Development of a simulation minimally invasive surgery (MIS) training program in a curricula of pediatric surgery: A replicable experience

Abstract

Background: Simulation in MIS can act as a bridge to proficiency by creating a ‘pre-trained’ novice. A MIS simulation program for pediatric and neonatal minimal invasive surgery (PNMIS) included in the curricula and an MIS education fellowship were developed in 2012. Aim: To describe the program, analyze its results and inspire other groups to replicate the experience. Methods: It is structured in 3 stages: initial, intermediate and advanced.The exercises are supervised, structured, including formative feedback and a pre and post test with debriefing. In the final stage,neonatal models are included to integrate the knowledge and specific maneuvers with the techniques of suture learned in previous stages. Low-cost training models’ development has been our sub-specialty. Results: Since 2013 none of the residents has performed a MIS procedure without having attended the corresponding module.The first MIS education fellow is nowadays the chief of pediatric surgery in his native institution and started PNMIS. Telesimulation for essential skills was incorporated and its effectiveness published [7,21].The team has already run 184 on site and 41 telesimulated courses including 842 individually coached workstations and 1026 hours of telesimulation Seventy five % of participants largely changed their surgical efficiency and 52% significantly increased the complexity of the procedures they were performing.Our academic production includes 8 articles published in peer review journals and 1 European book chapter and 2 research awards [5,7,13,17-23] Discussion: We encourage all enthusiasts to move forward in basic implementation and move towards the ideal program over time.

Keywords

• Surgical education
• Simulation-based training in pediatric minimally invasive surgery