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Systematic review of the implementation of simulation training in surgical residency curriculum

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Abstract

Purpose

We reviewed the literature regarding the specific methods and strategies for implementing simulation-based training into the modern surgical residency curriculum. Residency programs are still struggling with how best to implement it into their curricula from a practical viewpoint.

Methods

A systematic review was performed using Ovid MEDLINE, EMBASE, PubMed, PsycINFO, Web of Science, and other resources for studies involving the use of simulation for technical skills training in the surgical residency curriculum. Studies were selected based on the integration of simulation into the curriculum and/or a description of the details of implementation and the resources required.

Results

In total, 2533 unique citations were retrieved based on this search, and 31 articles met the inclusion criteria. Most simulators were focused on laparoscopic procedures, and training occurred most often in a skills lab. The assessment of skills consisted mostly of speed of task completion. Only 4 studies addressed issues of cost, and 6 programs mentioned human resources without any mention of skills center personnel or administrative support.

Conclusions

All of the studies described the nature of the simulation training, but very few commented on how it was actually implemented and what was needed from organizational, administrative and logistical perspectives.

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References

  1. Sturm LP, Windsor JA, Cosman PH, Cregan P, Hewett PJ, Maddern GJ. A systematic review of skills transfer after surgical simulation training. Ann Surg. 2008;248:166–79.

    Article  PubMed  Google Scholar 

  2. Seymour NE. VR to OR: a review of the evidence that virtual reality simulation improves operating room performance. World J Surg. 2008;32:182–8.

    Article  PubMed  Google Scholar 

  3. Gurusamy K, Aggarwal K, Palanivelu L, Davidson B. Systematic review of randomized controlled trials on the effectiveness of virtual reality training for laparoscopic surgery. Br J Surg. 2008;95:1088–97.

    Article  CAS  PubMed  Google Scholar 

  4. ACGME Program Requirements for Graduate Medical Education in General Surgery. https://www.acgme.org/acgmeweb/Portals/0/PFAssets/ProgramRequirements/440_general_surgery_07012015.pdf. Accessed 21 August 2016.

  5. Hamilton EC, Scott DJ, Kapoor A, Nwariaku F, Bergen PC, Rege RV, et al. Improving operative performance using a laparoscopic hernia simulator. Am J Surg. 2001;182:725–8.

    Article  CAS  PubMed  Google Scholar 

  6. Powers TW, Murayama KM, Toyama M, Murphy S, Denham Iii EW, Derossis AM, et al. Housestaff performance is improved by participation in a laparoscopic skills curriculum. Am J Surg. 2002;184:626–30.

    Article  PubMed  Google Scholar 

  7. Neumann M, Hahn C, Horbach T, Schneider I, Meining A, Heldwein W, et al. Score card endoscopy: a multicenter study to evaluate learning curves in 1-week courses using the Erlangen Endo-Trainer. Endoscopy. 2003;35:515–20.

    Article  CAS  PubMed  Google Scholar 

  8. Dayal R, Faries PL, Lin SC, Bernheim J, Hollenbeck S, DeRubertis B, et al. Computer simulation as a component of catheter-based training. J Vasc Surg. 2004;40:1112–7.

    Article  PubMed  Google Scholar 

  9. Clark JA, Volchok JA, Hazey JW, Sadighi PJ, Fanelli RD. Initial experience using an endoscopic simulator to train surgical residents in flexible endoscopy in a community medical center residency program. Curr Surg. 2005;62:59–63.

    Article  PubMed  Google Scholar 

  10. Schijven MP, Jakimowicz JJ, Broeders IAMJ, Tseng LNL. The Eindhoven laparoscopic cholecystectomy training course—Improving operating room performance using virtual reality training: results from the first E.A.E.S. accredited virtual reality trainings curriculum. Surg Endosc. 2005;19:1220–6.

    Article  CAS  PubMed  Google Scholar 

  11. Seymour NE. Integrating simulation into a busy residency program. Min Inv Ther All Tech. 2005;14:280–6.

    Article  Google Scholar 

  12. Griffin S, Kumar A, Burgess N, Donaldson P. Development of laparoscopic suturing skills: a prospective trial. J Endourol. 2006;20:144–8.

    Article  PubMed  Google Scholar 

  13. Levine RL, Kives S, Cathey G, Blinchevsky A, Acland R, Thompson C, et al. The use of lightly embalmed (fresh tissue) cadavers for resident laparoscopic training. J Min Invas Gynec. 2006;13:451–6.

