Basic Surgical Skills Research Articles

FTP4.2 Keeping it Simple: An Ongoing Near-Peer Teaching Programme Success for Surgical Skills and Simulation

Abstract Aims Over 2 years in our DGH we developed a programme of surgical simulation for medical students including acute scenarios and basic surgical skills. We aimed to roll this out on a bigger scale to include near-peer teaching between medical students, PAs, and FYs, and gain feedback to assess our progress. Methods The previous programme involved simulated acute scenarios with the Sim Man run by registrars for medical students with help from FY1s. We invited FYs involved in delivering sessions, to write new scenarios and take over leadership. We linked sessions with a weekly Surgical Skills Club and handed ownership of specific sessions to FYs to run near-peer teaching on suturing, knot tying and US guided vascular access. Electronic feedback from trainers and trainees rated satisfaction with teaching, confidence in skills, and enjoyment. Results Feedback was gained from 24 students for 4 Sim sessions over 4 months. 100% of students rated the scenarios very good or excellent. 100% felt they improved their skills in management of acutely unwell surgical patients, eg pancreatitis, appendicitis. 6 FY trainers took part and 100% rated the experience as “excellent”. Weekly feedback from Surgical Skills session attendees was consistently rated Very Good or Excellent, and trainer feedback was highly rated for improving confidence and leadership. Conclusion Near Peer Teaching of a combined programme of surgical simulation and skills is an excellent tool to improve confidence in managing acutely unwell patients in a safe environment, develops surgical skills, and promotes leadership roles at an early stage.

Are COVID-Era General Surgery Interns Starting Residency Behind on Basic Surgical Skills?

To compare incoming general surgery interns' performance on a basic skills assessment before and after the COVID pandemic. A retrospective cohort study compared surgical skill performances of incoming general surgery interns. Each underwent an evidence-based standardized assessment (pretest) with 12-basic surgical knot tying and suturing tasks. A post-test was administered after a 3-month self-directed skills curriculum. Student's t-tests compared proficiency scores from pre-COVID vs. COVID-era general surgery interns before and after curriculum completion. p < 0.05 was significant. Data was collected from surgical residents in an academic general surgery program in the United States. General surgery interns from 2017 to 2019 (pre-COVID) and 2021 to 2022 (COVID-era) were included. Interns with missing data or extreme outliers were excluded. A total of 100 interns in general surgery were included in the pretest cohort (59 pre-COVID, 41 COVID-era) and 101 interns were in the post-test cohort (66 pre-COVID, 35 COVID-era). COVID-era interns scored significantly lower on the pretest compared to pre-COVID interns (COVID-era 721.9+/-268.8 vs. pre-COVID 935.9+/- 228.0, p < 0.001). After the skills curriculum both cohorts improved their proficiency scores. However COVID-era interns still scored significantly lower (COVID-era 1255.0+/-166.3 vs. pre-COVID 1369.8+/-165.6, p = 0.001). This analysis objectively described deficits in fundamental surgical skills for incoming interns whose medical school education was disrupted by the COVID-19 pandemic. A targeted surgical skills curriculum partially remediated these deficiencies. However, many surgical interns may need additional intervention and potentially more time in order to fully develop their surgical skills and meet the competency requirements required for advancement.

Multiple teaching methods in undergraduate surgical training: a blended style may be the optimal choice!

BackgroundThere are various methods for teaching surgery to undergraduate students. Lecture-based learning (LBL) is a teacher-centered approach that comprehensively, accurately, and systematically conveys knowledge. Team-based, case-based, and problem-based learning methods are student-centered approaches that increase student enthusiasm and subject-related motivation. However, the COVID-19 pandemic disrupted conventional methods for teaching surgery to undergraduate students and its impact continues even today. This research investigates a variety of surgical teaching strategies and suggests optimal strategies for undergraduate students, especially within the context of the COVID-19 crisis.MethodsVarious teaching methods in undergraduate medical education that have emerged over the last 5 years are reviewed and analyzed, specifically those used for surgical training during the COVID-19 pandemic.ResultsTraditional in-person teaching methods have been replaced by novel approaches that increase efficiency, including social media adoption, simulation-based training, flipped-classroom concepts, and “Hand as Foot” teaching. However, traditional and novel approaches can be combined to teach students the fundamentals of science and basic surgical skills, which include incision, suturing and drainage, and chest tube insertion. Each method has its advantages and disadvantages under certain circumstances.ConclusionSeveral alternative teaching strategies and a combination of methods can complement traditional face-to-face learning, promoting the successful dissemination of academic knowledge and the improvement of clinical surgical skills in terms of objectivity, time-efficiency, and feasibility. The effects of the COVID-19 pandemic on the learning context can provide a reference for future teaching in response to unavoidable emergencies.

