Surgical Simulation - Hardcover

Hardcover

ISBN 10: 1783081562 ISBN 13: 9781783081561

Verlag: Anthem Press, 2014

Inhaltsangabe

Now widely recognized as one of the most effective methods for training future surgeons, simulation has become an integral part of the multidimensional landscape that makes up a surgical education curriculum, and its role in surgical training only continues to grow. But no matter how advanced or complex the simulation tool, it is of little use without a knowledgeable educator and a well-prepared curriculum.

This book provides an overview of the current status of simulation-based training in various surgical disciplines and explains the science of surgical education, from developing a simulation programme to properly assess surgeons-in-training, to transferring the skills acquired through simulation into real-life settings. As such, the book can be used as a guide for understanding the basics of surgical education and the growing role played by simulation-based training.

Now widely recognized as one of the most effective methods for training future surgeons, simulation has become an integral part of the multidimensional landscape that makes up a surgical education curriculum. This book provides an overview of the current status of simulation-based training in various surgical disciplines and explains the science of surgical education, from developing a simulation programme to properly assess surgeons-in-training, to transferring the skills acquired through simulation into real-life settings. As such, the book can be used as a guide for understanding the basics of surgical education.

Über diesen Titel

Über die Autorin bzw. den Autor

Prokar Dasgupta is the professor of robotic surgery and urological innovation at King's College London and hon. consultant urological surgeon at Guy's and St Thomas' Hospitals. He is the editor-in-chief of the 'British Journal of Urology International'.

Kamran Ahmed is an academic clinical lecturer at King's College London and specialist registrar in urology at Guy's Hospital.

Peter Jaye is a consultant in emergency medicine at Guy's and St Thomas' NHS Foundation Trust (GSTT) and the director of simulation at GSTT, and leads simulation for King's Health Partners.

Mohammed Shamim Khan is a consultant urologist at Guy's Hospital and honorary reader at King's College London. He is the director of the BAUS Office of Education.

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Surgical Simulation

By Prokar Dasgupta, Kamran Ahmed, Peter Jaye, Mohammed Shamim Khan

Wimbledon Publishing Company

Copyright © 2014 Prokar Dasgupta, Kamran Ahmed, Peter Jaye and Mohammed Shamim Khan
All rights reserved.

ISBN: 978-1-78308-156-1

Contents

1. Surgical Simulation: An Overview, 1, 
2. Simulation in Historical Perspective: The History of Medical and Surgical Simulation, 15, 
3. The Role of Animal Models in Surgical Training and Assessment, 23, 
4. Full Procedural Surgical Simulation, 41, 
5. Developing Non-technical Skills, 51, 
6. Learning Curves for Simulators, 63, 
7. Developing a Simulation Programme, 73, 
8. Patient Safety and Simulation, 85, 
9. Psychometrics, 95, 
10. Future of Surgical Simulation, 111, 
Author Details, 123, 

CHAPTER 1

SURGICAL SIMULATION: AN OVERVIEW

Jason Y. Lee and Elspeth M. McDougall

Simulation-Based Surgical Training

Definitions

Assessment – a process of documenting an individual's knowledge, skills and attitudes or beliefs on a given topic or content

Certification – confirming a specific or pre-determined level of knowledge, skills or attitudes through a formal assessment process

Credentialing – an objective process of establishing the qualifications of individuals or organisations through a formal assessment or evaluative process

Curriculum – any planned educational experience that involves goals, objectives, teaching methods and assessment or evaluation of individuals

Simulation – a person, device, or set of conditions that attempts to imitate a real environment

Virtual reality – a computer-based simulation of a real environment that allows for immersive interaction

As a result of advancements in science and technology, the field of surgery has witnessed significant changes and growth over the past few decades. The introduction of new surgical technologies has also been accompanied by more challenging surgical procedures for a more complex patient population. In addition, factors such as legislated limitations on resident work hours, an increased emphasis on safety and patient-centred care and increasing pressures to utilise costly operating room (OR) resources more efficiently have mandated significant changes to surgical training curricula.

