Advances in Pediatric Surgery Simulation-Based Training

Abstract

Pediatric surgery is the diagnostic, operative, and postoperative surgical care of children with congenital and acquired anomalies and diseases. The early history of the specialty followed the classic “see one, do one, teach one” philosophy of training but has since evolved to modern methods including simulation-based training (SBT). Current trainees in pediatric surgery face numerous challenges, such as the decreasing incidence of congenital disease and reduced work hours. SBT consists of several modalities that together assist in the acquisition of technical skills and improve performance in the operating room. SBT has evolved to incorporate simulator models and video gaming technology, in parallel with the development of simulation in other surgical and non-surgical pediatric fields. SBT has advanced to a level of sophistication that means that it can improve the skills of not only pediatric surgery trainees but also practicing attending surgeons. In this review, we will discuss the history of pediatric surgery, simulation in pediatric surgery training, and the potential direction of pediatric surgical simulation training in the future.

Advancements in surgical education: exploring animal and simulation models in fetal and neonatal surgery training

“…In such a confined surgical space, the surgeon must make many physical and spatial adaptations. The surgeon's development of these skills takes much time and practice ( 15 ). Thirdly, successful fetal and neonatal surgeries require a thorough understanding of the unique developmental changes that occur in these early stages of life, which is acquired only via the appropriate combination of didactic and experiential learning.…”

“…Pediatric and fetal surgery requires operating in small, confined spaces, which is very different as compared to adults. Given these space constraints, laparoscopic techniques are more challenging for fetal and neonatal surgeons ( 15 ). Individual development of these skills can be accomplished through laparoscopic trainers that replicate reduced space conditions and simulate neonatal surgical situations ( 32 ).…”

“…Further, these simulators can assist in fostering a better understanding of anatomy and surgery in affected families. Limitations of VR and AR are expense, cybersickness, and the level of fidelity ( 15 ).…”

“…Sandrini et al showed that models of fetal hearts demonstrate the complexity of both normal and pathological cardiac architecture ( 43 ). 3D models can be created with many of the characteristics of the original structures, including their dimensions, geometry, surface roughness and even color ( 15 ). 3D models allow surgeons and residents to adopt a more hands-on approach to learning complex procedures without a patient needing to be present ( 44 ).…”