55. Simulation based training of technical surgical skills: A review of a five-year collaborative research program supported by the RCPSC Medical Education Funds

Abstract

During the past five years, with support from the RCPSC, a collaborative group of researchers conducted projects investigating issues related to simulation based training of technical surgical skills. The aim of this presentation is to review the body of work generated, its significance, and outline future research plans. 
 In all studies, participants were medical students and residents from 3 medical schools in Ontario. First, we successfully demonstrated that trainees benefit from simulation-based practice by improving their ability to multitask. This ability not only increases technical proficiency, but also results in an enhanced ability to learn other aspects of surgery. Second, we showed that the adaptation of learning theories helps in optimizing training curricula by matching the fidelity of a simulator to the trainees’ level of expertise. Third, we provided validation of both expert and computer based methods for assessment. We showed that computer based assessments are sufficient for the evaluation of trainees learning fundamental skills, while expert based measures are more effective in the evaluation of performance on complex technical skills. Finally we demonstrated that examination-induced stress has a facilitating effect on trainees’ skills performance. 
 This body of research lends support for the inclusion of a simulation based approach to training technical skills. It also highlights the importance of the choice of assessment methods. Collectively this work highlights the need for further research in the optimization of training methods by the incorporation of learning theory into the existing training curricula. Related to this, further research in our laboratory will investigate the effects of practice schedule and expert feedback, as well as the role of self-regulated practice in the acquisition of technical surgical skills.
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