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“In the real world, a surgeon will face different situations. The concept of surgical education is that you will have already worked through these scenarios and know how to react,” said Carol R. Bradford, MD, MS, executive vice dean for academic affairs and professor of otolaryngology-head and neck surgery at the University of Michigan Medical School in Ann Arbor.
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January 2019Expanded Role for Simulation
Newer simulation tools may incorporate some of the latest technology from the entertainment world, but not all are well validated for usefulness. In one 2017 systematic review of otolaryngology simulators, 54 out of 64 products had been vetted by only one validation study, and none received the highest level of recommendation from these studies (J Surg Educ. 2017;74:203-215).
“Simulation and gamification (game-based technology) deliver experiential learning through highly interactive, engaging methods that often include complex graphics and 3D components,” said Sonya Malekzadeh, MD, FACS, director of the residency program in otolaryngology-head and neck surgery at MedStar Georgetown University Hospital in Washington, D.C. The use of simulation-based medical education has exploded recently due to recent medical education reform and political and societal pressures for quality and safety, she said.
“Simulation is becoming increasingly utilized not only as a method to teach skills and behaviors, but to assess the performance and even competency of our trainees,” she added. “Simulation training can also enhance team performance, reduce errors, and, ultimately, improve patient care. We need to invest in simulation technology, simulation curricula, and outcomes measurements.”
Weigh the cost of any simulator against its utility before investing in it, said Christie A. Barnes, MD, associate residency program director and director of resident education, at the University of Nebraska Medical Center department of otolaryngology/head and neck surgery in Omaha.
“Otolaryngology is a hard specialty to simulate because of the varied modalities we utilize, including lasers and scopes. We are lacking in good simulation tools. We have some good temporal bone models right now,” said Dr. Barnes. Her institution tested and then passed on buying a $50,000 new temporal bone drilling simulator. “We already do more realistic training with our cadaverous models. Cadaveric dissection is one area of training where we have had great feedback from our residents that this is a good educational tool.” Electronic textbooks that can be updated quickly will be more useful to the surgical trainees of the future than printed books, she added.
Interactive online educational modules, web-based workshops, electronic medical libraries, and simulation-based learning appeal to tech-savvy, young residents, said Dr. Malekzadeh.
“Mobile learning is popular with the current generation of medical learners. It involves retrieving information and resources over a cellular network, and uses mobile technologies as tools and platforms so learners can access instructional materials remotely for just-in-time learning,” but all of these high-tech tools should be used in a complementary way, she said.
“Blended instruction supplements the e-learning curriculum through a hybrid of electronic, face-to-face, or hands-on methods. Studies have shown that blended learning is more accepted and effective,” she said. “Active participation with increased learner engagement results in better student performance and improved educational outcomes.”