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Updates on the use of Simulation Based Medical Education within this Speciality
Surgery has traditionally been learnt by repeated practice on patients...
Trainee surgeons were exposed to innumerable operative cases over many years, with supervision tailored to their needs.
This process has changed radically in recent years. Service targets and reductions in working time have reduced training opportunities for young doctors; and strong ethical imperatives have made it unacceptable for novices to learn “on patients”. Traditional approaches are therefore no longer tenable.
Simulation offers obvious benefits, especially in mastering counter intuitive techniques such as minimal access surgery.
Three major classes of surgical simulators are recognized. Reality-based simulators are ones in which the learner interacts with solid, real-life materials and uses surgical instruments expected to be used in the operating room. Web-based simulation allows learners to interact with online curricula, exercising the cognitive aspects of surgery (e.g. what are the steps of a gallbladder removal, what surgical instruments are needed). The most technologically sophisticated class of simulator is the VR simulator, which features a computer-generated model of anatomy and requires that the learner use near similar instrumentation to interact with virtual tissue structures and models.
Non-technical skills are increasingly recognised as important in surgical practice and these can be taught alongside technical ability using simulation and structured debrief.
In summary, surgical simulation offers extraordinary opportunities to teach multiple clinical scenarios in a safe, nonhuman patient environment where performance feedback is immediate and objective.
Mr Jon Hanson
Consultant Colorectal Surgeon
Clinical Lead for Simulation Centre North East