Mastering instruments before operating on a patient: the role of simulation training in tool use skills

• Published in: Surgical innovation Vol. 21; no. 6; p. 637
• Main Authors: Zheng, Bin, Fu, Bo, Al-Tayeb, Thamer A, Hao, Yi Fan, Qayumi, A Karim
• Format: Journal Article
• Language: English
• Published: United States 01.12.2014
• Subjects: Computer Simulation; Computer-Assisted Instruction - methods; Humans; Laparoscopy - education; Learning Curve; Natural Orifice Endoscopic Surgery - education; Surgeons - education; Time Factors; laparoscopy; tool complexity; NOTES; surgical education; simulation; learning curve
• ISSN: 1553-3514
• DOI: 10.1177/1553350614532533

We examined the impact of tool complexity on surgeons' performance and evaluated the value of using a simulation-based program for reducing training cost. Three pairs of surgical graspers with increasing mechanical complexity, which were designed for open, laparoscopic, and endoscopic procedures, were used in performing a simple object transportation task. Task times and mental workload of 17 surgeons were compared using all 3 variations of the graspers to test the impact of tool complexity on surgical performance. Subsequently, 4 of these surgeons decided to enter a 3-week training phase and practiced with these 3 surgical instruments on a daily basis. Learning curves were plotted to examine the value of using simulation for proficiency training with these tools. Task time was significantly prolonged as tool complexity increased. Practice in a simulated environment shortened the task time significantly and moderately reduced mental workloads. However, the difference in task time varied among the 3 types of tools. Between days 1 and 9, task times for each types of grasper were reduced by 55% (endoscopic), 42% (open), and 22% (laparoscopic). Tool complexity may degrade a surgeon's performance. Extensive simulation training programs are important for surgeons to gain proficiency in handling a tool before they practice on patients.