Simulated training improves surgical residents' skills

Simulated training so improved surgical residents' performance that St. Michael's Hospital in Toronto implemented it before the organization published the results of its pilot program in the July issue of the Annals of Surgery.

In the study from the University of Toronto, 25 surgical residents underwent either conventional residency training for laparoscopic colorectal surgery (removing a tumor from the colon) or followed a new curriculum that included a virtual reality simulator, cognitive training (when and how to operate, how to work as a team) and practice on cadavers.

"Often surgical residents came to the OR and we didn't know whether they had the skills or the knowledge to perform safe surgery. Their education took place in the OR under the guidance of an experienced surgeon. Now we are moving that learning curve from the OR to a virtual environment. Only people who demonstrate proficiency are allowed to come to the OR," Dr. Teodor Grantcharov, a surgeon at St. Michael's and one of the researchers, said in an announcement.

All students then performed the procedure in the operating room. It was videotaped and analyzed by outside experts. They also took a multiple-choice test on their knowledge of the procedure.

Those who underwent the simulated training scored on average 16 out of 20 on technical performance compared with 8 out of 20 for those who underwent the conventional training. After simulated training, that group averaged 10 out of 18 on the multiple-choice test, while those in the conventional program averaged 7.5 out of 18.

Simulated training is becoming more common, with nursing students practicing clinical procedures in the online environment of Second Life, for example. The Veterans Health Administration earlier this year entered a $1 million contract to use Decision Simulation's DecisionSim as its "virtual patient platform." It's being used to help providers to  explore different decision paths and observe the consequences on virtual patients.

Earlier this year, Henry Ford Hospital researchers in Detroit found that simulation training improved medical residents' critical decision-making skills in performing resuscitations in the emergency department.

To learn more:
- read the abstract
- here's the announcement