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Simulation Training in Surgical Education

  • Surgical Education (S. Tisherman, Section Editor)
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Abstract

Purpose of Review

Our review aims to describe the use of simulation-based training throughout the continuum of surgical education.

Recent Findings

In addition to well-known procedural-based surgical simulation modalities like the Fundamentals of Laparoscopic Surgery and Fundamentals of Endoscopic Surgery, there are several novel uses of simulation including its use for preparing medical students for surgical residency, resident interviews and onboarding, residency training, mental skills training, and continuing education for practicing surgeons.

Summary

Simulation is a cost effective and useful method to improve trainee exposure and confidence to execute technical and nontechnical skills throughout the surgical career. There is clearly a role for simulation-based training with medical students, residents, and practicing surgeons to optimize performance through deliberate practice of skills in a safe environment. Due to the evolution of surgical techniques and an increased emphasis for proficiency-based training and certification of skills, simulation will play an increasingly integral role in surgical education.

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References

Papers of particular interest, published recently, have been highlighted as: ∙ Of importance ∙∙ Of major importance

  1. Nasca T, Day S, Amis E Jr, ACGME Duty Hour Task Force. The new recommendations on duty hours from the ACGME Task Force. N Engl J Med. 2010;3(1):1–6. doi:10.1056/NEJMsb1005800.

    Google Scholar 

  2. Williams RG, Dunnington GL. Accreditation Council for Graduate Medical Education core competencies initiative: the road to implementation in the surgical specialties. Surg Clin North Am. 2004;84(6):1621–46. doi:10.1016/j.suc.2004.06.018.

    Article  PubMed  Google Scholar 

  3. Mattar SG, Alseidi AA, Jones DB, Jeyarajah DR, Swanstrom LL, Aye RW, et al. General surgery residency inadequately prepares trainees for fellowship: results of a survey of fellowship program directors. Ann Surg. 2013;258(3):440–9. doi:10.1097/SLA.0b013e3182a191ca.

    Article  PubMed  Google Scholar 

  4. Scott DJ, Dunnington GL. The new ACS/APDS skills curriculum: moving the learning curve out of the operating room. J Gastrointest Surg. 2008;12(2):213–21. doi:10.1007/s11605-007-0357-y.

    Article  PubMed  Google Scholar 

  5. American College of Surgeons. ACS/APDS surgery resident skills curriculum. 2017. https://www.facs.org/education/program/resident-skills. Accessed 28 Apr 2017.

  6. Sutherland LM, Middleton PF, Anthony A, Hamdorf J, Cregan P, Scott D, et al. Surgical simulation. Ann Surg. 2006;243(3):291–300. doi:10.1097/01.sla.0000200839.93965.26.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Dunkin B, Adrales GL, Apelgren K, Mellinger JD. Surgical simulation: a current review. Surg Endosc Other Interv Tech. 2007;21(3):357–66. doi:10.1007/s00464-006-9072-0.

    Article  CAS  Google Scholar 

  8. Gordon JA. The human patient simulator: acceptance and efficacy as a teaching tool for students. Acad Med. 2000;75(5):522.

    Article  CAS  PubMed  Google Scholar 

  9. Ericsson KA, Krampe RT, Tesch-Römer C. The role of deliberate practice in the acquisition of expert performance. Psychol Rev. 1993;100(3):363–406. doi:10.1037/0033-295X.100.3.363.

    Article  Google Scholar 

  10. Abernethy B, Poolton JM, Masters RSW, Patil NG. Implications of an expertise model for surgical skills training. ANZ J Surg. 2008;78(12):1092–5. doi:10.1111/j.1445-2197.2008.04756.x.

    Article  PubMed  Google Scholar 

  11. Sanfey H, Ketchum J, Bartlett J, Markwell S, Meier AH, Williams R, et al. Verification of proficiency in basic skills for postgraduate year 1 residents. Surgery. 2010;148(4):759–67. doi:10.1016/j.surg.2010.07.018.

