10 Studies on Surgical Training

Here are 10 studies that evaluated the effectiveness of various surgical training techniques.

1. Video-based coaching may be a useful tool for surgeons' continuing medical education. Surgeons identified episodes of failure and alternative approaches during the coaching session. The participants also agreed that coaching via video playback is a powerful tool.

2. General surgery residents have different training experiences at university, community and military programs. Community residents were most satisfied with their operative experience, most likely to feel their opinions are important and least likely to believe attending physicians will think less of them if residents ask for help.

3. Proficiency-based training may be more effective for acquiring psychomotor skills than more traditional approaches, such as time- and repetition-based training. Study results showed novices in proficiency-based training outperformed other novices despite similar practice times and repetitions.

4. Curriculum focused on teaching surgical residents professionalism could improve their performance in a number of areas, including patient sensitivity and ethics. After a professionalism curriculum was implemented, surgical residents' perceived professionalism improved in six domains (accountability, ethics, altruism, excellence, patient sensitivity and respect).

5. Home training using inexpensive trainer boxes may be an effective way to retain and improve laparoscopic skills. There was no difference on the post-test and the retention test between residents enrolled in home training with inexpensive trainer boxes and residents in a simulation center using standard video trainers. However, the home-trained group did practice more, which was associated with a higher suture retention score.

6. A new platform that integrates optical tracking, magnetic tracking and a videographic recording system was successful in assessing surgical performance. Each modality could differentiate between expert and novice participants and metrics were well-correlated across modalities.

7. Rensselaer Polytechnic Institute in Troy, N.Y., is partnering with Beth Israel Deaconess Medical Center and Tufts University in Boston to create a virtual operating room to train surgeons. The virtual OR will simulate a minimally invasive surgical technique called single-incision laparoscopic surgery for procedures such as gallbladder removal and gastric banding.

8. While a training program by the Veterans Health Administration reduced the rate of adverse events and harm in surgery, there is room for improvement. When the training program was implemented, the rate of reported adverse events decreased from 3.21 to 2.4 per month, while reported close calls increased from 1.97 to 3.24 per month.

9. Operating room "war stories" may have an untapped potential for surgical training. Researchers found that these stories taught clinical and programmatic topics, such as resource management and professionalism.

10. Implementing a surgical intern survival skills curriculum can increase general surgery interns' confidence levels. The interns rated themselves more confident after the course in 27 of the 33 elements assessed.

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