrated utility in suture skills training on surgical residents. Objective: Evaluate validity of a simulated training curriculum of basic suture skills for medical students. methods: Study conducted on 2013. Medical students were selected from the School of Medicine of Pontificia Universidad Católica de Chile (EMPUC). The program included four theoretical sessions and six practical sessions in order to training basic surgical tasks (five in total) on a simulated rubber model: one handed knot-tying, simple suture, vertical mattress suture, subcuticular interrupted suture and subcuticular running suture. A survey was applied to the participants to qualify each element of the program, on a scale of 1 to 7 (face-validity). One task (simple suture) was recorded on video, before and after training, to be evaluated by two experts on a blind fashion (content validity). Experts measure participant skills using an OSATS (Objective Structured Assessment of Technical Skills) and operative time. Statistical analysis for non-parametric variables, median and interquartile range, significant p-value < 0.05. results: Thirty-six medical students participated, with assistance percentage was over 80%. Students qualified the experience favorably: simulated bench-model 6.0 ; p < 0.001) after training in every participant. conclusion: This simulated curriculum delivers an alternative method for the development of technical competencies in medical students and could be incorporated on medical schools curricula.

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“…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.…”

Section: Virtual-reality Simulationmentioning

confidence: 99%

“…To overcome the focus in the literature on validating specific simulators for specific surgical tasks, Schout and colleagues recommend designing and evaluating a comprehensive training program rather than validating only one aspect of the curriculum that can be performed on a simulator. 18 This article has been peer reviewed. …”

mentioning

confidence: 99%

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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Validation and implementation of surgical simulators: a critical review of present, past, and future

Cited by 202 publications

References 74 publications

The impact of a simulation-based training lab on outcomes of hysterectomy

The impact of a simulation-based training lab on outcomes of hysterectomy

Programa Pionero De Simulación en Sutura Para Estudiantes De Medicina De Pregrado

Simulation in surgical education

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