International Journal of Healthcare Simulation

Background:

The COVID-19 Pandemic has had a significant disruption to the provision of Surgical Training. Core and Improving Surgical Trainees (CSTs and ISTs) are noted to be a group profoundly affected due to the impact of the pandemic in reducing operative time, cancelled elective procedures and redeployment to other specialities ^[1,2].

Aim:

We aimed to evaluate the benefit of Small Group Surgical Simulation teaching for CSTs and ISTs recently deployed in the Norfolk and Norwich University Hospital.

Simulation activity outline:

Physical simulation models were designed with the use of animal tissue and/or surgical simulators (such as laparoscopic box trainers) to simulate surgical procedures appropriate for the grade of trainees.

Method:

We designed a monthly Surgical Simulation Programme, which took place in the Surgical Skills Laboratory. Topics were selected from those suitable for Simulation from the Intercollegiate Surgical Curriculum Programme (ISCP) Core Surgical Curriculum ^[3]. Consultants and Senior Registrars from various Surgical Specialties were approached. Animal tissue and surgical simulators were used in conjunction, to simulate surgical environments as closely as possible with funding provided by NANIME (Norfolk and Norwich Institute of Multi-professional Education). Sessions were advertised to all CSTs and ISTs; however, due to COVID, restrictions on the number of participants were restricted to <10. Participants were asked to anonymously complete pre- and post-session surveys.

Results:

Participants felt that the COVID pandemic affected opportunities to perform/assist or observe the surgical skills. Participant comments on COVID affecting opportunities included ‘Reduced opportunities due to cancelled lists’, ‘Fewer elective cases so less opportunity ‘ and ‘Affected in the Peak of COVID but it is improving. Following the session, 100% of participants found the sessions to be effective in improving confidence in performing the surgical skill and 87% found the sessions to be extremely effective. Participants found the teaching sessions to be useful due to the opportunities of ‘Close supervision and direct feedback’, ‘Set of tasks’, ‘Practise with animal models’, ‘Having the tutor there to assist and help us’ and ‘[Discussing] theory prior to learning the procedure’.

Implications for future practice:

Surgical simulation provides opportunities for early-year trainees to learn and perform surgical skills during the COVID-19 pandemic. Small-group surgical simulation allows CSTs and ISTs to develop and practise skills under supervision of tutors, with trainees finding real-time feedback useful. In a post-COVID era, a surgical simulation teaching programme could provide an effective training opportunity to shorten the steep learning curve of core surgical training.