    Article  Google Scholar 

  14. Chang L, Petros J, Hess DT, Rotondi C, Babineau TJ. Integrating simulation into a surgical residency program: is voluntary participation effective? Surg Endosc. 2007;21:418–21.

    Article  CAS  PubMed  Google Scholar 

  15. Passman MA, Fleser PS, Dattilo JB, Guzman RJ, Naslund TC. Should simulator-based endovascular training be integrated into general surgery residency programs? Am J Surg. 2007;194:212–9.

    Article  PubMed  Google Scholar 

  16. Fann JI, Caffarelli AD, Georgette G, Howard SK, Gaba DM, Youngblood P, et al. Improvement in coronary anastomosis with cardiac surgery simulation. J Thorac Cardiovasc Surg. 2008;136:1486–91.

    Article  PubMed  Google Scholar 

  17. Goova MT, Hollett LA, Tesfay ST, Gala RB, Puzziferri N, Kehdy FJ, et al. Implementation, construct validity, and benefit of a proficiency-based knot-tying and suturing curriculum. J Surg Educ. 2008;65:309–15.

    Article  PubMed  Google Scholar 

  18. Jensen AR, Milner R, Achildi O, Gaughan J, Wilhite DB, Grewal H. Effective instruction of vascular anastomosis in the surgical skills laboratory. Am J Surg. 2008;195:189–94.

    Article  PubMed  Google Scholar 

  19. Jensen AR, Wright AS, McIntyre LK, Levy AE, Foy HM, Anastakis DJ, et al. Laboratory-based instruction for skin closure and bowel anastomosis for surgical residents. Arch Surg. 2008;143:852–8.

    Article  PubMed  Google Scholar 

  20. Kirby TO, Numnum TM, Kilgore LC, Straughn JM. A prospective evaluation of a simulator-based laparoscopic training program for gynecology residents. J Am Coll Surg. 2008;206:343–8.

    Article  PubMed  Google Scholar 

  21. Sickle KRV, Ritter EM, Baghai M, Goldenberg AE, Huang I-P, Gallagher AG, et al. Prospective, randomized, double-blind trial of curriculum-based training for intracorporeal suturing and knot tying. J Am Coll Surg. 2008;207:560–8.

    Article  PubMed  Google Scholar 

  22. Burkhart HM, Riley JB, Hendrickson SE, Glenn GF, Lynch JJ, Arnold JJ, et al. The successful application of simulation-based training in thoracic surgery residency. J Thorac Cardiovasc Surg. 2010;139:707–12.

    Article  PubMed  Google Scholar 

  23. Edelman DA, Mattos MA, Bouwman DL. FLS skill retention (Learning) in first year surgery residents. J Surg Res. 2010;163:24–8.

    Article  PubMed  Google Scholar 

  24. Fann JI, Calhoon JH, Carpenter AJ, Merrill WH, Brown JW, Poston RS, et al. Simulation in coronary artery anastomosis early in cardiothoracic surgical residency training: the Boot Camp experience. J Thorac Cardiovasc Surg. 2010;139:1275–81.

    Article  PubMed  Google Scholar 

  25. Nguyen PH, Acker CE, Heniford BT, Stefanidis D. What is the cost associated with the implementation of the FLS program into a general surgery residency? Surg Endosc. 2010;24:3216–20.

    Article  PubMed  Google Scholar 

  26. Olson TP, Becker YT, McDonald R, Gould J. A simulation-based curriculum can be used to teach open intestinal anastomosis. J Surg Res. 2010;172:53–8.

    Article  PubMed  Google Scholar 

  27. Rodriguez-Sanjuan JC, Manuel-Palazuelos C, Fernandez-Diez MJ, Gutierrez-Cabezas JM, Alonso-Martin J, Redondo-Figuero C, et al. Assessment of resident training in laparoscopic surgery based on a digestive system anastomosis model in the laboratory. Cirug Espan. 2010;87:20–5.

    Article  Google Scholar 

  28. Joyce DL, Dhillon TS, Caffarelli AD, Joyce DD, Tsirigotis DN, Burdon TA, et al. Simulation and skills training in mitral valve surgery. J Thorac Cardiovasc Surg. 2011;141:107–12.

    Article  PubMed  Google Scholar 

  29. Kobayashi SA, Jamshidi R, O’Sullivan P, Palmer B, Hirose S, Stewart L, et al. Bringing the skills laboratory home: an affordable webcam-based personal trainer for developing laparoscopic skills. J Surg Educ. 2011;68:105–9.

    Article  PubMed  Google Scholar 

  30. Panait L, Hogle NJ, Fowler DL, Bell RL, Roberts KE, Duffy AJ. Completion of a novel, virtual-reality-based, advanced laparoscopic curriculum improves advanced laparoscopic skills in senior residents. J Surg Educ. 2011;68:121–5.

