Advertisement

The Future of Surgical Simulation

  • Richard M. SatavaEmail author
Chapter
Part of the Comprehensive Healthcare Simulation book series (CHS)

Abstract

By defining the current status of simulation, we are able to project a reasonable estimation of the next generation in simulation. There are few new methodologies that leverage off nonmedical simulation to develop curricula which provide quantitative assessment of skills performance and to set benchmarks for performance which must be met: full life-cycle curriculum development and proficiency-based progression (PBP) training and assessment, which should become the standards for creating skills courses as well as training and assessing skills performance. In addition, it is anticipated that crowdsourcing video review (using crowd-sourced structured assessment of technical skills (C-SATS)), which has demonstrated validity for video review of initial performance, high-stakes test, and maintenance of certification in near-real time, will provide valuable evidence to hospital privileging committees, surgeon proficiency improvement, and, most important, feedback to surgeons for self-improvement learning. Simulators are beginning to move out of simple skills and tasks, with development of new full procedures as well as adding haptics (sense of touch). The unknown is the role of immersive virtual reality (VR) using head-mounted displays and whether they will remain a novelty or become affordable and mainstream. Unless there are sources of funding for further innovations in education and simulation, progress will be relatively slow.

Keywords

Curriculum development Proficiency-based progression (PBP) Simulation Training Assessment C-SATS Virtual reality Simulators skills performance High-stakes test 

References

  1. 1.
    Zevin B, Levy J, Satava RM, Grantcharov TP. A consensus-based framework for design, validation, and implementation of simulation-based training curricula in surgery. J Am Coll Surg. 2012;215(4):580–6.CrossRefGoogle Scholar
  2. 2.
    Gallagher AG, O’Sullivan GC. Fundamentals of surgical simulation: principles and practice (improving medical outcomes – zero tolerance). London: Springer Verlag; 2012.CrossRefGoogle Scholar
  3. 3.
    Gallagher AG. Oxford English Dictionary. https://www.oxforddictionaries.com. Accessed 7 Dec 2016.
  4. 4.
    Aggarwal R, Grantcharov T, Darzi A. Framework for systematic training and assessment of technical skills. J Am Coll Surg. 2007;204(4):697–705.CrossRefGoogle Scholar
  5. 5.
    Arora S, Aggarwal R, Sirimanna P, Moran A, Grantcharov T, Kneebone R, Sevdalis N, Darzi A. Mental practice enhances surgical technical skills: a randomized controlled study. Ann Surg. 2011;253(2):265–70.CrossRefGoogle Scholar
  6. 6.
    Sachdeva A. Medicine meets virtual reality 11; 2003. http://www.medscape.com/viewarticle/449220_4. Accessed 7 Dec 2016.
  7. 7.
    Gallagher AG. Metric-based simulation training to proficiency in medical education: What it is and how to do it. Ulster Med J. 2012;81(3):107–13.PubMedPubMedCentralGoogle Scholar
  8. 8.
    Dreyfus Stuart E, Dreyfus HL. A five staged model of mental activities involved in directed skill acquisition. Washington, DC: Storming Media; 1980.CrossRefGoogle Scholar
  9. 9.
    Moglia A, Ferrari V, Morelli L, Ferrari M, Mosca F, Cuschieri A. A systematic review of virtual reality simulators for robot-assisted surgery. Eur Urol. 2016;69(6):1065–80.CrossRefGoogle Scholar
  10. 10.
    Butler KL, Hirsh DA, Petrusa ER, Yeh DD, Stearns D, Sloane DE, Linder JA, Basu G, Thompson LA, de Moya MA. Surgery clerkship evaluations are insufficient for clinical skills appraisal: the value of a medical student surgical objective structured clinical examination. J Surg Educ. 2017;74(2):286–94.CrossRefGoogle Scholar
  11. 11.
    Bishawi M, Pryor AD. Should technical aptitude evaluation become part of resident selection for surgical residency? Surg Endosc. 2014;28(10):2761–2.CrossRefGoogle Scholar
  12. 12.
    Jenison EL, Gil KM, Lendvay TS, Guy MS. Robotic surgical skills: acquisition, maintenance, and degradation. JSLS. 2012;16(2):218–28.CrossRefGoogle Scholar
  13. 13.
    Gallagher AG, Ritter EM, Champion H, et al. Virtual reality simulation for the operating room: proficiency-based training as a paradigm shift in surgical skills training. Ann Surg. 2005;241:364–72.CrossRefGoogle Scholar
  14. 14.
    Gallagher AG, Henn P. Simulation fidelity: more than experience and mere repetition? Stud Health Technol Inform. 2014;196:128–34.PubMedGoogle Scholar
  15. 15.
    Siu KC, Best BJ, Kim JW, Oleynikov D, Ritter FE. Adaptive virtual reality training to optimize military medical skills acquisition and retention. Mil Med. 2016;181(5 Suppl):214–20.CrossRefGoogle Scholar
  16. 16.
    Lendvay TS, White L, Kowalewski T. Crowdsourcing to assess surgical skill. JAMA Surg. 2015;150(11):1086–7.CrossRefGoogle Scholar
  17. 17.
    Bernardi G, Morocutti G, Spedicato L, Zanuttini D. The value of clinical wisdom in randomized studies, real-world registries and new hypotheses. J Cardiovasc Med (Hagerstown). 2007;8(5):313–7.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of SurgeryUniversity of Washington Medical CenterSeattleUSA

Personalised recommendations