Alphonsus Chong's Personal Wiki

This is a commentary on a paper by Sparks et al.

Technical skills are a pre-requisite, but insufficient for “surgical mastery”.

Non-technical skills include teamwork, leadership, situational awareness, and decision making.

Both technical and non-technical skills can be learnt. Simulation can help here. Beyond a substitute for real clinical situations, simulations provide more opportunity for debriefing, reflection, and assessment. Also low-frequency, high acuity situations can be simulated to allow trainees to gain experience without placing the patients in danger.

Technical and non-technical skills are interdependent. In their study, mid and high fidelity simulation enhanced non-technical skill acquisition compared to low fidelity simulation in which the surgeons were not required to perform technical tasks.

The commentators agree that moderate fidelity - defined as that able to “activate the psychological reality of the operative field and engage the surgeon in technical tasks” - is sufficient for training purposes.

Source:

Smink, D. S., Yule, S. J., & Ashley, S. W. (2017). Realism in Simulation. JAMA Surgery, 152(9), 825. https://doi.org/10.1001/jamasurg.2017.1086

Sparks, J. L., Crouch, D. L., Sobba, K., Evans, D., Zhang, J., Johnson, J. E., … Hildreth, A. (2017). Association of a surgical task during training with team skill acquisition among surgical residents: The missing piece in multidisciplinary team training. JAMA Surgery, 152(9), 818–825. https://doi.org/10.1001/jamasurg.2017.1085