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Simulators in Training

  • Brian J. Dunkin
Chapter

Abstract

The rapid pace of change in medical technology has put unprecedented pressure on clinicians to learn new procedures and instrumentation and adopt them safely into their practice without compromising patient outcomes. No longer can a surgeon rely on the skills learned in training to carry them through their career. In the last two decades alone, medicine has seen the introduction of video cameras, ultrasound machines, CT scanners, MRI machines, and robots into the operating room in an effort to provide less invasive and more exact surgical care. Learning to use these devices safely and rapidly is a constant challenge. In addition, cost constraints and concerns about patient safety make it no longer acceptable to practice procedural technique in the real clinical environment. Finally, medical procedures have advanced beyond a “one man show” requiring the careful coordination of multiple team members to be successful.

All of these challenges have caused the medical community to turn to the use of simulators to create a noncritical environment in which to rehearse patient care and gain feedback about performance. The types of simulators used vary greatly in sophistication and design, but can be categorized into three groups – inanimate, animate, and cadaver. This chapter will focus on the development and use of inanimate simulators. The different types of inanimate simulators will be described along with their design. The development of metrics of skills acquisition will also be described and a clinical example of designing a surgical simulator, creating metrics of skills acquisition for it, and proving that practice on simulated tasks improves real clinical performance will be given.

Keywords

Laparoscopic Surgery Technical Skill Skill Acquisition Simulation Platform Surgical Simulator 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Sedlack RE, Kolars JC (2004) Computer simulator training enhances the competency of gastroenterology fellows at colonoscopy: results of a pilot study. Am J Gastroenterol 99(1):33–37CrossRefGoogle Scholar
  2. 2.
    Cohen J, Cohen SA, Vora KC et al (2006) Multicenter, randomized, controlled trial of virtual-reality simulator training in acquisition of competency in colonoscopy. Gastrointest Endosc 64(3):361–368CrossRefGoogle Scholar
  3. 3.
    Reddick EJ, Olsen DO, Daniell JF et al (1989) Laparoscopic laser cholecystectomy. Laser Med Surg News Adv 7(1):38–40Google Scholar
  4. 4.
    Fried GM, Fledman LS, Vassiliou MC et al (2004) Proving the value of simulation in laparoscopic surgery. Ann Surg 240(3):518–528CrossRefGoogle Scholar
  5. 5.
    Fried GM, Derossis AM, Bothwell J et al (1999) Comparison of laparoscopic performance in vivo with performance measured in a laparoscopic simulator. Surg Endosc 13:1077–1081CrossRefGoogle Scholar
  6. 6.
    Feldman LS, Hagarty SE, Ghitulescu G et al (2004) Relationship between objective assessment of technical skills and subjective in-training evaluations in surgical residents. J Am Coll Surg 198:105–110CrossRefGoogle Scholar
  7. 7.
    Vassiliou MC, Feldman LS, Andrew CG et al (2005) A global assessment tool for evaluation of intraoperative laparoscopic skills. Am J Surg 190(1):107–113CrossRefGoogle Scholar
  8. 8.
    Fraser SA, Klassen DR, Feldman LS et al (2003) Evaluating laparoscopic skills: setting the pass/fail score for the MISTELS system. Surg Endosc 17:964–967CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Brian J. Dunkin
    • 1
  1. 1.Department of Surgery, Weill Cornell College of MedicineThe Methodist HospitalHoustonUSA

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