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The Pretrained Novice: Using Simulation-Based Training to Improve Learning in the Operating Room

Department of Surgery, Division of General and Laparoendoscopic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas, sickle{at}uthscsa.edu

E. Matt Ritter, MD

Department of Surgery, Uniformed Services University of the Health Sciences, Washington, District of Columbia

C. Daniel Smith, MD

Emory Simulation, Training And Robotics (E*STAR), Emory University School of Medicine, Atlanta, Georgia

Enabling trainees to acquire advanced technical skills before they begin the operating room experience benefits both trainee and patient. Whether medical students who had received exclusively simulation-based training could perform laparoscopic suturing and knot-tying as well as senior surgery residents was determined. Simulators were used to train 11 fourth-year medical students with no previous suturing experience to perform intracorporeal suturing and to successfully tie a free-hand intracorporeal knot. Students’ skills were assessed by the performance of the fundal suturing portion of a Nissen fundoplication in a porcine model. Their operative performance was evaluated for time, needle manipulations, and total errors. Results were compared to those of 11 senior-level surgery residents performing the same task. The study concluded that trainees could learn advanced technical skills such as laparoscopic suturing and knot tying by using simulation exclusively. The trainees and senior level surgery residents had a similar number of needle manipulations.

Key Words: simulation • laparoscopic suturing • pre-trained novice

Surgical Innovation, Vol. 13, No. 3, 198-204 (2006)
DOI: 10.1177/1553350606293370


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