Abstract
The use of simulation in surgical training is ever growing. Evidence suggests such training may have beneficial clinically relevant effects. The objective of this research is to investigate the effects of surgical simulation training on clinically relevant patient outcomes by evaluating randomized controlled trials (RCT). PubMed was searched using PRISMA guidelines: “surgery” [All Fields] AND “simulation” [All Fields] AND “patient outcome” [All Fields]. Of 119 papers identified, 100 were excluded for various reasons. Meta-analyses were conducted using the inverse-variance random-effects method. Nineteen papers were reviewed using the CASP RCT Checklist. Sixteen studies looked at surgical training, two studies assessed patient-specific simulator practice, and one paper focused on warming-up on a simulator before performing surgery. Median study population size was 22 (range 3–73). Most articles reported outcome measures such as post-intervention Global Rating Scale (GRS) score and/or operative time. On average, the intervention group scored 0.42 (95% confidence interval 0.12 to 0.71, P = 0.005) points higher on a standardized GRS scale of 1–10. On average, the intervention group was 44% (1% to 87%, P = 0.04) faster than the control group. Four papers assessed the impact of simulation training on patient outcomes, with only one finding a significant effect. We found a significant effect of simulation training on operative performance as assessed by GRS, albeit a small one, as well as a significant reduction to operative time. However, there is to date scant evidence from RCTs to suggest a significant effect of surgical simulation training on patient outcomes.
Highlights
Surgical training has traditionally been based on an apprenticeship model [1, 2], to which there are substantial benefits
Sixteen studies looked at surgical training, two studies assessed patient-specific simulator practice prior to the actual procedure, and one paper focused on warming-up on a simulator before performing surgery
There are multiple reasons for this, among them are technological advances that allow for increasing fidelity [53], residency work hour restrictions necessitating a shift of surgical education to outside operating room (OR) [9, 10, 12, 13, 54], and a changing medico-legal landscape concerning treatment standards [5]
Summary
Surgical training has traditionally been based on an apprenticeship model [1, 2], to which there are substantial benefits. Geneva University Hospitals, Rue Gabriel-Perret-Gentil 5, 1205 Geneva, Switzerland 3 Faculty of Medicine, University of Geneva, Geneva, Switzerland instruction and feedback in a live setting, enhancing the role of the expert as a scaffold for the trainee [3]. In the current climate of long waiting lists and schedules swamped by consultations and paperwork, the ethical and monetary costs to spending the time of expert surgeons necessary to train novices have never been higher [7, 8]. Concerns have been raised about unintended consequences [9, 12, 13], such as dilution to the quantity and quality of training opportunities [12]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
