May 15, 2009

Study Promotes The Use Of Simulator Training For Future Surgeons

A Danish research study shows that using simulators to train surgeons makes them quicker and better at performing their duties, BBC News reported.

Researchers looked in to the issue after calls to introduce strict guidelines for NHS doctors, who unlike like many other countries, are not formally trained in the use of simulators.

However, it was determined that simulator instruction should be included during the formal training process after monitoring the performance of 24 junior doctors carrying out keyhole surgery, according to the Copenhagen University Hospital team.

Obstetrics and gynecology medics were observed in two specific groups - one that had the traditional training of working alongside doctors and tutoring and another that supplemented this with seven hours of simulator training.

The doctors that used the computer simulators were found to be twice as quick, taking just 12 minutes to complete the operation on a patient, and according to a points system used to judge the quality of the work, they also carried out better procedures.

"Simulator training should be incorporated into the curriculum for all surgical trainees before they embark on patient procedures. This can potentially improve patient safety and improve operation room efficiency," said lead researcher Christian Rifbjerg.

Sir Liam Donaldson, England's chief medical officer, called for more simulation training in the NHS, saying during his annual report that simulators "reduce errors and make surgery much safer".

NHS already uses simulators for everything from practicing surgery to administering drugs, yet unlike other countries, such as Israel, there are no strict guidelines about how much time doctors should train under them.

An increase in the use of simulators has been one of the key suggestions from The British Medical Association, although it has stated that real-life training with consultants should not be compromised.

"Simulation offers obvious benefits. Sophisticated virtual reality simulators can provide anatomically realistic recreations of many operations," said Roger Kneebone, an expert in surgical education at Imperial College London.

However, trainee surgeons also needed to develop communication and leadership skills as well as be ready for the unexpected, Kneebone suggested, adding all of which required different training to simulators.

"In my own career as a surgeon I have seen the huge benefits which innovations in surgical simulation have made possible so I am pleased but not surprised by these findings which we welcome," said Health Minister Lord Darzi.

Darzi is working with NHS colleagues to develop a new strategy for simulation-based training in order to ensure the best training for doctors and the best quality of care for patients undergoing surgery.

A range of simulation techniques are now being taught at The Royal College of Surgeons (RCS)'s new clinical skills unit, where trainees can practice stitching and other techniques on simple plastic models in a simulated operating theatre suite.

"The skills center will change the way surgical training is delivered in the UK. Traditionally, measuring performance in the operating theatre has concentrated on the surgeons alone," said College President, John Black.

He added that while technical ability and dexterity are critical to the success of operations, so too is teamwork, communication skills and leadership qualities.

"We have learned from other highly skilled industries, including the airline industry, that many errors are due to human factors and this is also true in surgery. We have, therefore, responded by placing greater emphasis on training the whole surgical team," he said.

The simulator study is published in the latest edition of the British Medical Journal.


On The Net:

British Medical Journal

Department of Health