Competency assessment for the Versius surgical robot: a validity investigation study of a virtual reality simulator-based test.

When introducing new equipment like robotic surgical systems, it is essential to ensure that surgeons have the basic skills before operating on patients. The objective was to investigate the validity evidence for a competency-based test for basic robotic surgical skills using the Versius® trainer. We recruited medical students, residents, and surgeons which were classified based on data on clinical experience with the Versius system as either novices (0min), intermediates (1-1000min), or experienced (> 1000min). All participants completed three rounds of eight basic exercises on the Versius trainer, where the first was used for familiarization and the final two for data analysis. The simulator automatically recorded data. Validity evidence was summarized using Messick's framework, and the contrasting groups' standard-setting method was used to define pass/fail levels. 40 participants completed the three rounds of exercises. The discriminatory abilities of all parameters were tested, and five exercises including relevant parameters were selected to be part of the final test. 26 of 30 parameters could differentiate between novices and experienced surgeons but none of the parameters could discriminate between the intermediate and experienced surgeons. Test-retest reliability analysis using Pearson's r or Spearman's rho showed only 13 of 30 parameters had moderate or higher reliability. Non-compensatory pass/fail levels were defined for each exercise and showed that all novices failed all the exercises and that most experienced surgeons either passed or nearly passed all five exercises. We identified relevant parameters for five exercises that could be used to assess basic robotic skills for the Versius robotic system and defined a credible pass/fail level. This is the first step in developing a proficiency-based training program for the Versius system.

A Case Study of Karanja Tail in the Management of Dushta Vrana

Healing of Vrana is a physiological process of regeneration and repair after injury. Frequency of injury is more common and management of wound is basic surgical skill. The wound is the biggest challenge to medical profession since vedic era . The wound is healed by three way first is primary intention , second is secondary intention third is by tertiary intention .Sushruta Samhita classical text of Ayurveda has elaborately explained Shashthi ( sixty types of procedures) for the management of wounds to achieve good early healing without complication. His techniques are broadly classified as Vrana Shodhana (wound cleaning) and Vrana Ropana (wound healing). Karanja Taila due to its shodhana and ropana properties plays a important role in Dushta vrana . In Dushta vrana vata and kapha dosha has predominant and Karanja Taila has vataghana and kaphagna properties that help in dosha shamana in Dushta vrana.

Prior Robotic Console Expertise May Improve Basic Skills at the New Hugo RAS Simulator: Results from a Cohort Trial and Implications for Skill Transference Across Platforms

BackgroundRobot-assisted surgery ensures minimal invasiveness; since the expiry of the Da Vinci patent, new robotic systems have entered the market. Recently, the Hugo RAS received CE approval for several surgical procedures. However, more is needed to know about skill acquisition at the new simulator. ObjectiveThis study aims to analyse the factors impacting basic surgical skills at the Hugo RAS simulator. Design, setting, and participantsWe present a cross-sectional study involving 71 participants of different backgrounds invited to a hands-on session with the Hugo RAS simulator voluntarily. All of them had no prior expertise with the system. Participants were recruited among medical/nurse students, residents, and laparoscopic and robotic surgeons. InterventionAll participants underwent a hands-on “pick and place” exercise at the Hugo RAS simulator; the metrics of a second-round pick and place exercise were recorded. Outcome measurements and statistical analysisMetrics were analysed with regard to the following variables: demographics, videogame use, and prior surgical experience (no surgical expertise, experience with laparoscopy, and experience with robotic console). Results and limitationsAll participants completed the test. Of them, 77.5% were naïve to surgery, 8.5% had prior laparoscopic expertise, and 14.1% had prior robotic console experience. The time to complete the pick and place exercise was significantly lower (p < 0.001) among prior robotic surgeons (38 s, interquartile range [IQR] 34–45) compared with both naïve participants (61 s, IQR 53–71) and laparoscopists (93 s, IQR 53–162). The overall score of the exercise decreased with age (p = 0.046); however, the overall scores were significantly and steadily higher among surgeons experienced in robotic consoles across all age groups (p = 0.006). Neither gender (p = 0.7) nor videogame use (p = 0.9) correlated significantly with the metrics. ConclusionsThis is the first study analysing factors impacting basic skill acquisition at a new robotic simulator. Experience with robotic consoles may represent a major factor, raising the hypothesis of the transferability of basic robotic skills across different robotic systems. Further studies are required to explore this issue. Patient summaryIn the present study, we analysed which characteristics may affect the basic surgical skills at a novel robotic platform.

