A Promising Future for Hands-On At-Home Training in Pediatric Surgery

Abstract

Introduction Sufficient training is needed to acquire and retain the procedural skills needed for the surgical correction of congenital anatomical malformations. This study aims to assess the opinions of trainees and pediatric surgeons on the use of simulation-based continued at-home training, which can help to acquire these skills.

Methods This study consisted of two parts. First, an international survey among trainees and pediatric surgeons assessed their opinions on simulation-based at-home training for pediatric surgical procedures (5-point Likert scale). Second, participants of pediatric colorectal courses were instructed to practice the posterior sagittal anorectoplasty procedure at-home on a simulation model and, subsequently, complete a questionnaire regarding their opinions on continuous at-home training (5-point Likert scale).

Results A total of 163 participants (83% pediatric surgeons) completed the international survey (response rate 43%). Overall, participants considered the training useful for both laparoscopic (mean 4.7) and open procedures (mean 4.2) and agreed that it may be used at home after a hands-on course (mean 4.3).

Twenty participants completed the questionnaire on continued training (response rate 36%). All agreed that at-home training was of added value (mean 4.5) and that the skills were transferable to the clinical setting (mean 4.3). At-home training was regarded a suitable exercise after a hands-on workshop (mean 4.3), but less so without a workshop (mean 3.7, p=0.017).

Conclusion Participating trainees and pediatric surgeons were of the opinion that simulation models and at-home training have added value. This implies that simulation-based training may be used more often in pediatric surgical training.

Keywords

simulation-based training - hands-on workshop - survey - continued training - pediatric surgery

Publication History

Received: 13 January 2022

Accepted: 18 February 2022

Article published online:
01 September 2022

• References

• 1 Dawe SR, Pena GN, Windsor JA. et al. Systematic review of skills transfer after surgical simulation-based training. Br J Surg 2014; 101 (09) 1063-1076
• 2 Gaba DM. The future vision of simulation in health care. Qual Saf Health Care 2004; 13 (Suppl. 01) i2-i10
• 3 Sturm LP, Windsor JA, Cosman PH, Cregan P, Hewett PJ, Maddern GJ. A systematic review of skills transfer after surgical simulation training. Ann Surg 2008; 248 (02) 166-179
• 4 Ziv A, Wolpe PR, Small SD, Glick S. Simulation-based medical education: an ethical imperative. Simul Healthc 2006; 1 (04) 252-256
• 5 de Montbrun SL, Macrae H. Simulation in surgical education. Clin Colon Rectal Surg 2012; 25 (03) 156-165
• 6 Moorthy K, Vincent C, Darzi A. Simulation based training. BMJ 2005; 330 (7490): 493-494
• 7 Lateef F. Simulation-based learning: just like the real thing. J Emerg Trauma Shock 2010; 3 (04) 348-352
• 8 Evgeniou E, Loizou P. Simulation-based surgical education. ANZ J Surg 2013; 83 (09) 619-623
• 9 Cecilio-Fernandes D, Cnossen F, Jaarsma DADC, Tio RA. Avoiding surgical skill decay: a systematic review on the spacing of training sessions. J Surg Educ 2018; 75 (02) 471-480
• 10 Van Bruwaene S, Schijven MP, Miserez M. Maintenance training for laparoscopic suturing: the quest for the perfect timing and training model: a randomized trial. Surg Endosc 2013; 27 (10) 3823-3829
• 11 Stefanidis D, Korndorffer Jr JR, Markley S, Sierra R, Scott DJ. Proficiency maintenance: impact of ongoing simulator training on laparoscopic skill retention. J Am Coll Surg 2006; 202 (04) 599-603
• 12 Joosten M, Bökkerink GMJ, Levitt MA, Diefenbach KA, Reck CA, Krois W, de Blaauw I, Botden SMBI. The use of an inanimate simulation model for the correction of an anorectal malformation in the training of colorectal pediatric surgery. Eur J Pediatr Surg 2022; 32 (03) 287-293 DOI: 10.1055/s-0041-1723035.
• 13 van Ling JA, Bökkerink GMJ, de Blaauw I, Botden SMBI. Development of a posterior sagittal anorectal surgical teaching model. BMC Pediatr 2021; 21 (01) 57
• 14 Accessed January 13, 2022 at: https://www.pediatrickboxx.com/product/pediatrickboxx-arm/
• 15 Accessed January 13, 2022 at: https://www.youtube.com/watch?v=ndchnyi5DBs
• 16 Taibi DM, Kardong-Edgren S. Health care educator training in simulation: a survey and web site development. Clinical Simuation Nursing 2014; 10 (01) e47-e52
• 17 Korndorffer Jr JR, Bellows CF, Tekian A, Harris IB, Downing SM. Effective home laparoscopic simulation training: a preliminary evaluation of an improved training paradigm. Am J Surg 2012; 203 (01) 1-7
• 18 de Berker HT, Bressington MJ, Mayo IM, Rose A, Honeyman C. Surgical training during the COVID-19 pandemic: challenges and opportunities for junior trainees. J Plast Reconstr Aesthet Surg 2021; 74 (03) 644-710
• 19 White EM, Shaughnessy MP, Esposito AC, Slade MD, Korah M, Yoo PS. Surgical education in the time of COVID: understanding the early response of surgical training programs to the novel coronavirus pandemic. J Surg Educ 2021; 78 (02) 412-421
• 20 James HK, Pattison GTR. Disruption to surgical training during Covid-19 in the United States, United Kingdom, Canada, and Australasia: a rapid review of impact and mitigation efforts. J Surg Educ 2021; 78 (01) 308-314
• 21 Aziz H, James T, Remulla D. et al. Effect of COVID-19 on surgical training across the United States: a national survey of general surgery residents. J Surg Educ 2021; 78 (02) 431-439
• 22 Joosten M, Bökkerink GMJ, Stals JJM, Leijte E, De Blaauw I, Botden SMBI. The effect of an interval training on skill retention of high complex low volume minimal invasive pediatric surgery skills: a pilot study. J Laparoendosc Adv Surg Tech A 2021; 31 (07) 820-828
• 23 Mashaud LB, Castellvi AO, Hollett LA, Hogg DC, Tesfay ST, Scott DJ. Two-year skill retention and certification exam performance after fundamentals of laparoscopic skills training and proficiency maintenance. Surgery 2010; 148 (02) 194-201