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Promoting Surgical Residents’ Basic Skills via the Design and Implementation of a Simulation Training Tool

Published: 01 August 2019 Publication History

Abstract

Background. Surgical training in authentic work environments needs guidance practices, including simulation training within a competence-based framework. The use of simulators may actually have negative effects on professional learning if there is a lack of competence-based goals, tools, and guidance, integrated with work practices, and applied by trainers.
Intervention. We designed simulation training tools to promote the surgical residents’ abilities to perform competently in basic surgical skills. Our educational and surgical team worked together and (i) specified the goals for the tasks, (ii) specified the skills to be achieved, (iii) and analyzed the learning outcomes. The assumption was that after completing the simulation training, the resident would gain precise basic skills.
Methods. Eight (8) licensed doctors, starting their specialization in surgery or gynecology, participated in the study. In accordance with the training design the residents were asked to self-assess their achieved skills by completing questionnaires, before and after the training period. In addition, the skills achieved were assessed individually by the trainer at the end of the training period. All the assessments were carried out on a scale based on OSATS (Objective Structured Assessment of Technical Skills) and modified specifically for this study.
Results. The residents and their trainers evaluated the simulation training design as effective, and as beneficial for learning basic surgical skills. However, it proved difficult for the residents to achieve the targets consistently and to assess their own skills. Some fine-tuning is needed to enhance the integration of simulation training tools with practical learning.
Discussion. The simulation training appeared to motivate the trainees. Overall, there is a need for discussion on the implications for competence-based theories and simulation practices.
Limitations. The small number of participants limited the possibilities for statistical analysis. The analyses and results should be seen as merely indicative. Further studies are needed.