A Hands-On Surgical Event to Improve Medical Student Operating Room Confidence

IntroductionThe negative perceptions and lack of exposure to surgery and the operating room (OR) have been known to divert students away from surgical specialties. This study describes the impact of a surgical subspecialty exposure event (OR Essentials), combined with surgical faculty and M4 mentorship on preclinical medical students' confidence at an academic medical center. MethodsOR essentials event teaches surgical skills to preclinical medical students through hands-on skill-based workshops in a simulated OR setting. Pre and postevaluations were administered to measure program impact. ResultsOne hundred four preclinical medical students participated. Following OR essentials, students reported a significant increase in confidence in the OR (P < 0.0001) and in basic surgical skills (P < 0.0001). ConclusionsEarly surgical exposure events like OR essentials provide opportunities to improve medical student confidence in the OR, which will hopefully support recruitment of future surgeons.

(356) Microsurgical Training in a High-volume Academic Infertility Practice. What we Learn from the Residents

Abstract Introduction Surgical education has been traditionally rooted in the apprenticeship model, where the experts teach the surgeons-in-training during real-time surgeries. With the advent of robotics, the emphasis on simulation and virtual reality training is upon us. Objective The goal of this study is to examine lessons learned from the first few years of our institution’s microsurgical training. Methods A structured resident male infertility microsurgical training program was devised and multiple attempts at implementing it were made. When resident lack of interest/ time availability as well as COVID pandemic factored in, adjustments were made. And the devised assessment was applied to real-time surgeries. A structured assessment of the trainee’s skills was used by the faculty surgeon at initiation of the training, and throughout. All aspects of the assessment were evaluated on the scale of 1-5, with 1 being the lowest and 5 the highest. (Table 1) According to the individual improvement, the difficulty of the skills and steps of the procedure were advanced accordingly. This evaluation was not communicated with the trainees in order to avoid their undue stress/ intimidation. Results A total of 78 microscopic vasectomy reversal surgeries were performed by one staff surgeon and four consecutive resident surgeons between January 2020 and May 2022. All residents were in their 2nd year of Urology training (PGY-2). On average, each of the trainees participated in 17 vasectomy reversals (13-21), with similar amount of surgical time spent (about 3-4 hrs/ case). At initiation of their training, each individual had similar basic and microscopic surgical skills, procedure knowledge, economy of motion and tissue/ instrument/ needle handling ability (scores of 2-3 out of 5). Two of the trainees displayed higher level of interest and better listening skills, which resulted in willingness to correct their errors and ultimately improve on their surgical techniques. The resident with initial poor skill set and poor interest/ listening skills did not progress to more advanced stages of training and was relegated to initial dissection/ exposure and placement of adventitial sutures. The resident with slightly better surgical skills but unwilling to make corrections to his technique, progressed to the next level of placing occasional luminal sutures. The remaining two residents displayed the most interest, involvement and receptiveness to the feedback. They both progressed to the final stages of the training, with one of them performing the entire operation as a primary surgeon, with the staff assisting. (Table 2). Conclusions While the structured residency microsurgical training program is of utmost importance, competing professional and personal interests of the resident-surgeons may affect its full execution. Careful observation of the trainees, their skills, ability to receive and process the feedback in combination with teaching faculty’s patience and flexibility are paramount to the safe and effective “real-life” training. When devising a surgical training program it is important to keep in mind that surgical residents prefer hands-on operating experiences. Disclosure No

Experiences of public-private contracting for caesarean delivery in rural district public hospitals: A qualitative interview study.

