Simulation Training Research Articles

Curriculum Innovation: Design, Implementation, and Evaluation of an Interdisciplinary Teamwork-Focused Neurocritical Care In Situ Simulation Training Program

Curriculum Innovation: Design, Implementation, and Evaluation of an Interdisciplinary Teamwork-Focused Neurocritical Care In Situ Simulation Training Program

Simulation-Based Telemedicine Training Program for Residents in Physical Medicine and Rehabilitation: A Virtual Standardized Patient Activity

Background: The COVID-19 pandemic has ushered in a new era of healthcare delivery, emphasizing the crucial role of telemedicine. This study aimed to address the training needs of physical medicine and rehabilitation (PM&R) residents in telemedicine through an Interactive Virtual Telemedicine training program utilizing standardized patient methodology. Methods: A tailored virtual standardized patient simulation module was developed for PM&R residents. Prior to the training, residents completed pre-training questionnaires. The training consisted of (1) a 2-hour classroom didactic session covering telemedicine strategies for conducting physical examinations and triaging, as well as anticipated challenges. (2) a 2-hour zoom telemedicine simulation training exposed residents to three distinct patient scenarios (sickle cell crisis, acute low back pain, and neurorehabilitation). (3) a three-stage debriefing tool was employed for post-training reflection. Results: Eight PM&R residents, predominantly males, with varying prior exposure to telemedicine, participated in the study. Post-training evaluations indicated that residents overwhelmingly found the simulation-based telemedicine training valuable and worth the didactic time invested. Data analysis demonstrated a significant increase in residents’ knowledge and confidence in telemedicine skills. Discussion: The study’s findings suggest that the telemedicine training program effectively enhanced residents’ understanding and confidence in telemedicine skills. Future research endeavors could involve a larger and more diverse group of residents to further assess training effectiveness and gather a wider array of perspectives on telemedicine. Expanding the use of standardized patients in telemedicine simulation training holds promise for advancing medical education in this evolving healthcare landscape.

Virtual reality simulation training in laparoscopic surgery – does it really matter, what simulator to use? Results of a cross-sectional study

BackgroundVirtual reality simulation training plays a crucial role in modern surgical training, as it facilitates trainees to carry out surgical procedures or parts of it without the need for training “on the patient”. However, there are no data comparing different commercially available high-end virtual reality simulators.MethodsTrainees of an international gastrointestinal surgery workshop practiced in different sequences on LaparoS® (VirtaMed), LapSim® (Surgical Science) and LapMentor III® (Simbionix) eight comparable exercises, training the same basic laparoscopic skills. Simulator based metrics were compared between an entrance and exit examination.ResultsAll trainees significantly improved their basic laparoscopic skills performance, regardless of the sequence in which they used the three simulators. Median path length was initially 830 cm and 463 cm on the exit examination (p < 0.001), median time taken improved from 305 to 167 s (p < 0.001).ConclusionsAll Simulators trained efficiently the same basic surgery skills, regardless of the sequence or simulator used. Virtual reality simulation training, regardless of the simulator used, should be incorporated in all surgical training programs. To enhance comparability across different types of simulators, standardized outcome metrics should be implemented.

Effectiveness of a virtual patient simulation training on improving provider engagement in suicide safer care.

Health care providers have a critical opportunity to mitigate the public health problem of suicide. Virtual patient simulations (VPS) allow providers to learn and practice evidence-based suicide prevention practices in a realistic and risk-free environment. The purpose of this study was to test whether receiving VPS training increases the likelihood that providers will engage in effective suicide safer care practices. Behavioral health and non-behavioral health providers (N = 19) at a Federally Qualified Health Center who work with patients at risk for suicide received the VPS training on risk assessment, safety planning, and motivation to engage in treatment. Providers' electronic health records were compared 6months pre- and post-VPS training on their engagement in suicide safer care practices of screening, assessment, safety planning, and adding suicide ideation to the problem list. Most behavioral health providers were already engaging in evidence-based suicide prevention care prior to the VPS training. Findings demonstrated the VPS training may impact the likelihood that non-behavioral health providers engage in suicide safer care practices. VPS training in evidence-based suicide prevention practices can optimize and elevate all health care providers' skills in suicide care regardless of role and responsibility, demonstrating the potential to directly impact patient outcomes.

