Simulation in advanced laparoscopy with an entero-enteric anastomosis model
Abstract
Background: there is a changing paradigm in surgical education, being laparoscopic training one of its major challenges. The objective of this study is to describe and evaluate our experience with a simulated laparoscopic small bowel anastomosis training model at a universitary surgical center.
Methods: a 4-week training program was conducted with participation of 3 general surgery residents. An ex vivo biological model in a box trainer was used to objectively evaluate a simulated entero-enterostomy.
Results: final procedure time was reduced an average of 15 minutes, with better outcomes according to OSATS scale.
Discussion: implementation of a modified, validated advanced laparoscopic skills training program showed positive results, taking only 4% of the weekly curricular schedule. The model has high fidelity, low cost and is easily reproducible.
Conclusions: simulated laparoscopic training is both mandatory and beneficial in surgical education.
References
(2) Fitts PM, Posner MI. Human performance. Belmont, CA: Brooks/Cole, 1967.
(3) Kolb DA. Experiential learning: experience as the source of learning and development. Englewood Cliffs, NJ: Prentice Hall, 1984.
(4) Kohn LT, Corrigan JM, Donaldson MS, eds. To err is human: building a safer health system. Washingtpn, DC: National Academies Press, 2000.
(5) Reznick R, MacRae H. Teaching surgical skills-changes in the wind. N Engl J Med 2006; 355:2664-9.
(6) Chinelli J, Rodriguez G. Simulación en laparoscopía durante la formación del cirujano general. Revisión y experiencia inicial. Rev Méd Urug 2018; 34(4):232-9.
(7) Martin JA, Regehr G, Reznick R, MacRae H, Murnaghan J, Hutchison C, et al. Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg 1997; 84:273-8.
(8) Bradley P. The history of simulation in medical education and possible future directions. Med Educ 2006; 40(3):254-62.
(9) Scott DJ, Bergen PC, Rege RV, Laycock R, Tesfay ST, Valentine RJ, et al. Laparoscopic training on bench models: better and more cost effective than operating room experience? J Am Coll Surg 2000; 191(3):272-83.
(10) Soper NJ, Fried GM. The fundamentals of laparoscopic surgery: its time has come. Bull Am Coll Surg 2008; 93(9):30-2.
(11) Universidad de la República, Facultad de Medicina, Escuela de Graduados. Programa de formación de especialistas en cirugía general. Montevideo: Facultad de Medicina-UdelaR, 2016. 15p. Disponible en: http://www.fmed.edu.uy/sites/www.egradu.fmed.edu.uy/files/Programa_de_postgrados/Especialidades/CIRUG%C3%8DA%20GENERAL.pdf [Consulta: 14 diciembre 2019].
(12) de Montbrun SL, Roberts PL, Lowry AC, Ault GT, Burnstein MJ, Cataldo PA, et al. A novel approach to assessing technical competence of colorectal surgery residents: the development and evaluation of the Colorectal Objective Structured Assessment of Technical Skill (COSATS). Ann Surg 2013; 258(6):1001-6.
(13) Kolozsvari NO, Feldman LS, Vassiliou MC, Demyttenaere S, Hoover ML. Sim one, do one, teach one: considerations in designing training curricula for surgical simulation. J Surg Edu 2011; 68(5):421-7.
(14) Hirsch ED, Jr. The core knowledge curriculum-what’s behind its success? Educ Leadership 1993; 50(8):23-30.
(15) Ericsson KA, Krampe RT, Tesch-Römer C. The role of deliberate practice in the acquisition of expert performance. Psychol Rev 1993; 100(3):363-406.
(16) McGaghie WC, Issenberg SB, Barsuk JH, Wayne DB. A critical review of simulation-based mastery learning with translational outcomes. Med Educ 2014; 48(4):375-85.
(17) Varas J, Mejía R, Riquelme A, Maluenda F, Buckel E, Salinas J, et al. Significant transfer of surgical skills obtained with an advanced laparoscopic training program to a laparoscopic jejunojejunostomy in a live porcine model: feasibility of learning advanced laparoscopy in a general surgery residency. Surg Endosc 2012; 26:3486-94.
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