Abstract
Background: Modern surgery demands high-quality and reproducibility. Due to new working directives, resident duty hours have been restricted and evidence exists that pure on-the-job training provides insufficient exposure. We hypothesize that supplemental simulations in animal models provide a realistic training to augment clinical experiences. This study reviews surgical training models, their costs and survey results illustrating academic acceptance.Methods: Animal models were identified by literature research. Costs were analyzed from multiple German and Austrian training programs. A survey on their acceptance was conducted among faculty and medical students.Results: 915 articles were analyzed, thereof 91 studies described in-vivo animal training models, predominantly for laparoscopy (30%) and microsurgery (24%). Cost-analysis revealed single-training costs between 307€ and 5,861€ depending on model and discipline. Survey results illustrated that 69% of the participants had no experience, but 66% would attend training under experienced supervision. Perceived public acceptance was rated intermediate by medical staff and students (4.26; 1–low, 10 high).Conclusion: Training in animals is well-established and was rated worth attending in a majority of a representative cohort to acquire key surgical skills, in light of reduced clinical exposure. Animal models may therefore supplement the training of tomorrow's surgeons to overcome limited hands-on experience until virtual simulations can provide such educational tools.
Highlights
This study aims at providing an overview of existing animal models for surgical training and a cost-analysis of various training applications
Overall the studies included all relevant information on the proposed surgical training models in animals
The majority of simulations were conducted in porcine models (70%), with a clear trend toward large animal models (75%) (Figure 3)
Summary
We hypothesize that supplemental simulations in animal models provide a realistic training to augment clinical experiences. Due to the restricted working hours enforced for residents, these traditional on-the-job training paradigms could be insufficient to learn key surgical skills and alternative approaches required [1]. For this purpose, supplemental education of key surgical techniques in animal models may provide a safe, realistic, and instructive training to augment clinical experiences and enhance patient safety. More complex clinical situations may require an in-vivo environment such as animal training to safely learn essential surgical skills. In-vivo team trainings have been invented that include all operating room (OR) staff to simulate a specific situation such as for example intraabdominal bleeding in a large animal, to optimize teamwork in critical situations
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