Virtual reality-based simulation learning on geriatric oral health care for nursing students: a pilot study

BackgroundThere is a great need for training and education in the nursing curriculum to improve nurses’ knowledge and skills to provide oral health care.MethodsA pilot study was conducted to evaluate the use of a virtual reality (VR)-based Oral Health Care Learning System to train geriatric oral health care among nursing students. Fifty undergraduate nursing students were randomly assigned to experimental (n = 25) and control (n = 25) groups. The experimental group received the VR-based simulation training on geriatric oral health care and the training was implemented twice at two weeks apart from March to November 2021. The control group did not receive the training intervention. Knowledge, attitude, and self-efficacy of geriatric oral health care as well as the intention to assist oral health care for older adults were assessed at the beginning, second, and fourth weeks. Generalized estimating equations were used to analyze the effectiveness of the VR-based simulation training.ResultsAfter the first round of training, students in the experimental group had significantly greater improvements in knowledge and self-efficacy of geriatric oral health care than in the control group. After the second round of training, students in the experimental group had significantly greater improvements in knowledge, attitude, and self-efficacy of geriatric oral health care as well as the intention to assist oral health care for older adult than in the control group.ConclusionsThe VR-based simulation training was effective to improve undergraduate nursing students’ knowledge, attitudes and self-efficacy of geriatric oral health as well as the intention to assist oral health care for older adults. The VR-based simulation learning system is an effective tool to provide practice experiences to build confidence and skills and to bridge the gap of understudied geriatric oral health content in entry-level nursing curricula.Trial RegistrationClinicalTrials.gov (NCT05248542; registration date 21/02/2022).

A Review on Cybersecurity in HR Systems: Protecting Employee Data in the Age of AI

This review critically examines the integration of artificial intelligence (AI) into human resource (HR) systems and evaluates its implications for cybersecurity. As digital transformation accelerates, HR systems increasingly process and store substantial volumes of sensitive employee data, making robust cybersecurity measures essential. The primary aim is to highlight significant cybersecurity challenges, identify advanced AI-driven security solutions, and understand their effectiveness in safeguarding employee data. Sources were selected based on relevance to the integration of AI in HR systems, their contribution to cybersecurity, and empirical evidence of both vulnerabilities and defenses.The review reveals that while AI can significantly enhance the detection of anomalies and automate security responses, it also introduces new vulnerabilities, such as sophisticated AI-driven attacks and biases in algorithmic decision-making. Key findings indicate a heightened need for dynamic security protocols that can evolve in tandem with AI technologies. Effective strategies highlighted include AI-enhanced encryption, behavioral analytics for threat detection, and AI-driven security training simulations. The findings emphasize the dual-edged nature of AI in cybersecurity for HR systems. For practitioners, adopting AI-driven security solutions offers a forward-thinking approach to protecting sensitive data but also requires a vigilant reassessment of security strategies in light of AI-specific threats. Policymakers are urged to consider more robust regulations that address the unique challenges posed by AI technologies. Ultimately, the paper calls for a proactive stance in cybersecurity management to anticipate and mitigate potential threats before they impact the integrity and trustworthiness of HR systems

A pattern recognition artificial olfactory system based on human olfactory receptors and organic synaptic devices.

Neuromorphic sensors, designed to emulate natural sensory systems, hold the promise of revolutionizing data extraction by facilitating rapid and energy-efficient analysis of extensive datasets. However, a challenge lies in accurately distinguishing specific analytes within mixtures of chemically similar compounds using existing neuromorphic chemical sensors. In this study, we present an artificial olfactory system (AOS), developed through the integration of human olfactory receptors (hORs) and artificial synapses. This AOS is engineered by interfacing an hOR-functionalized extended gate with an organic synaptic device. The AOS generates distinct patterns for odorants and mixtures thereof, at the molecular chain length level, attributed to specific hOR-odorant binding affinities. This approach enables precise pattern recognition via training and inference simulations. These findings establish a foundation for the development of high-performance sensor platforms and artificial sensory systems, which are ideal for applications in wearable and implantable devices.

Algorithms For Cold-Start Game Recommendation Based On GNN Pre-training Model

Abstract In the absence of sufficient user behavior data, game recommendation systems face the cold-start problem. To address this issue, this paper proposes a solution based on the Graph Neural Network pre-training model to alleviate the cold-start problem. The proposed model directly reconstructs cold-start user/game embeddings using a meta-learning setup based on dataset training simulations and uses an adaptive neighbor sampler to improve user interaction relations and thereby to improve game recommendation performance. Experimental results demonstrate the effectiveness and practicality of the recommendation model proposed in this study. Moreover, the proposed model is embedded in the game recommendation system to visualize the recommendation results.

