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Implementation of a surgical simulation care pathway approach to training in emergency abdominal surgery

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Title: Implementation of a surgical simulation care pathway approach to training in emergency abdominal surgery
Authors: Beyer-Berjot, L
Patel, V
Sirimanna, P
Hashimoto, DA
Berdah, S
Darzi, A
Aggarwal, R
Item Type: Journal Article
Abstract: Background Simulation-based care pathway approach (CPA) training is a novel approach in surgical education. The objective of the present study was to determine whether CPA was feasible for training surgical residents and could improve efficiency in patients’ management. A common disease was chosen: acute appendicitis. Methods All five junior residents of our department were trained in CPA: preoperative CPA consisted in virtual patients (VPs) presenting with acute right iliac fossa pain; intraoperative CPA involved a virtual competency-based curriculum for laparoscopic appendectomy (LAPP); finally, post-operative VP were reviewed after LAPP. Thirty-eight patients undergoing appendectomy were prospectively included before (n = 21) and after (n = 17) the training. All demographic and perioperative data were prospectively collected from their medical records, and time taken from admission to management was measured. Results All residents had performed less than 10 LAPP as primary operator. Pre- and intraoperative data were comparable between pretraining and post-training patients. Times to liquid and solid diet were significantly reduced after training [7 h (2–20) vs. 4 (4–6); P = 0.004, and 17 h (4–48) vs. 6 (4–24); P = 0.005] without changing post-operative morbidity [4 (19%) vs. 0 (0); P = 0.11] and length of stay [48 h (30–264) vs. 44 (21–145); P = 0.22]. Conclusions CPA training is feasible in abdominal surgery. In the current study, it improved patients’ management in terms of earlier oral intake.
Issue Date: 28-Oct-2019
Date of Acceptance: 1-Oct-2019
URI: http://hdl.handle.net/10044/1/85864
DOI: 10.1007/s00268-019-05242-1
ISSN: 0364-2313
Publisher: Springer
Start Page: 696
End Page: 703
Journal / Book Title: World Journal of Surgery
Volume: 44
Issue: 3
Copyright Statement: © Socie´te´ Internationale de Chirurgie 2019. The final publication is available at Springer via https://doi.org/10.1007/s00268-019-05242-1
Sponsor/Funder: National Institute of Health Research
National Institute for Health Research
Funder's Grant Number: NF SI 061710038
Keywords: Science & Technology
Life Sciences & Biomedicine
Surgery
3-D VIRTUAL WORLDS
OPERATING-ROOM
SKILLS
IMPACT
APPENDECTOMY
OUTCOMES
PERFORMANCE
DIAGNOSIS
EDUCATION
TRIAL
Adolescent
Adult
Appendectomy
Appendicitis
Curriculum
Emergency Service, Hospital
Female
Humans
Laparoscopy
Male
Prospective Studies
Simulation Training
Humans
Appendicitis
Laparoscopy
Appendectomy
Prospective Studies
Curriculum
Adolescent
Adult
Emergency Service, Hospital
Female
Male
Simulation Training
Science & Technology
Life Sciences & Biomedicine
Surgery
3-D VIRTUAL WORLDS
OPERATING-ROOM
SKILLS
IMPACT
APPENDECTOMY
OUTCOMES
PERFORMANCE
DIAGNOSIS
EDUCATION
TRIAL
1103 Clinical Sciences
Surgery
Publication Status: Published
Online Publication Date: 2019-10-28
Appears in Collections:Department of Surgery and Cancer
Institute of Global Health Innovation