Simulation-Based Education and Performance Assessments for Pediatric Surgeons

Abstract

Education in the knowledge, skills, and attitudes necessary for a surgeon to perform at an expert level in the operating room, and beyond, must address all potential cognitive and technical performance gaps, professionalism and personal behaviors, and effective team communication. Educational strategies should also seek to replicate the stressors and distractions that might occur during a high-risk operation or critical care event. Finally, education cannot remain fixed in an apprenticeship model of “See one, do one, teach one,” whereby patients are exposed to the risk of harm inherent to any learning curve. The majority of these educational goals can be achieved with the addition of simulation-based education (SBE) as a valuable adjunct to traditional training methods. This article will review relevant principles of SBE, explore currently available simulation-based educational tools for pediatric surgeons, and finally make projections for the future of SBE and performance assessments for pediatric surgeons.

Keywords

simulation - education - pediatric - surgery - performance

• References

• 1 Ericsson KA. Deliberate practice and acquisition of expert performance: a general overview. Acad Emerg Med 2008; 15 (11) 988-994
• 2 Carlsson S, Berglund A, Sjoberg D , et al. Effects of surgeon variability on oncologic and functional outcomes in a population-based setting. BMC Urol 2014; 14 (1) 25
• 3 Ingraham AM, Cohen ME, Bilimoria KY , et al. Comparison of 30-day outcomes after emergency general surgery procedures: potential for targeted improvement. Surgery 2010; 148 (2) 217-238
• 4 Birkmeyer JD, Finks JF, O'Reilly A , et al; Michigan Bariatric Surgery Collaborative. Surgical skill and complication rates after bariatric surgery. N Engl J Med 2013; 369 (15) 1434-1442
• 5 Hamstra SJ, Brydges R, Hatala R, Zendejas B, Cook DA. Reconsidering fidelity in simulation-based training. Acad Med 2014; 89 (3) 387-392
• 6 Undre S, Koutantji M, Sevdalis N , et al. Multidisciplinary crisis simulations: the way forward for training surgical teams. World J Surg 2007; 31 (9) 1843-1853
• 7 Zendejas B, Brydges R, Hamstra SJ, Cook DA. State of the evidence on simulation-based training for laparoscopic surgery: a systematic review. Ann Surg 2013; 257 (4) 586-593
• 8 Zendejas B, Brydges R, Wang AT, Cook DA. Patient outcomes in simulation-based medical education: a systematic review. J Gen Intern Med 2013; 28 (8) 1078-1089
• 9 McGaghie WC, Issenberg SB, Cohen ER, Barsuk JH, Wayne DB. Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Acad Med 2011; 86 (6) 706-711
• 10 Cook DA, Brydges R, Hamstra SJ , et al. Comparative effectiveness of technology-enhanced simulation versus other instructional methods: a systematic review and meta-analysis. Simul Healthc 2012; 7 (5) 308-320
• 11 Lasko D, Zamakhshary M, Gerstle JT. Perception and use of minimal access surgery simulators in pediatric surgery training programs. J Pediatr Surg 2009; 44 (5) 1009-1012
• 12 McDougall EM. Validation of surgical simulators. J Endourol 2007; 21 (3) 244-247
• 13 Bidarkar SS, Deshpande A, Kaur M, Cohen RC. Porcine models for pediatric minimally invasive surgical training—a template for the future. J Laparoendosc Adv Surg Tech A 2012; 22 (1) 117-122
• 14 Stefanidis D, Yonce TC, Green JM, Coker AP. Cadavers versus pigs: which are better for procedural training of surgery residents outside the OR?. Surgery 2013; 154 (1) 34-37
• 15 Hamilton JM, Kahol K, Vankipuram M, Ashby A, Notrica DM, Ferrara JJ. Toward effective pediatric minimally invasive surgical simulation. J Pediatr Surg 2011; 46 (1) 138-144
• 16 Azzie G, Gerstle JT, Nasr A , et al. Development and validation of a pediatric laparoscopic surgery simulator. J Pediatr Surg 2011; 46 (5) 897-903
• 17 Nasr A, Gerstle JT, Carrillo B, Azzie G. The Pediatric Laparoscopic Surgery (PLS) simulator: methodology and results of further validation. J Pediatr Surg 2013; 48 (10) 2075-2077