IMMERSIVE LEARNING: VIRTUAL REALITY’S IMPACT ON MEDICAL CURRICULUM

Virtual Reality (VR) is revolutionizing education by offering immersive and interactive learning experiences that enhance engagement and retention. Despite its potential benefits, implementing VR in education faces challenges such as high costs, technical requirements, and content development. In the medical field, VR is transforming medical education by providing realistic simulations for training in various procedures, anatomy visualization, and patient interactions. Studies indicate that VR improves procedural skills, anatomical understanding, and diagnostic accuracy among medical students. Furthermore, VR offers personalized learning experiences, remote training capabilities, and collaborative opportunities in medical training. Looking ahead, VR has the potential to revolutionize healthcare by enhancing patient care, treatment planning, and telemedicine services through immersive experiences and advanced simulations. Key Words: Virtual Reality (VR), VR education, Immersive Experience, VR in medical field, VR anatomy, Technological Innovation.

Enhancing Physicians' Autonomy through Practical Trainings.

In medical emergencies adherence to standardized clinical protocols is crucial to ensure a better outcome for patients. Newly qualified physicians may play several roles in serving the National Health Service (substituting general practitioners, on-call duty, working in emergency rooms, etc.) in Italy. In these situations, the physician may have to manage critical patients autonomously. Moreover, newly qualified physicians may show a considerable deficiency in routine medical activities. In fact, many universities do not provide a practical simulation training programme, which is why a substantial number of students only face clinical emergencies when they start working after graduation. A cross-sectional study was performed by engaging medical doctors. Both experienced physicians and newly licensed physicians (graduated less than 24 months ago) were included in the study. A questionnaire was distributed to each participant during SIMED's Courses from June 2021 to December 2022. The questionnaire consisted of two sections. The first one analyzed participation in standardized practical courses on medical emer gencies (Basic Life Support, Advanced Cardiac Life Support, International Trauma Life Support and a course on Advanced Airway Management). The second section analyzed the perceived autonomy of health professionals in the management of five different work settings, using a 5-point likert scale. 2,168 questionnaires were analyzed, of which 68.7% were from newly qualified doctors and 31.3% from more experienced doctors The highest rate of physicians who undertook training courses was achieved for the basic life support course (77.5%) and the lowest rate for the advanced trauma course (15.9%). Physicians perceive themselves the highest autonomy in Primary Care setting (63.1%), while in the Emergency Department they perceive themselves with less autonomy (24.0%). In the analyzed sample, experienced physicians show a higher percentage of autonomy than newly qualified doctors (31.4% vs 8.1%) in all scenarios. Our analysis shows a possible correlation between the self-perceived autonomy of physicians and attending practical simulation courses. Although the role of training through practical courses is relevant, the percentage of trained professionals is insufficient and therefore the implementation of practical training projects has to be encouraged.

Training in Endoscopic Endonasal Neurosurgical Procedures: A Systematic Review of Available Models

Abstract Background Proficiency in endoscopic endonasal neurosurgery (EEN) requires a unique skill set and is associated with a steep learning curve. Endoscopic simulation models present an opportunity for trainees to enhance their surgical skills and anatomical knowledge in a risk-free environment. To date, four main categories of training modalities have been recorded: cadaveric, synthetic, animal, and virtual reality (VR) models. Objective To analyze the features, advantages, and disadvantages of each EEN training model, describe the stages of simulation training, and propose future directions and an algorithm for EEN training. Methods A comprehensive search was performed including studies published before August 2023. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed in the search and selection of studies included. Terms for searching title and abstract were (“simulation”) AND (“endoscopic endonasal”) AND (“neurosurgery”). Articles were screened for duplicates. Results We identified 176 references, and 43 studies met the inclusion criteria. Twelve articles described cadaveric models, with 7 of them studying internal carotid artery injury management and 3 of them cerebrospinal leak management; 14 articles illustrated synthetic models, 1 article described animal models, and 16 articles outlined VR simulations. Conclusion Cadaveric models provide realistic hands-on surgical training with acceptable cost and remain the gold standard method for training. Synthetic models are most effective for preoperative surgical planning and animal models are best suited for testing of hemostatic techniques. VR simulations may become the primary training tool for novices to acquire basic anatomical knowledge as their role in advanced surgical planning is evolving.

Cadaveric Simulation in Rib Plating is Beneficial for Helping Surgical Trainees to Assimilate New Technologies.