Governments in sub-Saharan Africa are exploring public-private-engagements for the delivery of health services. While there is existing empirical literature on public-private-engagements in high-income countries, we know much less about their operation in low and middle-income countries. Obstetric services are a priority area where the private sector can make an important contribution in terms of skilled providers. The objective of this study was to describe the experiences of managers and generalist medical officers, of private general practitioner (GP) contracting for caesarean deliveries in five rural district hospitals in the Western Cape, South Africa. A regional hospital was also included to explore perceptions of public-private contracting needs amongst obstetric specialists. Between April 2021 and March 2022, we conducted 26 semi-structured interviews with district managers (n = 4), public sector medical officers (n = 8), an obstetrician in a regional hospital (1), a regional hospital manager (1) and private GPs (n = 12) with public service contracts. Thematic content analysis using an inductive, iterative approach was applied. Interviews with medical officers and managers revealed justifications for entering into these partnerships, including retention of medical practitioners with anaesthetic and surgical skills and economic considerations in staffing small rural hospitals. The arrangements held benefits for the public sector in terms of bringing in required skills and having after hours cover; and for the contracted private GPs who could supplement their income, maintain their surgical and anaesthetic skills and keep up to date with clinical protocols from visiting specialists. The arrangements held benefits for both the public sector and the contracted private GPs and were deemed to be an example of how national health insurance could be operationalised for rural contexts. Perspectives of a specialist and manager from a regional hospital provided insight into the need for different public-private solutions for this level of care in which contracting out of elective obstetric services should be considered. The sustainability of any GP contracting arrangement, such as described in this paper, will require ensuring that medical education programmes include basic surgical and anaesthetic skills training so that GPs opening practice in rural areas have the required skills to provide these services for district hospitals where needed.

OC-053 POSTERIOR COMPONENT SEPARATION AND THE USE OF BOTULINUM TOXIN IN ABDOMINAL WALL RECONSTRUCTION: NEED TO LEARN THE TECHNIQUE DURING THEIR RESIDENCY?

Abstract Tittle Posterior component separation and the use of botulinum toxin in abdominal wall reconstruction: need to learn the technique during their residency? Aim We aim to evaluate the transversus abdominis release (TAR) and the use of botulinum toxin A (BTA) in abdominal wall reconstruction learning curve based on proper identification of muscle layers and nervous component in the surgery and by US. Material and Methods Prospective study including patients submitted to TAR and preoperative BTA injection (n 15), perform by 3 seniors surgeons and a group of residents (10). Resident's acquisition and development of fundamental skills were evaluated by comparing pre (theorical: identification of muscle layers and by US and in images of the surgeries) and post-course (identification of muscle layers by US, BTA injection, and in surgery) assessment measurements. Results Out of 20 captured attempts by novices, 20 successful trials were evaluated. An increase in identification post-course of the abdominal wall components by US was shown in comparison of the attempt´s pre-course (p ≤ 0.023) and application of BAT in the patients was success in all the patients. Components of the abdominal wall (muscles layers and nervous component) improve after theorical course (p ≤ 0.048). Conclusions Correct identification by US and images of all the components during training showed to be effective in determining acquisition and development of basic surgical skills. The outcomes indicated that skills in vivo improved and that this training should therefore be part of the regular residency training program.

Changes in functional neuroimaging measures as novices gain proficiency on the fundamentals of laparoscopic surgery suturing task.

