Background and Aims: simulators are widely used in occupations where practice in authentic environments would involve high human or economic risks. surgical procedures can be simulated by increasingly complex and expensive techniques. this review gives an update on computer-based virtual reality (vr) simulators in training for laparoscopic cholecystectomies.Materials and Methods: from leading databases (medline, cochrane, embase), randomised or controlled trials and the latest systematic reviews were systematically searched and reviewed. twelve randomised trials involving simulators were identified and analysed, as well as four controlled studies. furthermore, seven studies comparing black boxes and simulators were included.Results: the results indicated any kind of simulator training (black box, vr) to be beneficial at novice level. after vr training, novice surgeons seemed to be able to perform their first live cholecystectomies with fewer errors, and in one trial the positive effect remained during the first ten cholecystectomies. no clinical follow-up data were found. optimal learning requires skills training to be conducted as part of a systematic training program. no data on the cost-benefit of simulators were found, the price of a vr simulator begins at eur 60 000.Conclusions: theoretical background to learning and limited research data support the use of simulators in the early phases of surgical training. the cost of buying and using simulators is justified if the risk of injuries and complications to patients can be reduced. Developing surgical skills requires repeated training. in order to achieve optimal learning a validated training program is needed.

BackgroundVideo analyses of real-life newborn resuscitations have shown that Neonatal Resuscitation Program (NRP) guidelines are followed in fewer than 50 % of cases. Multidisciplinary simulation is used as a first-rate tool for the improvement of teamwork among health professionals. In the study we evaluated the impact of the crisis resource management (CRM) and anesthesia non-technical skills instruction on teamwork during simulated newborn emergencies.MethodsNinety-nine participants of two delivery units (17 pediatricians, 16 anesthesiologists, 14 obstetricians, 31 midwives, and 21 neonatal nurses) were divided to an intervention group (I-group, 9 teams) and a control group (C-group, 6 teams). The I-group attended a CRM and ANTS instruction before the first scenario. After each scenario the I-group performed either self- or peer-assessment depending on whether they had acted or observed in the scenario. All the teams participated in two and observed another two scenarios. All the scenarios were video-recorded and scored by three experts with Team Emergency Assessment Measure (TEAM). SPSS software and nlme package were used for the statistical analyses.ResultsThe total TEAM scores of the first scenario between the I- and C-group did not differ from each other. Neither there was an increase in the TEAM scoring between the first and second scenario between the groups. The CRM instruction did not improve the I-group’s teamwork performance. Unfortunately the teams were not comparable because the teams had been allowed to self-select their members in the study design. The total TEAM scores varied a lot between the teams. Mixed-model linear regression revealed that the background of the team leader had an impact on differences of the total teamwork scores (D = 6.50, p = 0.039). When an anesthesia consultant was the team leader the mean teamwork improved by 6.41 points in comparison to specialists of other disciplines (p = 0.043).ConclusionThe instruction of non-technical skills before simulation training did not enhance the acquisition of teamwork skills of the intervention groups over the corresponding set of skills of the control groups. The teams led by an anesthesiologist scored the best. Experience of team leaders improved teamwork over the CRM instruction.

New attitudes to medical ethics and demands for efficiency have brought increased attention to surgical skills and training. It is important to characterize the expertise and skill involved in the multidimensional surgical profession. At a time of change, there is a need to discuss the nature of surgical expertise, and also the prospects for resident training, with special reference to new minimally invasive techniques (MIS). In this paper, we selectively review knowledge on surgical expertise and the specific demands placed on a skilled MIS surgeon. In addition, the review contains a selection of studies from those areas that have been seen as important for the future of training in surgery.

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Abstract. Surgical There also seem to be grounds for connecting user support into structured simulator training program.

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Abstract-A vast variety of artificial intelligence techniques have been deployed to specific healthcare problems during the last thirty years with varying levels of success while there is a shortage of systematic matching of AI capabilities with the breadth of application opportunities. In this paper, we describe the process of identifying opportunities for deploying artificial intelligence to healthcare and social services on regional and national levels in Finland. The project involved a large number of stakeholders from a variety of backgrounds ranging from governmental agencies to entrepreneurs. The process described includes idea generation of an application or solution and its elaboration in workshops using a design thinking method. The resulting idea pool was filtered down to 34 best use case descriptions, which went through an architectural design process identifying AI capabilities needed in the components of these designs reported in this paper. The potential ones of the use cases were selected for prototype development. The subsequent steps in the process include feasibility prototypes and evaluation of the economic and business value of the solutions and applications.