Alphonsus Chong's Personal Wiki

In the last three decades, simulation has become a key tool in the training of doctors and the maintenance of patient safety. Simulation offers an immersive, realistic way of learning technical skills. Recent changes to the training schemes in many surgical specialities mean that the hours spent working between senior house officer and consultant have been reduced. This, combined with other pressures (such as reduced operating hours), means that surgery has moved away from its traditional apprenticeship model and toward a competency-based one. Simulation can be a standardized and safe method for training and assessing surgeons. Use of simulation for training has become significant alongside the development of laparoscopic techniques, and evidence suggests that skills obtained in simulation are applicable in real clinical scenarios. Simulation allows trainees to make mistakes, to ask the “what if?” questions, and to learn and reflect on such situations without risking patient safety. Virtual reality simulators have been used to allow experts to plan complicated operations and assess perioperative risks. Most recently, fully immersive simulations, such as those with whole theater teams involved, and patient-centered simulations allow development of other key skills aside from purely technical ones. Use of simulation in isolation from traditional teaching methods will furnish the surgeon in training with skills, but the best time and place to use such skills comes only with experience. In this article we examine the role of simulation in surgical training and its impact in the context of reduced training time.

1. again there is this talk about competency vs apprenticeship based model – this is a false dichotomy
2. presenting it as an opportunity rather than challenge
3. history
4. emphasises externalities rather than advances in learning technology and pedagogy
5. water landings for pilots as simulation –> hudson
6. simulation shown to help in laparascopic
7. simulation focus on “learning” rather than “doing”; can do variation
8. need for feedback
9. not just for trainees –> for experts too! –> Amit
   1. new/ complex surgery
   2. non-technical skills
   3. patient focused simulation
10. problems
    1. too tasked based/ abstract
    2. haptics - good for low-fi (difficult for virtual)

Agha, R. A., & Fowler, A. J. (2015). The role and validity of surgical simulation. International Surgery. https://doi.org/10.9738/INTSURG-D-14-00004.1