Technical skills simulation for postgraduate surgical training

Thesis

Technical skills are a fundamental component of surgical training. Traditionally, these skills are learnt in an operating theatre under supervision. Access to surgical theatres have been unfavourably affected by several factors, including shift working, demand for service provision, consultant-led operating and working hour restrictions. Opportunities for surgical technical skills training further deteriorated during the COVID-19 pandemic.

Simulation is an effective modality for learning technical skills outside of the operating theatre. Evidence, however, shows the inadequate and inconsistent implementation of simulation into surgical training with barriers such as limited faculty availability, resources, and time constraints for trainees. My research focussed on this gap by exploring how technical skill simulation can be implemented alongside conventional surgical training.

In part I, I explored the evolution of surgical training and simulation, reviewing the evidence available for modalities that could develop technical skills. In part II, I identified the deficiencies in technical skill training and the lack of instruction for the use of simulation through a curriculum review and two systematic reviews. Additionally, I explored the barriers to implementing simulation through a scoping literature review. In part III, I used qualitative methodologies to understand general surgical and obstetrics and gynaecology trainees’ experiences when engaging with simulation as part of their routine training. Finally, in part IV, I discussed the broader implications of my findings for both training and further research and the limitations of the research.

My thesis emphasises the importance of innovation in implementing simulation as an adjunct to conventional training for technical skills. I propose a pragmatic approach that enhances the training experience without unduly increasing the trainee or educator burden and aligns with national interests for training and healthcare workforce development.

Authors: Siddharth, A

• DOI: 10.5287/ora-qzee46zxy
• Type of award: DPhil
• Level of award: Doctoral
• Awarding institution: University of Oxford
• Language: English
• Keywords: surgical training; medical education; simulation; post graduate medical education; technical skills
• Subjects: Training; Operations, Surgical; Simulation methods; Medical education