Abstract: Educational Efficacy of a Procedural Surgical Simulator in Plastic Surgery Residency Training : A Phase I Multi-Site Study (Plastic Surgery 2013)

Saturday, October 12, 2013: 1:20 PM

Sarah A Long, BA , Thayer School of Engineering, Dartmouth College, Hanover, NH

Carrie Scharf Stern, MD , Plastic Surgery, Montefiore Medical Center, Bronx, NY

Zachary Napier, BA , George Washington University School of Medicine, Washington, DC

Benjamin Mandel, MD , University of Wisconsin School of Medicine and Public Health, Madison, WI

Hooman Soltanian, MD , Division of Plastic Surgery, University Hospitals - Case Medical Center, Cleveland, OH

Michael Bentz, MD , University of Wisconsin School of Medicine and Public Health, Madison, WI

Joseph M. Rosen, MD , Plastic Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH

Alexes Hazen, MD , Institute of Reconstructive Plastic Surgery, NYU Langone Medical Center, New York, NY

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Background

The use of computer simulation to facilitate training across a variety of medical and surgical specialties has become increasingly popular in recent years. It is now mandatory that general surgery residency programs incorporate teaching in a skills laboratory in their curriculae¹. The efficacy of these tools have been supported in literature, however, there remains a relative paucity in the development and use of simulation to facilitate training in the plastic and reconstructive surgery field. Interactive 3D visualization technology can address this need by, in a safe way: facilitating comprehension of complex anatomy via unique visualization, as well as critical steps of a given procedure.

Materials & Methods

Using previously developed cleft lip and palate simulation technology, our team developed a model demonstrating a technique latissimus musculocutaneous flap breast reconstruction technique following mastectomy^2,3. The procedure was divided into discrete peer-reviewed tasks by members of the American Council of Academic Plastic Surgeons (ACAPS) Ad-Hoc Committee on Virtual Reality and Simulation and critical didactic points were identified. Interactive questions in a multiple choice format were developed to provide an objective assessment of cognitive competency, incorporating anatomical and procedural knowledge.

A Phase I multicenter pilot study was conducted at four U.S. medical centers. Medical students and residents used the simulator's 3D interactive tutorial, augmented by voiceover and didactic labels. 37 subjects completed pre- and post-tests before and after using the simulator.

Results

Preliminary results indicate that training on the BioDigital Latissimus Musculocutaneous Flap Simulator enhances procedural knowledge and understanding. Scores were significantly higher after using the simulator, with a mean improvement of 3.24 out of 21 questions and evaluated in a paired t-test. The data demostrated a significant positive correlation between time spent using the simulator and improvement in test scores.

Conclusion

The BioDigital Latissimus Musculocutaneous Flap Simulator is currently the only existing cognitive plastic surgery procedure simulator which includes peer-reviewed steps and has been tested across several training programs. This study suggests that this simulator is an effective tool for surgical education, and validates step-based cognitive simulation in the field of plastic and reconstructive surgery. Next steps include technological improvements, further validation, and development of additional simulators to construct a virtual library of procedures.

22982 Educational Efficacy of a Procedural Surgical Simulator in Plastic Surgery Residency Training : A Phase I Multi-Site Study