Simulation and surgical training

Abstract

The aim of this review was to outline current forms of surgical simulation and methods of assessing technical skills using these forms of simulation. To review this subject, a literature search was done using key words 'assessment', 'simulation', 'surgery', 'technical skills' and 'virtual reality'. Simulation in surgery has several forms, inorganic (synthetic & computer) and organic (animal or cadaver). Surgical simulation is a mode of training which is promising and may be effective. Technical errors in the simulated environment do not have clinical consequences and does not have a morbidity or mortality. We must ensure that the competent skills learnt in the simulation environment are translated to the real environment. This can be achieved if the same assessment tools are used in both environments. Surgical training is entering a new era, with increased scrutiny and an evolving work and training environment. We as surgical teachers must ensure that the surgeons of the future are as competent as or better than their predecessors using these new modes of training which we have access to.

Deployment of self-expandable stents in aneurysmatic cerebral vessels: comparison of different computational approaches for interventional planning

“…The interest in numerical tools, which support clinician decisions, has increased over the last few years. Rapid advances in technology and the demand for improved patient safety have led to an increased use of simulation technologies in medicine (Dawson et al 2007;Sarker and Patel 2007;Tsang et al 2008). Such support becomes increasingly important when, as in the case of endovascular treatment of cerebral aneurysms, the number of previously treated patients is limited (i.e.…”

Innovations in surgery simulation: a review of past, current and future techniques

“…Common techniques offered by low-fidelity bench-top simulators include knot-tying and suturing (20). However, high-fidelity bench-top simulators which combine both synthetic and animal parts have also been developed (2).…”

“…Lowfidelity models only allow practice of individual skills or techniques rather than an entire operation, while highfidelity models can replicate an entire surgery with a high degree of realism. Although high-fidelity models are desirable for closely emulating the operating room environment, low-fidelity models are cheaper and allow quick and repetitive simulation of a specific skill to enable mastery of individual techniques (20). Importantly, the level of fidelity should be appropriate to the type of task and training stage: a low-fidelity simulator is better suited for a novice practicing basic surgical skills such as handeye coordination and knot-tying, while a higher-fidelity system that encompasses a wide variety of skills better serves advanced surgeons (19).…”

Simulation in surgical education

“…[12][13][14][15] Cadavers are infrequently used in surgical education because of cost, limited availability and inability to simulate complications such as bleeding. 12,15 Synthetic benchtop models and tower trainers Synthetic models include those designed to teach open surgical procedures (commonly referred to as benchtop models) and Review 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).…”

“…12 The advantages of animal models include realism and opportunities to mimic complications. However, they have been criticized for their expense, the fact that their anatomy can differ from that of humans, and ethical reasons.…”