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. 2022 Nov;36(11):8441-8450.
doi: 10.1007/s00464-022-09098-w. Epub 2022 Mar 2.

A new approach for the acquisition of trauma surgical skills: an OSCE type of simulation training program

Catalina Ortiz  1   2 , Javier Vela  1   2 , Caterina Contreras  1   2 , Francisca Belmar  1   2 , Ivan Paul  1   2 , Analia Zinco  3 , Juan Pablo Ramos  3 , Pablo Ottolino  2   3 , Pablo Achurra  1   2 , Nicolas Jarufe  4 , Adnan Alseidi  5 , Julian Varas  6   7
Affiliations

A new approach for the acquisition of trauma surgical skills: an OSCE type of simulation training program

Catalina Ortiz et al. Surg Endosc. 2022 Nov.

Abstract

Background: Worldwide, trauma-related deaths are one of the main causes of mortality. Appropriate surgical treatment is crucial to prevent mortality, however, in the past decade, general surgery residents' exposure to trauma cases has decreased, particularly since the COVID-19 pandemic. In this context, accessible simulation-based training scenarios are essential.

Methods: A low-cost, previously tested OSCE scenario for the evaluation of surgical skills in trauma was implemented as part of a short training boot camp for residents and recently graduated surgeons. The following stations were included bowel anastomosis, vascular anastomosis, penetrating lung injury, penetrating cardiac injury, and gastric perforation (laparoscopic suturing). A total of 75 participants from 15 different programs were recruited. Each station was videotaped in high definition and assessed in a remote and asynchronous manner. The level of competency was assessed through global and specific rating scales alongside procedural times. Self-confidence to perform the procedure as the leading surgeon was evaluated before and after training.

Results: Statistically significant differences were found in pre-training scores between groups for all stations. The lowest scores were obtained in the cardiac and lung injury stations. After training, participants significantly increased their level of competence in both grading systems. Procedural times for the pulmonary tractotomy, bowel anastomosis, and vascular anastomosis stations increased after training. A significant improvement in self-confidence was shown in all stations.

Conclusion: An OSCE scenario for training surgical skills in trauma was effective in improving proficiency level and self-confidence. Low pre-training scores and level of confidence in the cardiac and lung injury stations represent a deficit in residency programs that should be addressed. The incorporation of simulation-based teaching tools at early stages in residency would be beneficial when future surgeons face extremely severe trauma scenarios.

Keywords: Simulation training; Surgical education technology; Surgical training; Trauma surgery.

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Conflict of interest statement

Drs. Catalina Ortiz, Javier Vela, Caterina Contreras, Francisca Belmar, Ivan Paul, Analia Zinco, Juan Pablo Ramos, Pablo Ottolino, Pablo Achurra, Nicolas Jarufe, and Julian Varas were financed and supported by a Chilean Research Grant FONDECYT REG 1171908 from CONICYT and by the Department of Digestive Surgery, Faculty of Medicine, Pontificia Universidad Católica de Chile. Dr. Julian Varas is the Founder of Training Competence, an official spinoff startup from the Pontificia Universidad Católica de Chile. The startup and the Pontificia Universidad Católica de Chile are the owners of the rights and distribution of the C1DO1 platform used for the assessment in this study. Dr. Adnan Alseidi has no conflict of interest or financial ties to disclose.

Figures

Fig. 1
Fig. 1
OSATS individual scores before and after training. *p-value < 0.01, **p-value < 0.001
Fig. 2
Fig. 2
SRS individual scores before and after training. *p-value < 0.01, **p-value < 0.001
Fig. 3
Fig. 3
A–E Confidence level results per station. PGY1 postgraduate year 1, PGY2 postgraduate year 2, PGY3 postgraduate year 3, RGS recently graduated surgeons
See this image and copyright information in PMC

References

    1. Bedard AF, Mata LV, Dymond C, Moreira F, Dixon J, Schauer SG, Ginde AA, Bebarta V, Moore EE, Mould-Millman N-K. A scoping review of worldwide studies evaluating the effects of prehospital time on trauma outcomes. Int J Emerg Med. 2020;13:64. doi: 10.1186/s12245-020-00324-7. - DOI - PMC - PubMed
    1. Callcut RA, Mell MW. Modern advances in vascular trauma. Surg Clin N Am. 2013;93(941–961):ix. doi: 10.1016/j.suc.2013.04.010. - DOI - PubMed
    1. Lerner EB, Moscati RM. The golden hour: scientific fact or medical “urban legend”? Acad Emerg Med. 2001;8:758–760. doi: 10.1111/j.1553-2712.2001.tb00201.x. - DOI - PubMed
    1. Teixeira PGR, Inaba K, Hadjizacharia P, Brown C, Salim A, Rhee P, Browder T, Noguchi TT, Demetriades D. Preventable or potentially preventable mortality at a mature trauma center. J Trauma. 2007;63:1338–1346. doi: 10.1097/TA.0b013e31815078ae. - DOI - PubMed
    1. Schoeneberg C, Schilling M, Probst T, Lendemans S. Preventable and potentially preventable deaths in severely injured elderly patients: a single-center retrospective data analysis of a German trauma center. World J Surg. 2014;38:3125–3132. doi: 10.1007/s00268-014-2755-0. - DOI - PubMed

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