We all know that surgeons practice their craft for many years in medical school and residencies, but that’s not where surgeon education ends. Many people may not know that surgeons continue to train throughout their careers using lots of methods including cadavers, digital tools, traditional classes, labs and seminars and self-training methods.
Partly due to the COVID-19 pandemic, but primarily due to advances in technology, training using computer-based simulation has skyrocketed. In fact, leading medical schools and hospitals across the globe have deployed surgical simulation tools that allow surgeons, residents and medical students to practice specific surgical procedures in a highly realistic training environment.
The latest simulation technology relies on advanced graphics and gaming capabilities under the hood, leverages a virtual reality-style approach with haptic feedback and even allows surgeons to practice procedures using the same surgical instruments used in real surgeries. Its immersive approach has been proven to increase surgeons’ skills and lead to better patient experiences.
For medical teams and trainers, using simulation technology to refine essential surgical skills can create more confident, skilled surgeons, help attract top-notch residents looking for advanced training opportunities and create stronger brands for health organizations. But it’s not as simple as purchasing a simulator and handing it over to your surgical team. To get the most out of any surgical simulation training program, trainers should follow a few of these best practices.
Establish a Baseline
During surgical simulation training, I often work with surgeons at many different levels of experience, from residents at medical colleges and universities to professional surgeons looking to sharpen their skills on a particular procedure. To create training that delivers value for every person in a class or session, I start by assigning simulation exercises based on each person’s experience level and area of expertise. Training must be adapted to the needs of the individual trainee, so it is often helpful to test skills before starting the actual training course. This allows both the instructor and trainee to set the right goals up front.
For example, a young resident may have minimal hands-on laparoscopic surgical experience. I will make sure that they focus on practicing essential skills such as camera navigation, hand-eye coordination, clipping and cutting in an abstract environment before moving on to more complex laparoscopic scenarios. I might start by giving them a cholecystectomy training scenario on the simulator and focusing their attention on one part of the operation – such as the ability to accurately clip and cut – before moving on to other parts of the laparoscopic procedure. This gives the trainee an opportunity to focus on developing fundamental skills and master the basics before moving on to more complex parts of the operation.
Regardless of the baseline, the goal for every surgeon – no matter what their expertise level is at the beginning of training – is to improve their skills by the end of the course.
Reinforce Skills Through Repetition
The goal of surgical training is to mimic an operation on the human body as closely as possible while deepening a surgeon’s skills throughout the process. But a successful operation starts well before the first incision. Surgical simulation uses the best aspects of ‘learning by doing’ and ‘learning by mistakes’ against the understanding that humans learn by repetition.
With simulation training, surgeons can learn how to correct a mistake without even making the mistake — preparing them for the situation and teaching them how to correct it without any repercussions or damage. A surgical simulator will typically identify how a surgeon performed an exercise, what they may be doing wrong and provide suggestions to improve and secure a more positive patient outcome.
This provides an opportunity to practice the proper ergonomics of surgery through repetition – from understanding important details like hand positioning on surgical instruments to knowing where a surgeon should stand while performing an operation. For example, in laparoscopy, both the patient and team positioning as well as trocar positioning are important and are a significant part of discussions pre-surgery. Exercises can help pinpoint specific actions or movements for a successful operation, allowing surgeons the chance to make and correct mistakes within specific areas while still moving forward to the next steps of the operation.
Leverage Simulation Data to Track Progress
A surgical simulator provides a way for surgeons and residents to establish their skill set through repetition before testing out a specific procedure on a cadaver. This provides an opportunity to follow proficiency level-based training of key steps of operations in a clean environment and then apply these results to a life-like cadaver for training purposes.
A simulator is not a human subject, and the data produced is not swayed by any outside factors, providing an unbiased skills assessment. Variables such as procedure time, camera path length and overall safety can all be measured and scored to demonstrate competency in completing specific tasks. This can even be used to demonstrate positive or negative proficiency in completing certain orthopedic skills.
Simulation technology offers unique insights that can’t be replicated from other non-technical training resources. For example, when performing an arthroscopic procedure on a simulator, a surgeon will be notified if they accidentally scratch a bone with an instrument.
Expand Your Training Program
As technology becomes more commonplace in training, surgical simulation will continue to grow in relevance and impact. Just as pilots are expected to complete a set number of flight simulation hours, surgical simulation training offers surgeons and prospective surgeons the ability to learn and reinforce essential skills before operating on patients. It is anticipated that the majority of surgeons-in-training will eventually rely on simulation.
By following a few best practices, trainers can deploy a solid simulation training program that is highly effective at surgeon advancement, easily measurable and improves the overall performance and reputation of surgical and health care teams.