Rib fixation procedures are being performed more frequently as they have shown multiple advantages over traditional non-operative management in well-selected patients. We have developed a rib-fixation simulation on cadavers for use by surgical residents in attempt to improve their comfort, knowledge and ability to use this new technology. Residents in years 3 through 5 of training attended a rib-fixation simulation course with cadavers. Trauma faculty and representatives of manufacturers of rib-fixation hardware participated. The simulation consisted of groups of residents reviewing anatomy and creating adequate exposure for the entire procedure. Each group created rib fractures in the cadaver, determined which materials were needed, and then performed the rib-fixation procedure. Following the simulation, we surveyed the residents to determine the impact of the structured cadaveric rib fixation-based course on their comfort level. The survey was performed using a four- and five-level Likert questionnaire. The results were analyzed using paired t-tests. Of the participating residents, 72% of residents had performed five or fewer rib-fixation procedures in their training in the first cohort, while in the cohort for the following year, 65% had performed 5-10 procedures. The simulation had a statistically significant benefit to the residents' comfort level with rib plating (2.5 versus 3.6, p-value: 0.003). The greatest impact on the comfort level was seen in year 3 of training (2 versus 4, p-value 0.02). One hundred percent of residents found that having faculty and representatives present for the simulation was very helpful. The survey demonstrated that most residents gained new knowledge regarding the anatomy and technical dissection. In 20 of 25 encounters, residents strongly agreed that this simulation was beneficial for their surgical education, when used in addition to real operative experience. Every resident reported that they would recommend the simulation to younger resident classes. Rib-fixation simulations on cadavers were beneficial for surgical residents' self-assessed comfort level. The simulation increased residents' knowledge, comfort, and ability to perform rib-fixation procedures. We have seen a significant increase in resident participation in these cases after simulation training. Based on these findings, we will continue to incorporate these simulations into our program's curriculum.

Teaching of manual cataract extraction in ophthalmic surgical training programmes.

Manual cataract extraction techniques such as extracapsular cataract extraction (ECCE) or manual small incision cataract (MSICS) surgery have been replaced by phacoemulsification cataract surgery. Surgical training opportunities for manual techniques of cataract extraction are limited in modern surgical training programmes. This study evaluated the current trends of ECCE/MSICS training opportunities amongst trainees and trainers in the Irish Ophthalmic Surgical Training Program. An electronic survey was distributed to all ophthalmic surgical trainees and consultants in the country. It addressed the experience and exposure to ECCE/MSICS. Nineteen of 33 (57%) trainees and 29 of 55 (55%) of consultants completed the survey. Twelve of 19 (63%) trainees viewed an ECCE procedure performed live. Twenty-seven of 29 (93%) consultants performed an ECCE procedure during their surgical career; 8 of 27 (30%) performed an ECCE within the last 1-3 years. Fourteen of 19 (74%) trainees stated they do not feel confident converting from phacoemulsification to ECCE independently. Sixteen of 19 (89%) trainees believe manual cataract extraction training should be included in their surgical training. Nineteen of 29 (65%) consultants believe training in manual cataract extraction should be part of the surgical training programme. There is a paucity of manual cataract extraction being performed in Ireland, limiting live surgical training in this technique. This survey highlights the limited experience of trainees in this valuable skill that is occasionally required for a successful surgical outcome. The authors conclude that wet laboratory simulated training of manual cataract extraction will bridge this gap.

Framework for Federated Learning and Edge Deployment of Real-Time Reinforcement Learning Decision Engine on Software Defined Radio

Machine learning promises to empower dynamic resource allocation requirements of Next Generation (NextG) wireless networks including 6G and tactical networks. Recently, we have seen the impact machine learning can make on various aspects of wireless networks. Yet, in most cases, the progress has been limited to simulations and/or relies on large processing units to run the decision engines as opposed to deploying it on the radio at the edge. While relying on simulations for rapid and efficient training of deep reinforcement learning (DRL) may be necessary, it is key to mitigate the sim-real gap while trying to improve the generalization capability. To mitigate these challenges, we developed the Marconi-Rosenblatt Framework for Intelligent Networks (MR-iNet Gym), an open-source architecture designed for accelerating the deployment of novel DRL for NextG wireless networks. To demonstrate its impact, we tackled the problem of distributed frequency and power allocation while emphasizing the generalization capability of DRL decision engine. The end-to-end solution was implemented on the GPU-embedded software-defined radio and validated using over-the-air evaluation. To the best of our knowledge, these were the first instances that established the feasibility of deploying DRL for optimized distributed resource allocation for next-generation of GPU-embedded radios.

