Simulation changing surgical training

Surgical training has changed radically in the last few decades.  Competency-based training has replaced the traditional apprenticeship model based on Halsted’s principles, dating back to the 19th century.

In two review articles published in the Journal of Pediatric Urology, Monash University’s Mr Ram Nataraja reveals the significant benefits of surgical simulation in surgical training and education.

Mr Nataraja is a consultant paediatric and neonatal surgeon and Director of surgical simulation at Monash Children’s Hospital, and a senior lecturer at Monash University’s Department of Paediatrics.

“Healthcare education has evolved rapidly in the last twenty years, with changes especially evident in surgical training,” Mr Nataraja said.

“Simulation methodology is now an integral part of training various surgical subspecialties, especially for technical skills learning.”

“However, it is important to recognise that the role of simulation in surgical education is broader than merely technical skill acquisition.”

Many adverse incidents in surgical practice arise from or involve failures in communication, teamwork, and situational awareness, rather than technical expertise.

Mr Nataraja said that simulation can promote the learning, practice, refinement, and assessment of both technical and non-technical skills in a patient-safe environment.

“In addition to allowing learners to make mistakes without adverse patient impacts, simulation also allows for specific rehearsal of rare or unique situations,” he said.

Simulation modalities that have been shown to enhance surgical training and education include (but are not limited to): open surgical models and trainers, laparoscopic bench trainers, virtual reality trainers, simulated patients and role-play, hybrid simulation and scenario-based simulation.

“Some of these modalities are readily available and others more expensive; located in specialised surgical simulation centres,” Mr Nataraja said.

“Advances in simulator design have resulted in decreased cost and bring aspects of simulation-based medical education within the reach of all departments, even in resource-constrained environments.”

Mr Nataraja review includes an overview of essential educational principles that underpin contemporary medical education and support the practical application of surgical simulation.  His key message is that surgical simulation does not have to be expensive or time-consuming to be effective, and can be incorporated into busy surgical timetables.