The traditional residency training paradigm established by Dr William Halsted placed a strong emphasis on structured apprenticeships, with trainees developing surgical expertise in a supervised clinical setting over a prolonged training period consisting of increasing levels of responsibility (1). However, the current surgical landscape has required significant modifications to this model, including the development of specific learning objectives outside of the clinical setting and an increased utilisation of simulation-based educational strategies. This repetitive practice of difficult surgical skills in a risk-free environment away from the patient provides the trainee with immediate feedback and the opportunity to train to a predetermined expert proficiency, and seems intuitively, therefore, more efficacious and efficient for both the patient and the healthcare system. This type of surgical education both allows trainees to meet the learning objectives necessary to achieve surgical competency and ensures that they and their surgical educators are able to focus on the development of surgical judgement during the OR experience.

The training of a competent surgeon is, without a doubt, a complex, multi-dimensional process. It is key to any learning activity, however, that the process address three main learning domains relevant to each individual trainee: cognitive, psychomotor and affective objectives (2). In order to meet these learning objectives, it is important to select educational strategies or tools that are congruent with the curricular goals, referred to by educators as a 'goals–tools match'. Simulation-based training is but one such strategy and should be integrated into an overall, well-developed surgical training curriculum. Proponents of simulation must be careful not to anoint it as the panacea for all surgical training issues or deficiencies. For some surgical training objectives, simulation may not provide the requisite experience needed by trainees to achieve competency, no matter how high its fidelity. For other objectives, there may be much simpler and more cost-effective instructional methods that can be utilised to achieve the same educational outcome. It is critical that educators understand the benefits and advantages of simulation-based training over other teaching strategies and implement such methods accordingly, thereby ensuring the 'goals–tools match' so strongly emphasised by contemporary educators (3).

Simulation-based training has been defined as:

A person, device, or set of conditions which attempts to present evaluation problems authentically. The student or trainee is required to respond to the problems as he or she would under natural circumstances. (4)

While simulation can imitate reality, it does not duplicate real-life clinical situations. Rather than considering this a limitation, it should be viewed as the very reason that simulation-based education can be an effective teaching tool on today's surgical training programmes. One of the key conceptual frameworks relevant to the development of expertise, the theory of deliberate practice (5), espouses the need for multiple repetitions of a skill and the provision of constructive feedback to ensure the skill is being learned correctly. Surgical simulation provides the trainee with an opportunity to repeatedly perform a specific skill, or set of skills, in a low-risk environment away from actual patients, thus allowing for a safe environment where things can 'go wrong' many times over. When properly designed and implemented, simulation- based training methods can also allow for individualised learning that takes into consideration differences in baseline skill levels of the students. There is also the possibility of building different clinical variations into the simulated training sessions, allowing trainees to practise with cases of increasing difficulty and complexity as well as experiencing rare clinical scenarios (6–7). Surgical simulation-based training not only permits structured, comprehensive and immersive learning opportunities, but also allows the educator to provide timely and constructive formative or summative feedback based on trainee performance, ensuring acquisition of correct proficiency-based competency.

Assessment of Trainees Using Surgical Simulation

The ability to provide accurate assessments of students is an essential component of any educational curriculum and is critical to successful surgical residency training (3). Regardless of whether it is the assessment of acquired knowledge and skills, changes in trainee behaviour, modifications to trainee attitudes or the ideal outcome of improved patient care, the ability to provide reliable and valid assessments is of paramount importance, particularly in the case of summative assessments (8–9). Whether it be simulation 'devices' such as pelvic box trainers and virtual reality (VR) laparoscopic simulators, or simulated 'clinical scenarios' such as mock OR team training sessions, surgical simulation-based training methods must be objectively validated and rigorously evaluated if they are to be used for the assessment of trainee competence.

Reliability speaks to the...

Details zur Ausgabe

• Verlag: Anthem Press
• Erscheinungsdatum: 2014
• Sprache: Englisch
• ISBN 10: 1783081562
• ISBN 13: 9781783081561
• Einband: Gebundene Ausgabe
• Anzahl der Seiten: 132
• Herausgeber: Dasgupta Prokar, Ahmed Kamran, Jaye Peter
• Kontakt zum Hersteller: preigu GmbH & Co. KG; mail@preigu.de; ; Lengericher Landstr. 19; Osnabrück; Niedersachsen; 49078; Deutschland