    Article  PubMed  Google Scholar 

  31. Zimmerman H, Latifi R, Dehdashti B, Ong E, Jie T, Galvani C, et al. Intensive laparoscopic training course for surgical residents: program description, initial results, and requirements. Surg Endosc. 2011;25:3636–41.

    Article  PubMed  Google Scholar 

  32. Varas J, Mejı´a R, Riquelme A, Maluenda F, Buckel E, Salinas J, Martı´nez J, Aggarwal R, Jarufe N, Boza C. Significant transfer of surgical skills obtained with an advanced laparoscopic training program to a laparoscopic jejunojejunostomy in a live porcine model: feasibility of learning advanced laparoscopy in a general surgery residency. Surg Endosc. 2012;26:3486–94.

    Article  PubMed  Google Scholar 

  33. Palter VN, Grantcharov TP. Development and validation of a comprehensive curriculum to teach an advanced minimally invasive procedure: a randomized controlled trial. Ann Surg. 2012;256:25–32.

    Article  PubMed  Google Scholar 

  34. Rinewalt D, Du H, Velasco JM. Evaluation of a novel laparoscopic simulation laboratory curriculum. Surgery. 2012;152:550–6.

    Article  PubMed  Google Scholar 

  35. Teitelbaum EN, Soper NJ, Santos BF, Rooney DM, Patel P, Nagle AP, Hungness ES. A simulator-based resident curriculum for laparoscopic common bile duct exploration. Surgery. 2014;156:880–93.

    Article  PubMed  Google Scholar 

  36. Martin J, Regehr G, Reznick R, MacRae H, Murnaghan J, Hutchison C, et al. Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg. 1997;84:273–8.

    Article  CAS  PubMed  Google Scholar 

  37. Hopmans CJ, den Hoed PT, van der Laan L, van der Harst E, van der Elst M, Mannaerts GH, et al. Assessment of surgery residents’ operative skills in the operating theater using a modified Objective Structured Assessment of Technical Skills (OSATS): a prospective multicenter study. Surgery. 2014;156:1078–88.

    Article  PubMed  Google Scholar 

  38. General Surgery Training Requirements. The AMERICAN BOARD of SURGERY. http://www.absurgery.org/default.jsp?certgsqe_training. Accessed 21 August 2016.

  39. Hammond L, Ketchum J, Schwartz B. Accreditation council on graduate medical education technical skills competency compliance: urologic surgical skills. J Am Coll Surg. 2005;201:454–7.

    Article  PubMed  Google Scholar 

  40. Stefanidis D, Acker C, Swiderski D, Heniford B, Greene F. Challenges during the implementation of a laparoscopic skills curriculum in a busy general surgery residency program. J Surg Educ. 2008;65:4–7.

    Article  PubMed  Google Scholar 

  41. Vassiliou MC, Feldman LS. Objective assessment, selection, and certification in surgery. Surg Oncol. 2011;20:140–5.

    Article  PubMed  Google Scholar 

  42. Vassiliou MC, Feldman LS, Andrew CG, Bergman S, Leffondre K, Stanbridge D, et al. A global assessment tool for evaluation of intraoperative laparoscopic skills. Am J Surg. 2005;190:107–13.

    Article  PubMed  Google Scholar 

  43. Kurashima Y, Feldman LS, Al-Sabah S, Kaneva PA, Fried GM, Vassiliou MC. A tool for training and evaluation of laparoscopic inguinal hernia repair: the Global Operative Assessment Of Laparoscopic Skills-Groin Hernia (GOALS-GH). Am J Surg. 2011;201:54–61.

    Article  PubMed  Google Scholar 

  44. Vaillancourt M, Ghaderi I, Kaneva PA, Vassiliou MC, Kolozsvari N, George I, et al. GOALS-incisional hernia: a valid assessment of simulated laparoscopic incisional hernia repair. Surg Innov. 2011;18:48–54.

    Article  PubMed  Google Scholar 

  45. Cox T, Seymour N, Stefanidis D. Moving the needle: simulation’s impact on patient outcomes. Surg Clin N Am. 2015;95:827–38.

    Article  PubMed  Google Scholar 

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Correspondence to Yo Kurashima.

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All authors declare that they have no conflicts of interest or financial ties to disclose.

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Kurashima, Y., Hirano, S. Systematic review of the implementation of simulation training in surgical residency curriculum. Surg Today 47, 777–782 (2017). https://doi.org/10.1007/s00595-016-1455-9

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