References

[1]
Ahlberg G., Enochsson L., Gallagher A. G., Hedman L., Hogman C., and McClusky D. A. (2007). Proficiency-based virtual reality training significantly reduces the error rate for residents during their first 10 laparoscopic cholecystectomies. American Journal of Surgery, 193(6), 797-804.
[2]
Alam M., Nodzenski M., Yoo S., Poon E., and Bolotin D. (2014). Objective structured assessment of technical skills in elliptical excision repair of senior dermatology residents: A multi rater, blinded study of operatingroom videorecordings. JAMA Dermatology, 150(6), 608-612.
[3]
Aldrich C. (2009). The complete guide to serious games and simulations. Somerset, NJ: Wiley.
[4]
Billett S. (2017). Developing domains of occupational competence: Workplaces and learner agency. In Mulder M. (Ed.), Competence-based vocational and professional education. Bridging the worlds of work and education (pp. 47-66). Cham, Switzerland: Springer.
[5]
Blank W. E. (1994). The Competency-based approach to education and training. In Brown M. (Ed.), A collection of readings related to competency-based training. EAE604 curriculum and competencies (pp. 32-53). Geelong, Victoria, Australia: Deakin University.
[6]
Brennan P. M., Loan J., Hughes M. A., Hennessey I., and Partridge R. W. (2014). Surgical training is undermined by inadequate provision of laparoscopic surgical simulators. The Royal College of Surgeons of England, 96, 304-307.
[7]
Brown V. and Clarke V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101.
[8]
Clapper T. (2014). Situational interest and instructional design: A guide for simulation facilitators. Simulation & Gaming, 45(2), 167-182.
[9]
Erikoislääkärikoulutusopas. (2015-2017). Itä-Suomen yliopisto, Terveystieteiden tiedekunta. Retrieved from https://www.uef.fi/web/laake/opinto-opas-2017-19
[10]
Fairhurst K., Strickland A., and Maddern G. (2012). The LapSim virtual reality simulator: Promising but not yet proven. Surgical Endoscopy, 25(2), 343-355.
[11]
Hämäläinen R., Lanz M., and Koskinen K. (2018). Collaborative systems and environments for future working life: Towards the integration of workers, systems and manufacturing environments. In C. Harteis (Ed.), The impact of digitalization in the workplace (pp. 25-38). Cham: Springer.
[12]
Hämäläinen R. H., Niilo-Rämä M., Lainema T., and Oksanen K. (2018). How to raise different game collaboration activities: The association between game mechanics, players’ roles and collaboration processes. Simulation & Gaming, 49(1), 50-71.
[13]
Harwayne-Gidansky I., Bellis J. M., McLaren H., Critelli K., Clark S., Chen Z., and . . . Chin K. (2017). Mannequin-based immersive simulation improves resident understanding of a clinical decision rule. Simulation & Gaming, 48(5), 657-669.
[14]
Kopainsky B., Alessi S. M., Pedercini M., and Davidsen P. I. (2015). Effect of prior exploration as an instructional strategy for system dynamics. Simulation & Gaming, 46(3-4), 293-321.
[15]
Larsen C. R., Soerensen J. L., Grantcharov T. P., Dalsgaard T., Schouenborg L., and Ottosen C. (2009). Effect of virtual reality training on laparoscopic surgery: Randomized controlled trial. BMJ, 338, b1802.
[16]
Martin J. A., Regehr G., Reznick R., Macrae H., Murnaghan J., Hutchison C., and Brown M. (1997). Objective structured assessment of technical skill (OSATS) for surgical residents. British Journal of Surgery, 84, 273-278.
[17]
Mulder M. (2014). Conceptions of professional competence. In Billett S., Harteis C., and Gruber H. (Eds.), International handbook of research in professional and practice-based learning (Vol. 1, pp. 107-137). Dordrecht, The Netherlands: Springer.
[18]
Nehring W. M. and Lashley F. R. (2009). Nursing simulation: A review of the past 40 years. Simulation & Gaming, 40(4), 528-552.
[19]
Newmark J., Dandolu V., Milner R., Grewal H., Harbison S., and Hernandez E. (2007). Correlating virtual reality and box trainer tasks in the assessment of laparoscopic surgical skills. American Journal of Obstetrics and Gynecology, 197, 546-546.
[20]
Oropesa I., Gonzále P. S., Lamata P., Chmarra M. K., Pagador J. B., Sánchez-Margallo J. A., and . . . Gómez E. J. (2011). Methods and tools for objective assessment of psychomotor skills in laparoscopic surgery. Journal of Surgical Research, 171, e81-e95.
[21]
Ruoranen M., Antikainen T., and Eteläpelto A. (2017). Promoting surgical learning and guidance focusing on operative risks and potential errors. Journal of Workplace Learning, 29(5), 322-338.
[22]
Ruoranen M., Collin K., Paloniemi S., and Eteläpelto A. (2013). Challenges for surgical trainees’ practice-based learning. In Higgs J., Sheehan D., Baldry-Currens J., Letts W., and Jensen G. (Eds.), Realising exemplary practice-based education (pp. 101-110). Rotterdam, The Netherlands: Sense.
[23]
Rybing J., Nilsson H., Jonson C. O., and Bang M. (2016). Studying distributed cognition of simulation-based team training with DiCoT. Journal Ergonomics, 59(3), 423-434.
[24]
Sandoval W. A. and Bell P. (2003). Design-based research methods for studying learning in context: Introduction. Educational Psychologist, 39(4), 199-201.
[25]
Silvennoinen M., Helfenstein S., Ruoranen M., and Saariluoma P. (2012). Learning basic surgical skills through simulator training. Instructional Science, 40, 769-783.
[26]
Tan S. C., Marlow N., Field J., Altree M., Babidge W., and Hewett P. (2012). A randomized crossover trial examining low- versus high-fidelity simulation in basic laparoscopic skills training. Surgical Endoscopy, 26(3), 207-214.
[27]
Teodorczuk A. and Billett S. (2017). Mediating workplace situational pressures: The role of artefacts in promoting effective interprofessional work and learning. Focus on Health Professional Education: A Multi-Disciplinary Journal, 18(3), 80-91.
[28]
Terrell S. R. (2012). Mixed-methods research methodologies. The Qualitative Report, 17(1), 254-280. Retrieved from https://nsuworks.nova.edu/tqr/vol17/iss1/14

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            cover image Simulation and Gaming
            Simulation and Gaming  Volume 50, Issue 4
            Aug 2019
            68 pages

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            Sage Publications, Inc.

            United States

            Publication History

            Published: 01 August 2019

            Author Tags

            1. competence-based learning
            2. design-based research
            3. guidance
            4. simulation training
            5. skills assessment

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