Validation of a synthetic simulation model of endoscopic rectus sheath plication.

Literature reviews outline minimally invasive approaches for abdominal diastasis in patients without skin excess. However, few surgeons are trained in endoscopic rectus sheath plication, and no simulated training programs exist for this method. This study aimed to develop and validate a synthetic simulation model for the training of skills in this approach under the Messick validity framework. A cross-sectional study was carried out to assess the participants' previous level of laparoscopic/endoscopic skills by a questionnaire. Participants performed an endoscopic plication on the model and their performance was evaluated by one blinded observer using the global rating scale OSATS and a procedure specific checklist (PSC) scale. A 5-level Likert survey was applied to 5 experts and 4 plastic surgeons to assess Face and Content validity. Fifteen non-experts and 5 experts in abdominal wall endoscopic surgery were recruited. A median OSATS score [25 (range 24-25) vs 14 (range 5-22); p < 0.05 of maximum 25 points] and a median PSC score [11 (range 10-11) vs 8 (range 3-10); p < 0.05 of maximum 11 points] was significantly higher for experts compared with nonexperts. All experts agreed or strongly agreed that the model simulates a real scenario of endoscopic plication of the rectus sheath. Our simulation model met all validation criteria outlined in the Messick framework, demonstrating its ability to differentiate between experts and non-experts based on their baseline endoscopic surgical skills. This model stands as a valuable tool for evaluating skills in endoscopic rectus sheath plication.

Role of surgical simulation on self-reported confidence level on cardiothoracic surgical trainees.

Simulated self-practice using simulation models could improve fine motor skills and self confidence in surgical trainees. The purpose of this study is to evaluate on self-reported confidence level in cardiothoracic surgical trainees by using surgical simulation models. We conducted a cross-sectional study on all surgeons (n=10) involved in MIS simulation training. All surgeons are required to perform on three minimally invasive surgery (MIS) procedures (Mitral Valve Repair, Mitral Valve Replacement and Aortic Valve Replacement). A questionnaire was designed based on two existing scales related to self-confidence, the surgical self-efficacy scale [SSES] and the perceived competency scale [PCS]. We assessed their self-confidence (before and after training) in the use of simulation in MIS procedures using rating scales 1-5. The mean score was calculated for each domain and used as the predictor variable. We also developed six questions (PCS) using Objective Structured Assessment of Technical Skills (OSAT) related to each domain and asked participants how confident they were after performing each MICS procedure. The mean score was 4.7 for all assessed domains, except "knowledge" (3.8). Surgeons who had performed one or more MIS procedures had higher scores (P<0.05). There was no correlation between the number of MIS procedures performed and self-confidence scores. The results indicate that the cardiac surgery training based on MIS simulation improves trainees and consultants in terms of the level of self-confidence. Although surgeons generally have high levels of self-confidence after simulation training in MIS cardiac procedures, there is still room for improvement with respect to technical skills related to the procedure itself and its results.

A Statewide Mobile Simulation Program For Improving Obstetric Skills in Rural Hospitals.

Closure of rural obstetric (OB) units has led to maternal care deserts, causing mothers to travel long distances for maternity care. Emergency departments (EDs) in hospitals where OB units have closed require regular training for personnel to maintain OB skills, as do rural Level-1 OB units with low volumes of maternity cases. We used a federal grant to develop an OB mobile simulation program to bring simulation-based training to rural providers. Our goal was to improve OB skills and standardize care through the framework of the Alliance for Innovation in Maternal Health (AIM) Patient Safety Bundles. We conducted needs assessments and built a mobile simulation unit. We defined 2 groups of learners: those in Level-1 OB units and those in EDs without OB units. For Level-1 OB units, we created a train-the-trainer curriculum, to create a statewide cohort of simulation experts to implement simulations in their facilities between our visits. We gifted each Level-1 unit an OB task trainer, implemented virtual train-the-trainer simulation and task trainer workshops, and conducted post-workshop assessments. We then traveled to each Level-1 unit and helped the cohort implement in situ simulations for their staff using facility-specific resources. We conducted assessments for the cohort and the hospital staff after the simulations. For EDs, we delivered virtual didactics to improve basic OB knowledge, then traveled to ED units, implemented in situ simulations, and conducted post-simulation assessments. We chose a postpartum hemorrhage (PPH) scenario for our first round of simulations. After train-the-trainer simulation workshops, 98% of participants surveyed agreed that workshop goals and objectives were achieved. After the task trainer workshop, 95% surveyed agreed that their knowledge of using the simulator had improved. After implementing in situ simulations in Level-1 OB units, 98.8% of the train-the-trainer cohort found that their ability to implement simulations had improved. The hospital staff participating in the simulations identified a 30% increase in ability to manage PPH. For the ED staff, postdidactic evaluations identified that 95.4% of participants reported moderate improvement in basic OB knowledge and after participation in the simulations >95% reported better skills as an ED team member when caring for pregnant patients. These results demonstrate improved skills of hospital staff in simulated PPH in Level-1 OB units and simulated OB emergencies in EDs that no longer have OB units. Further studies are warranted to assess improvement in maternal outcomes.