As trainees practice fundamental surgical skills, they typically rely on performance measures such as time and errors, which are limited in their sensitivity. The goal of our study was to evaluate the use of portable neuroimaging measures to map the neural processes associated with learning basic surgical skills. Twenty-one subjects completed 15 sessions of training on the fundamentals of laparoscopic surgery (FLS) suture with intracorporeal knot-tying task in a box trainer. Functional near infrared spectroscopy data were recorded using an optode montage that covered the prefrontal and sensorimotor brain areas throughout the task. Average oxy-hemoglobin (HbO) changes were determined for repetitions performed during the first week of training compared with the third week of training. Statistical differences between the time periods were evaluated using a general linear model of the HbO changes. Average performance scores across task repetitions increased significantly from the first day to the last day of training ( ). During the first day of training, there was significant lateral prefrontal cortex (PFC) activation. On the final day, significant activation was observed in the PFC, as well as the sensorimotor areas. When comparing the two periods, significant differences in activation ( ) were found for the right medial PFC and the right inferior parietal gyrus. While gaining proficiency, trainees activated the perception-action cycle to build a perceptual model and then apply the model to improve task execution. Learners engaged the sensorimotor areas more substantially as they developed skill on the FLS suturing task. These findings are consistent with findings for the FLS pattern cutting task and contribute to the development of objective metrics for skill evaluation.

Development of a proficiency-based training curriculum for beginners in endoscopic endonasal surgery

ObjectivePrecise endoscopic skills are critical for endoscopic endonasal surgery (EES) to ensure patient safety, as well as to succeed as a surgeon. Among these skills, basic skills such as hand-eye coordination and bimanual dexterity are the most important skills for novice surgeons. However, there is no proficiency-based training for the basic skills in EES. In this study, we aimed to develop a proficiency-based training curriculum for beginners in EES using tractable tasks and to assess the curriculum's validity and educational benefits. MethodsTraining tasks for basic surgical skills of EES were created by experts, using a low-cost and simple simulator. Subsequently, a proficiency-based training curriculum was developed through a preliminary study. The face and content validity of the curriculum was evaluated by expert surgeons. The construct validity was confirmed by comparing the scores of the medical students with those of the experts. In addition, the educational benefits of the curriculum were assessed by comparing the scores of the medical students before and after the implementation of the curriculum. ResultsA proficiency-based training curriculum using six tractable tasks was developed in the preliminary study. Replication of real surgical situation, camera navigation, and instrument operability under endoscopy were all highly appreciated (4.6, 4.6, and 4.8 out of 5 points, respectively), which indicates face validity. The content validity of the curriculum was demonstrated by the results of the questionnaire (4.4 out of 5 points). The curriculum was implemented by 12 medical students. The initial student scores were significantly lower than the expert scores (mean score: 61.9 vs. 100.0, p < 0.001), and each coefficient of variation of the student scores was higher than that of the expert scores (p < 0.01), supporting the construct validity of the curriculum. The mean student composite scores were statistically improved after the training (61.9 vs. 93.3, p < 0.0001). In addition, improvement of five other medical students’ EES skills through this training curriculum was confirmed in cadaver dissection (1.7 vs. 3.7, p < 0.0001). ConclusionThe validity of the proficiency-based training curriculum developed through the preliminary study was established based on the questionnaire of experts and the difference between student and expert scores. In addition, the educational benefits were demonstrated by the students’ learning curves. The low-cost and simple simulator seems appropriate as an entry model for beginners in EES, and this curriculum can provide rapid intervention and objective assessment of basic skills in EES.

Comparison of Instructor-Led and Video-Based Instruction in Teaching Suturing to Medical Students

IntroductionWe conducted a single-blind, prospective, randomized, 3-arm controlled trial to compare the efficacy of interactive and noninteractive video-based with instructor-led teaching in acquiring and retaining basic surgical skills. MethodsParticipants were pretested after providing written instruction using a simulator. After the pretest, students were randomized to three groups: noninteractive video-based instruction (NIVBI), instructor-led teaching with concurrent feedback, and interactive video-based instruction (IVBI). An immediate post-test and a retention test were performed 1 mo after the practice session's end to assess the efficacy of practice conditions. Two experts blinded to the experimental condition evaluated performance using expert-based assessment. Data were analyzed using SPSS. ResultsThere were no differences in expert-based assessments between groups at the pretest. All three groups showed significant improvements in expert-based scores between the pretests and post-tests as well as between pretests and retention tests (P < 0.0001). Instructor-led teaching and IVBI were equally effective initially for teaching this skill to naive medical students and showed better performance than NIVBI (P < 0.0001 each). At retention, IVBI displayed superior performance compared to NIVBI and the instructor-led group (P < 0.0001 each). ConclusionsOur result showed that video-based instruction could be as effective as instructor-led teaching in acquiring basic surgical skills. These findings support the idea that with thoughtful incorporation into technical skill curricula, video-based instruction may efficiently use faculty time and serve as a helpful adjunct for basic surgical skills training.

