BACKGROUND: The initial focus of simulation in surgical education was to provide instruction in procedural tasks and technical skills. Recently, the importance of instruction in nontechnical areas, such as communication and teamwork, was realized. On rotation, the surgical resident requires proficiency in both technical and non-technical skills through the entire patient care pathway, i.e., pre-, intra- and postoperatively. METHODS: The focus was upon implementation of a biliary disease-based surgical simulation curriculum. The cornerstones of this module were clinical care pathway simulation sessions, at the commencement and conclusion of the 3 days. Each resident completed a simulated outpatient encounter with a standardized patient (SP) presenting with biliary colic, performed a laparoscopic cholecystectomy on a porcine model in a simulated operating room and completed an uncomplicated follow-up visit with the same SP. Assessments of resident performance were collected for every pathway scenario using standardized assessment forms approved by the American Board of Surgery. Additional formative sessions included hands-on, didactic and SP encounter sessions. RESULTS: The biliary surgical simulation pathway curriculum was successful implemented over the course of a 3-day, immersive module. The curriculum was delivered within the Penn Medicine Clinical Simulation Center and accommodated six junior surgical resident learners. The curriculum was divided into 4-h sessions, each led by a department faculty member. The cost of the implementation approximated $17,500 (USD). CONCLUSION: It is imperative that surgical residents undergo simulation training directly linked to their hospital responsibilities so as to provide immediate performance improvement and reduce errors in the clinical environment. This pathway curriculum has successfully shown the feasibility to implement this novel approach to surgical simulation for junior resident training at an academic medical center. Such a patient-focused approach to surgical simulation should lead to higher-quality training for residents and supports the use of this pathway curriculum in the future.
BACKGROUND: The initial focus of simulation in surgical education was to provide instruction in procedural tasks and technical skills. Recently, the importance of instruction in nontechnical areas, such as communication and teamwork, was realized. On rotation, the surgical resident requires proficiency in both technical and non-technical skills through the entire patient care pathway, i.e., pre-, intra- and postoperatively. METHODS: The focus was upon implementation of a biliary disease-based surgical simulation curriculum. The cornerstones of this module were clinical care pathway simulation sessions, at the commencement and conclusion of the 3 days. Each resident completed a simulated outpatient encounter with a standardized patient (SP) presenting with biliary colic, performed a laparoscopic cholecystectomy on a porcine model in a simulated operating room and completed an uncomplicated follow-up visit with the same SP. Assessments of resident performance were collected for every pathway scenario using standardized assessment forms approved by the American Board of Surgery. Additional formative sessions included hands-on, didactic and SP encounter sessions. RESULTS: The biliary surgical simulation pathway curriculum was successful implemented over the course of a 3-day, immersive module. The curriculum was delivered within the Penn Medicine Clinical Simulation Center and accommodated six junior surgical resident learners. The curriculum was divided into 4-h sessions, each led by a department faculty member. The cost of the implementation approximated $17,500 (USD). CONCLUSION: It is imperative that surgical residents undergo simulation training directly linked to their hospital responsibilities so as to provide immediate performance improvement and reduce errors in the clinical environment. This pathway curriculum has successfully shown the feasibility to implement this novel approach to surgical simulation for junior resident training at an academic medical center. Such a patient-focused approach to surgical simulation should lead to higher-quality training for residents and supports the use of this pathway curriculum in the future.
Authors: Jeffrey H Peters; Gerald M Fried; Lee L Swanstrom; Nathaniel J Soper; Lelan F Sillin; Bruce Schirmer; Kaaren Hoffman Journal: Surgery Date: 2004-01 Impact factor: 3.982
Authors: Rajesh Aggarwal; Oliver T Mytton; Milliard Derbrew; David Hananel; Mark Heydenburg; Barry Issenberg; Catherine MacAulay; Mary Elizabeth Mancini; Takeshi Morimoto; Nathaniel Soper; Amitai Ziv; Richard Reznick Journal: Qual Saf Health Care Date: 2010-08
Authors: Rajesh Aggarwal; Teodor P Grantcharov; Jens R Eriksen; Dorthe Blirup; Viggo B Kristiansen; Peter Funch-Jensen; Ara Darzi Journal: Ann Surg Date: 2006-08 Impact factor: 12.969
Authors: Noel N Williams; Mayank K Mittal; Kristoffel R Dumon; Gretchen Matika; Lori A Pray; Andrew S Resnick; Jon B Morris Journal: J Surg Educ Date: 2011 Jan-Feb Impact factor: 2.891
Authors: Richard C Newton; Oliver T Mytton; Rajesh Aggarwal; William B Runciman; Michael Free; Bjorn Fahlgren; Masanori Akiyama; Barbara Farlow; Sara Yaron; Gerad Locke; Stuart Whittaker Journal: Qual Saf Health Care Date: 2010-08