Is In-Vivo laparoscopic simulation learning a step forward in the Undergraduate Surgical Education?

Abstract

BackgroundEssentials Skills in the Management of Surgical Cases – ESMSC is an International Combined Applied Surgical Science and Wet Lab course addressed at the Undergraduate level. Laparoscopic Skills is a fundamental element of Surgical Education and various Simulation-Based Learning (SBL) models have been endorsed. This study aims to explore if there is any significant difference in delegates' performance depending on whether they completed In Vivo module prior to the equivalent in the laparoscopic simulator.Materials and methods37 Medical Students from various EU countries were divided in 2 groups, and both completed the “Fundamentals in Laparoscopic Surgery” module in the Dry-lab Laparoscopic Simulator as well as the same module “In Vivo” on a swine model. Group A (18 students, 48.6%) completed the “Fundamentals in Laparoscopic Surgery - FLS” module prior to the “In Vivo”, whereas group B completed the “In Vivo” module first. Direct Observation of Procedural Skills (DOPS) were used to assess delegates' performance.ResultsThe mean DOPS scores for the “FLS” and “In Vivo” models were 2.27 ± 0.902 and 2.03 ± 0.833, respectively, and the delegates' performance was not statistically significantly different between them (p = 0.128). There was no statistically significant difference in the scores among different gender, year of study, school and handedness groups. The alteration in the sequence between Dry-lab “FLS” and “In Vivo” modules did not affect the performance in neither the “FLS” nor the “In Vivo” models.ConclusionsThe inexpensive, but low-fidelity “FLS” model could serve an equal alternative Simulation-Based Learning model for the early undergraduate training. Our study demonstrated that high fidelity In Vivo simulation for laparoscopic skills does not affect significantly the improvement in the delegates' performance at the undergraduate level. Further studies should be conducted to identify at which stage of training should high fidelity simulation be introduced.

Increasing motivation and engagement in neurosurgery for medical students through practical simulation-based learning

“…No difference was noted in any performance outcome across different years of study ( Table 1 , p > 0.05 for any association). Whilst our small sample size may limit the power of our analysis, previous experiences with the course [ 8 , 20 ], alongside other studies [ 21 ] support this finding. We feel this may represent a lack of exposure to practical surgical teaching in undergraduate surgical education which should be addressed further in larger scale prospective studies.…”

Hands train the brain—what is the role of hand tremor and anxiety in undergraduate microsurgical skills?

“…It combines high and low fidelity in vivo, ex vivo and dry lab simulation modules with applied surgical science and basic knowledge interactive workshops. The current curriculum (cores integrated for research—Ci4R) is set up in an ergonomic way to combine 40 learning modules which promote multidisciplinary learning strategies and facilitate various research projects as part of the course [6, 24, 26–28]. This concept has been previously described [27], and it has received accreditation by the European Council for Continuous Medical Education (EACCME).…”

A step forward in surgical education?

“…There is also the question of whether these simulations are realistic. Pantelidis et al 8 showed that these dry-lab simulations can be as efficacious as porcine models, and this is corroborated by Shaharan and Neary 7 . In addition, at the undergraduate level in particular, haptic feedback is not necessary for the development of a similar skillset, as evidenced by Pantelidis and colleagues.…”

“…They used 2 groups of students, and had them participate in both groups, either in vivo first or the dry-lab simulation first. They concluded that high-fidelity in vivo simulation does not significantly improve results in comparison with dry-lab simulation 8 .…”