Comparison of Attempts Needed for Veterinary Students to Reach Proficiency in a Basic and Advanced Robotic Simulator Task.

Surgical training of students is one of the most difficult aspects of veterinary medical education. Competing interests of house officers, owner's wishes, and ethical concerns have led to increasing use of inanimate models for basic surgical skills training. Robotic simulators have benefits for psychomotor training but have not been previously investigated in veterinary medicine. Understanding the necessary practice time for new training devices is important when determining their potential value. The aim of this study was to compare the number of attempts needed for veterinary students to reach proficiency in both a basic and advanced robotic simulator task, and to assess the predictive nature of performance variables. Each student performed a basic and advanced tasks on the Mimic dV-Trainer™ until proficiency was reached. Students required a median of eight attempts (95% CI = 7-8, range: 6-11) to reach proficiency for the basic task versus 22 attempts (95% CI = 20-26, range: 11-62) for the advanced task. The median time required to complete training for the basic and advanced task was 13.5 minutes (range: 8-24 minutes) and 26.5 minutes (range: 11-82 minutes) respectively. The difference in task attempts supports the training protocol and confirms proficiency can be attained in a short period of time. The number of attempts to reach proficiency correlated with specific performance variables which can be used by educators to aid in training students on a robotic simulator. Continued investigations on robotic simulators should be performed to investigate their use in improving psychomotor skills in veterinary students.

Establishing the Most Important Clinical Skills for New Graduate Veterinarians by Comparing Published Lists with Regional Stakeholder Expectations: A Bangladesh Experience.

Veterinary clinical skills training is evolving rapidly around the world and there is increasing interest in Bangladesh in opening clinical skills laboratories and using models in teaching. The first clinical skills laboratory was opened at Chattogram Veterinary and Animal Sciences University in 2019. The current study aimed to identify the most important clinical skills for veterinarians in Bangladesh to inform the further development of clinical skills laboratories and ensure resources are deployed effectively and efficiently. Lists of clinical skills were collated from the literature, national and international accreditation standards, and regional syllabi. The list was refined through local consultation, focused on farm and pet animals, and was disseminated via an online survey to veterinarians and final-year students who were asked to rate the level of importance of each skill for a new graduate. The survey was completed by 215 veterinarians and 115 students. A ranked list was generated with injection techniques, animal handling, clinical examination, and basic surgical skills among the most important. Some techniques requiring specific equipment and some advanced surgical procedures were considered less important. As a result of the study, the most important clinical skills for a new graduate in Bangladesh have been identified for the first time. The results will inform the development of models, the use of clinical skills laboratories, and the design of clinical skills courses for veterinary training. Our approach of drawing upon existing lists followed by local stakeholders consultation is recommended to others to ensure clinical skills teaching is regionally relevant.

Can mixed reality technologies teach surgical skills better than traditional methods? A prospective randomised feasibility study

BackgroundBasic surgical skills teaching is often delivered with didactic audio-visual content, and new digital technologies may allow more engaging and effective ways of teaching to be developed. The Microsoft HoloLens 2 (HL2) is a multi-functional mixed reality headset. This prospective feasibility study sought to assess the device as a tool for enhancing technical surgical skills training.MethodsA prospective randomised feasibility study was conducted. 36 novice medical students were trained to perform a basic arteriotomy and closure using a synthetic model. Participants were randomised to receive a structured surgical skills tutorial via a bespoke mixed reality HL2 tutorial (n = 18), or via a standard video-based tutorial (n = 18). Proficiency scores were assessed by blinded examiners using a validated objective scoring system and participant feedback collected.ResultsThe HL2 group showed significantly greater improvement in overall technical proficiency compared to the video group (10.1 vs. 6.89, p = 0.0076), and a greater consistency in skill progression with a significantly narrower range of scores (SD 2.48 vs. 4.03, p = 0.026). Participant feedback showed the HL2 technology to be more interactive and engaging with minimal device related problems experienced.ConclusionsThis study has demonstrated that mixed reality technology may provide a higher quality educational experience, improved skill progression and greater consistency in learning when compared to traditional teaching methodologies for basic surgical skills. Further work is required to refine, translate, and evaluate the scalability and applicability of the technology across a broad range of skills-based disciplines.