• 18 Plymale M, Ruzic A, Hoskins J , et al. A middle fidelity model is effective in teaching and retaining skill set needed to perform a laparoscopic pyloromyotomy. J Laparoendosc Adv Surg Tech A 2010; 20 (6) 569-573
• 19 Bacarese-Hamilton J, Pena V, Haddad M, Clarke S. Simulation in the early management of gastroschisis. Simul Healthc 2013; 8 (6) 376-381
• 20 Hawkinson EK, Davis LM, Barsness KA. Design and development of low-cost tissue replicas for simulation of rare neonatal congenital defects. Stud Health Technol Inform 2014; 196: 159-162
• 21 Barsness KA, Rooney DM, Davis LM. The development and evaluation of a novel thoracoscopic diaphragmatic hernia repair simulator. J Laparoendosc Adv Surg Tech A 2013; 23 (8) 714-718
• 22 Hawkinson EK, Davis LM, Barsness KA. Design and development of a laparoscopic gastrostomy tube placement simulator. Stud Health Technol Inform 2014; 196: 155-158
• 23 Davis LM, Barsness KA, Rooney DM. Design and development of a novel thoracoscopic tracheoesophageal fistula repair simulator. Stud Health Technol Inform 2013; 184: 114-116
• 24 Barsness KA, Rooney DM, Davis LM. Collaboration in simulation: the development and initial validation of a novel thoracoscopic neonatal simulator. J Pediatr Surg 2013; 48 (6) 1232-1238
• 25 Barsness KA, Rooney DM, Davis LM, Chin AC. Validation of measures from a thoracoscopic esophageal atresia/tracheoesophageal fistula repair simulator. J Pediatr Surg 2014; 49 (1) 29-32 , discussion 32–33
• 26 Davis LM, Hawkinson EK, Barsness KA. The evolution of design: a novel thoracoscopic diaphragmatic hernia repair simulator. Stud Health Technol Inform 2014; 196: 89-95
• 27 Seymour NE, Cooper JB, Farley DR , et al. Best practices in interprofessional education and training in surgery: experiences from American College of Surgeons-Accredited Education Institutes. Surgery 2013; 154 (1) 1-12
• 28 Falcone Jr RA, Daugherty M, Schweer L, Patterson M, Brown RL, Garcia VF. Multidisciplinary pediatric trauma team training using high-fidelity trauma simulation. J Pediatr Surg 2008; 43 (6) 1065-1071
• 29 ACGME Program Requirements for Graduate Medical Education in General Surgery. 2012. Available at: http://acgme.org/acgmeweb/Portals/0/PFAssets/ProgramRequirements/440_general_surgery_07012014.pdf . Accessed March 13, 2014
• 30 Education. AERAAPANCoMi. Standards for Educational and Psychological Testing. Washington, DC: American Educational Research; 1999
• 31 Zevin B, Levy JS, Satava RM, Grantcharov TP. A consensus-based framework for design, validation, and implementation of simulation-based training curricula in surgery. J Am Coll Surg 2012; 215 (4) 580-586 , e3
• 32 Stefanidis D, Arora S, Parrack DM , et al; Association for Surgical Education Simulation Committee. Research priorities in surgical simulation for the 21st century. Am J Surg 2012; 203 (1) 49-53
• 33 Emerging Trends TP. In lifelong learning: new directions for ACS surgical education programs. ACS Bull 2013; 98 (4) 9-13
• 34 Kohn LTCJ, Donalson MS. To Err is Human: Building a Safer Health System. Washington, DC: Institute of Medicine; 2000
• 35 Landrigan CP, Parry GJ, Bones CB, Hackbarth AD, Goldmann DA, Sharek PJ. Temporal trends in rates of patient harm resulting from medical care. N Engl J Med 2010; 363 (22) 2124-2134
• 36 Matlow AG, Baker GR, Flintoft V , et al. Adverse events among children in Canadian hospitals: the Canadian Paediatric Adverse Events Study. CMAJ 2012; 184 (13) E709-E718
• 37 Sømme S, Bronsert M, Kempe A, Morrato EH, Ziegler M. Alignment of training curriculum and surgical practice: implications for competency, manpower, and practice modeling. Eur J Pediatr Surg 2012; 22 (1) 74-79
• 38 Rowe MI, Courcoulas A, Reblock K. An analysis of the operative experience of North American pediatric surgical training programs and residents. J Pediatr Surg 1997; 32 (2) 184-191