Simulation-Based Learning Strategies to Teach Undergraduate Students Basic Surgical Skills: A Systematic Review

Abstract

We aimed to identify and critically appraiseall literature surrounding simulation-based learning (SBL) courses, to assess their relevance as tools for undergraduate surgical education, and create a design framework targeted at standardizing future SBL. We performed a systematic review of the literature using a specific keyword strategy to search at MEDLINE database. Of the 2371potentially eligible titles, 472 were shortlisted and only40explored active interventions in undergraduate medical education. Of those,20 were conducted in the United States,9 inEurope and11in the rest of the world. Nineteen studies assessed the effectiveness of SBL by comparing students' attributes before and after interventions, 1 study assessed a new tool of surgical assessment and 16 studies evaluated SBL courses from the students' perspectives. Of those 40 studies,12used dry laboratory,7wet laboratory,12mixed, and 9cadaveric SBL interventions.The extent to which positive results were obtained from dry, wet, mixed, and cadaveric laboratories were75%, 57%, 92%, and 100%, respectively. Consequently, the SBL design framework was devised, providing a foundation upon which future SBL interventions can be designed such that learning outcomes are optimized. SBL is an important step in surgical education, investing in a safer and more efficient generation of surgeons. Standardization of these efforts can be accelerated with SBL design framework, a comprehensive guide to designing future interventions for basic surgical training at the undergraduate level.