Opinions on basic surgical skills laboratory for undergraduate medical education: optional or a necessity in Nigeria

Background: The foundation in training in any profession attracts considerable attention because it is crucial to the long-term survival of that profession. The traditional method of acquiring set skills has always been that of initial observation, then assisting in the act, and finally performing under supervision. Today, there is a notable shift in that method of training for the acquisition of surgical skills, with emphasis on acquiring the skills first outside of the operating room in dry and wet laboratories. This study aims to evaluate the knowledge, experiences and opinions of medical doctors in Port Harcourt on basic surgical skills for undergraduate medical training in Nigeria. Methods: A questionnaire-based cross-sectional descriptive study was carried out among 564 Medical Doctors in Port Harcourt, Nigeria, using total population. Information on demographics, knowledge and experiences on basic surgical skills was collated and analyzed using the Statistical Package for the Social Sciences (SPSS) version 20.0. Results: The mean age of the respondents was 34.89±9.25. Mean knowledge score of basic surgical skills during undergraduate medical training was 63.73±14.80, and 86.52±16.32 during houseman-ship. Four hundred and forty-nine (79.6%) respondents had experienced practical challenges when carrying out basic surgical skills during medical practice after graduation. First experience at suturing patient's wound was full of struggling/difficulty for 213 (37.8%) respondents. Conclusion: Although the mean knowledge score for basic surgical skills among respondents was above average, practical experiences revealed that some respondents had difficulty in carrying out significant number of basic surgical skills. Supervised usage of basic surgical skills laboratory should be mandatory to ensure that it fulfils the purpose of its establishment.

ВОЗМОЖНАЯ ОРГАНИЗАЦИЯ ДОПОЛНИТЕЛЬНОГО ОБУЧЕНИЯ БАЗОВЫМ ХИРУРГИЧЕСКИМ НАВЫКАМ

Significance. Within the educational process in medical universities, one of the important aspects is the development of basic surgical skills. During the educational process this helps to decide on your specialty in general, and also improves the quality of training of future doctors. At present, there is no well-established structure for conducting courses in basic surgical skills. The purpose of the study was to evaluate the demand for an additional course in basic surgical skills among 1-6-year students of the Kuban State Medical University. Material and methods. To identify feasibility of an additional training in basic surgical skills, a survey was conducted covering 2190 students of the Kuban State Medical University in a remote format based on the GoogleScholar platform in September-October 2022. The questionnaire included the choice of the most optimal, from the point of view of the student, schedule, the number of students in the group and materials used. Results. Out of the students surveyed, the majority support the idea of ​​introducing additional training in small groups using biomaterials or artificial materials with the predominance of practicing surgical skills. Conclusion. According to the survey results, introducing an additional course to train students in basic surgical skills will be relevant and help to improve manual skills during the educational process, as well as to decide on specialty in the future. Scope of application. The aspects of the possible organization of additional training in basic surgical skills presented in the article will contribute to better training of medical university students.

Low-cost suture simulator to gain basic surgical skills.

To introduce a new low-cost simulation model for training basic surgical skills. The training model was made from a mixture of 20 g of acetic silicone with 11 g of maize starch. Validation consisted of serial training sessions, evaluating the mean pre- and post-training time and the mean final score according to the global rating scale. A decrease in the time required to perform the sutures was observed, comparing the average post and pre-training time of each training day, with a significant correlation between the order of training and the time for performing the simulation. The presented model proved to be capable of simulating the basic suture training skills. It is easy to make, has low cost, and can be easily reproduced in educational institutions.

Basic surgical skills in medical schools

Basic surgical skills in medical schools