Date Published: March 7, 2019
Author(s): Keri Rowley, Deepak Pruthi, Osamah Al-Bayati, Joseph Basler, Michael A. Liss.
The aim of this study was to investigate the effectiveness of surgical simulators created using household items and to determine their potential role in surgical skills training.
Ten urology residents attended a surgical skills workshop and practiced using surgical simulators and models. These included a wound closure model, an open prostatectomy model, a delicate tissue simulation, a knot-tying station, and a laparoscopic simulator. After the workshop, the residents completed a 5-point Likert questionnaire. Primary outcome was face validity of the models. Secondary outcomes included usefulness as a training tool and ability to replicate the models.
All models were easily created and successfully represented the surgical task being simulated. Residents evaluated the activities as being useful for training purposes overall. They also felt confident that they could recreate the simulators.
Low-fidelity training models can be used to improve surgical skills at a reasonable cost. The models will require further evaluation to determine construct validity and to determine how the improvements translate to OR performance. While high-fidelity simulators may continue to be utilized in formal surgical training, residents should be encouraged to supplement their training with innovative homemade models.
Today’s surgical trainees are increasingly challenged to improve their technical skills in an environment with reduced work hours . In a field where hands-on experience is paramount to developing competency, the solution has been the utilization of surgical simulators. Many models are available for endourology as well as laparoscopic and robot-assisted urology; however, few simulators exist for open urological surgery [2, 3]. This creates additional challenges for surgical trainees, who are exposed to fewer open surgery cases due to increasing use of minimally invasive surgery techniques .
Simulators currently available for urology training range from low-fidelity bench models to high-fidelity virtual reality models. The models used during the skills workshop for this study may be considered low fidelity, but have the advantage of being affordable, replicable, and portable for trainee use. Additionally, the simulators in this study focused on improving techniques for open urological procedures, which contrasts the more widely available simulators for laparoscopic and robot-assisted procedures .
This study provides support for exploring innovative methods for surgical skills simulation as it establishes face validity while minimizing costs. The models demonstrated reasonable realism, and the residents endorsed use of the models and activities for improving surgical skills. While these simulators may not fully replace the use of other costlier training options, the authors hope urology residents will take advantage of these affordable alternatives to supplement their training.