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World J Gastroenterol. May 28, 2006; 12(20): 3219-3224
Published online May 28, 2006. doi: 10.3748/wjg.v12.i20.3219
Evolution of surgical skills training
Kurt E Roberts, Robert L Bell, Andrew J Duffy
Kurt E Roberts, Robert L Bell, Andrew J Duffy, Department of Surgery, Yale University School of Medicine, 40 Temple Street, Suite 3A, New Haven, CT 06510, United Staets
Author contributions: All authors contributed equally to the work.
Correspondence to: Andrew J Duffy, MD, Department of Surgery, Yale University School of Medicine, 40 Temple Street, Suite 3A, New Haven, CT 06510, United Staets. andrew.duffy@yale.edu
Telephone: +1-203-7469060 Fax: +1-203-7469066
Received: March 29, 2006
Revised: April 6, 2006
Accepted: April 16, 2006
Published online: May 28, 2006
Abstract

Surgical training is changing: one hundred years of tradition is being challenged by legal and ethical concerns for patient safety, work hours restrictions, the cost of operating room time, and complications. Surgical simulation and skills training offers an opportunity to teach and practice advanced skills outside of the operating room environment before attempting them on living patients.

Simulation training can be as straight forward as using real instruments and video equipment to manipulate simulated “tissue” in a box trainer. More advanced, virtual reality simulators are now available and ready for widespread use. Early systems have demonstrated their effectiveness and discriminative ability. Newer systems enable the development of comprehensive curricula and full procedural simulations.

The Accreditation Council of Graduate Medical Education’s (ACGME) has mandated the development of novel methods of training and evaluation. Surgical organizations are calling for methods to ensure the maintenance of skills, advance surgical training, and to credential surgeons as technically competent.

Simulators in their current form have been demonstrated to improve the operating room performance of surgical residents. Development of standardized training curricula remains an urgent and important agenda, particularly for minimal invasive surgery. An innovative and progressive approach, borrowing experiences from the field of aviation, can provide the foundation for the next century of surgical training, ensuring the quality of the product. As the technology develops, the way we practice will continue to evolve, to the benefit of physicians and patients.

Keywords: Surgery, Training, Certification, Skills, Simulation, Curriculum