Preceptorship in robotic colorectal surgery: experience from the Australian private sector

This article describes a post-fellowship preceptorship training program to train sub-specialty colorectal surgeons in gaining proficiency in robotic colorectal surgery using a dual-surgeon model in the Australian private sector. The Australian colorectal surgeon faces challenges in gaining robotic colorectal surgery proficiency with limited exposure and experience in the public setting where the majority of general and colorectal surgery training is currently conducted. This training model uses graded exposure with a range of simulation training, wet lab training, and clinical operative cases to progress through both competency and proficiency in robotic colorectal surgery which is mutually beneficial to surgeons and patients alike. Ongoing audit of practice has shown no adverse impacts.

Participation Experience in Simulation Training Using Holographic Standardized Patients

To develop simulation practice education content and improve the quality of practice education by identifying nursing students' perception types regarding simulation practice education experiences using Holographic Standardized Patients (HSP) and analyzing and describing the characteristics of each type of nursing students' perception. This study is a qualitative study that applied phenomenological methods to explore the essential meaning of nursing students' perceptions of nursing students' simulation training using HSP. It was conducted after obtaining approval from the institutional ethics committee, and the data collection period was from October 24, 2022 to September 31, 2023. The interview was conducted as an in-depth interview. The participants were third-year nursing students at a university who received training implemented through simulation using HSP. Among the 14 students who voluntarily agreed to participate in the study after receiving an explanation of the contents of the study, they were the dropouts. The subjects were 10 people excluding. As a result of this study, 81 meaning compositions, 20 topic collections, and 4 categories were derived: 'interesting classes', 'expectations that overcome obstacles', 'models for future classes', and 'strengthening practical skills'. Korean nursing students have already become accustomed to digital culture for a long time, and it has been confirmed that this form of converged technology-based simulation education no longer poses a technical problem to students. If various simulation-based education is developed in the future, it is believed that it will lead to integrated development of nursing education and simulation education beyond the limited clinical practice environment.

Correlation of Self-Assessed Manual Dexterity and Actual Performance in Surgical Simulation – One Year Follow Up

Abstract Background Simulation training has proved to be beneficial in many fields of professions including medicine and might be included already during medical school. Aims We evaluated if medical students rate their manual dexterity as good or above average and if this self-assessment (SA) correlates with the actual performance in a surgical simulation. Methods Basic surgical tasks have been performed by medical students in the 3rd and 4th year for a total of 4 rounds on 2 identical Lap-Sim® surgical simulators. Three questionnaires, before and after the simulation as well as follow up after 1 year had to be answered. Descriptive statistics stratified by career goal (surgical/ undecided/ nonsurgical) for outcomes of simulation parameters are reported. Associations between surgical career goal and SA of manual dexterity with three performance parameters (tissue damage, time and path length) are estimated in linear regression models. Results Out of 102 participating students 41 stated surgery as their career goal, 18 a nonsurgical field, and 43 were undecided. 87.8% of the surgical group rated their dexterity as good or above average (86.1% in the undecided group), 88.9% of the nonsurgical group as below average or good. A positive association of SA with tissue damage has been found statistically significant (p=0.033). One year after the simulation (n=97) 13.4% changed their career goal from undecided to surgical, whereas 8.2% changed from undecided to non-surgical. 92.7% wanted to have simulation training integrated into the curriculum. Conclusion A correlation of self-assessed manual dexterity has been found in the surgical group for tissue damage, but not for time and path length. Simulation training might help students in decision making for a surgical field and therefore recruit future surgeons, which could be shown in the one-year follow-up.