Simulation-based Surgery Training
Last modified: June 13, 2006
Flight simulation has been successfully used to train commerical and military pilots for more than 30 years. It is essential since: 1) training in the real aircraft is dangerous for passengers, the public, the pilot, and the aircraft, 2) rapid cognitive assessment and proprioceptive action is required, 3) training for emergencies is difficult, and 4) the aircraft is expensive to operate. Surgery training, especially in minimally invasive procedures, has similar difficulties and simulation-based training has now worked its way through research and development into productization. Differences in the business environments and technical challenges between the two types of simulation have slowed the emergence of surgical trainers, but they have now begun to show value. Advances in cost effective computation technology as well as mathematical modeling and numerical techniques are allowing such trainers to be financially feasible. Not all surgical training requires a simulation trainer, just as not all aspects of flight instruction use simulation. Careful evaluation of surgical procedures and subtasks within those procedures is needed to select those aspects which will benefit. Such criteria, while objective to some degree, still embody a great deal of subjectivity. Once activities have been chosen, techniques learned from the evolution of flight trainers have been applied to the human factors and training elements to define what is essential to the learning experience. This information is combined with multi-disciplinary engineering and software development practices to create commercial quality simulation-based surgical trainers. An growing number of procedures are now becoming available on simulation- based training and the FDA has recently implicitly mandated the use of simulation- based trainers for physician certification in carotid stent placement.