Surgical skills training: simulation and multimedia combined

Context Basic surgical skills are needed throughout the medical profession, but current training is haphazard and unpredictable. There is increasing p ressure to provide transparency about training and performance standards. T here is a clear need for inexperienced learners to build a framework of bas ic skills before carrying out surgical procedures on patients. Effective le arning of a skill requires sustained deliberate practice within a cognitive framework, and simulation offers an opportunity for safe preparation. Objectives This paper presents a new approach to basic surgical skills trai ning, where tuition using a specially designed computer program is combined with structured practice using simulated tissue models. This approach to t eaching has evolved from practical experience with surgical skills training in workshops. Methods Pilot studies with 72 first-year medical students highlighted the n eed for separate programs for teaching and for self-directed learning. The authors developed a training approach in the light of this experience. Subs equent in-depth observational and interview studies examined (a) individual teaching sessions between surgical teachers and learners (five consultant surgeons and five senior house officers) and (b) group teaching sessions wi th general practitioners (14 participants in three group interviews). Furth er work has resulted in a self-directed learning program. Conclusions Qualitative analysis of observational and interview data provid es strong preliminary support for the effectiveness of this approach. The r esponse of teachers and learners was extremely positive. The combination of information (presented by computer) and practice of psychomotor skill (usi ng simulated tissue models) could be extended to other surgical and practic al skills.