    Article  PubMed  Google Scholar 

  12. ∙ Glass CC, Acton RD, Blair PG, Campbell AR, Deutsch ES, Jones DB, et al. American College of Surgeons/Association for Surgical Education medical student simulation-based surgical skills curriculum needs assessment. Am J Surg. 2014;207(2):165–9. doi:10.1016/j.amjsurg.2013.07.032. Needs assessment of Clerkship Directors and medical students to identify educational content for a simulation-based curriculum for medical students.

  13. ∙ Acton RD, Jones DB LKR. American College of Surgeons and Association for Surgical Education medical student simulation based surgical skills curriculum. Bull Am Coll Surg. 2015;100(4):35–9. Overview of ACS/ASE simulation-based curriculum for medical students, including methods of curriculum development and modules within the curriculum.

  14. American College of Surgeons. ACS/ASE medical student simulation-based surgical skills curriculum. 2013. https://www.facs.org/education/program/simulation-based. Accessed 20 Apr 2017.

  15. Louridas M, Szasz P, Fecso AB, Zywiel MG, Lak P, Bener AB, et al. Practice does not always make perfect: need for selection curricula in modern surgical training. Surg Endosc. 2017;70(2):193–9. doi:10.1007/s00464-017-5572-3.

    Google Scholar 

  16. ∙ Gardner AK, Ritter EM, Paige JT, Ahmed RA, Fernandez G, Dunkin BJ. Simulation-based selection of surgical trainees: considerations, challenges, and opportunities. J Am Coll Surg. 2016;223(3):530–6. doi:10.1016/j.jamcollsurg.2016.05.021. Aimee can you give a brief summary of why this is important please?

  17. ∙ Gardner AK, Steffes CP, Nepomnayshy D, Nicholas C, Widmann WD, Fitzgibbons SC, et al. Selection bias: examining the feasibility, utility, and participant receptivity to incorporating simulation into the general surgery residency selection process. Am J Surg. 2016;1171–7. doi:10.1016/j.amjsurg.2016.09.029. Aimee can you give a brief summary of why this is important please?

  18. Okusanya OT, Kornfield ZN, Reinke CE, Morris JB, Sarani B, Williams NN, et al. The effect and durability of a pregraduation boot camp on the confidence of senior medical student entering surgical residencies. J Surg Educ. 2012;69(4):536–43. doi:10.1016/j.jsurg.2012.04.001.

    Article  PubMed  Google Scholar 

  19. ∙∙ Minter RM, Amos KD, Bentz ML, Blair PG, Brandt C, D’Cunha J, et al. Transition to surgical residency. Acad Med. 2015;90(8):1116–24. doi:10.1097/ACM.0000000000000680. Mixed-methods, multi-institutional evaluation of surgery interns’ preparedness for surgical residency. This study compares responses from interns who participated in a residency preparatory course in their fourth year of medical school compared to those that had not participated in a preparatory course.

  20. ACS/ASE/APDS Resident Prep Curriculum. 2014. https://www.facs.org/education/program/resident-prep. Accessed 16 Apr 2017.

  21. Krajewski A, Filippa D, Staff I, Singh R, Kirton OC. Implementation of an intern boot camp curriculum to address clinical competencies under the new accreditation council for graduate medical education supervision requirements and duty hour restrictions. JAMA Surg. 2013;148(8):727. doi:10.1001/jamasurg.2013.2350.

    Article  PubMed  Google Scholar 

  22. Fernandez GL, Page DW, Coe NP, Lee PC, Patterson LA, Skylizard L, et al. Boot camp: educational outcomes after 4 successive years of preparatory simulation-based training at onset of internship. J Surg Educ. 2012;69(2):242–8. doi:10.1016/j.jsurg.2011.08.007.

    Article  PubMed  Google Scholar 

  23. ∙∙ Stefanidis D, Sevdalis N, Paige J, Zevin B, Aggarwal R, Grantcharov T, et al. Simulation in surgery: what’s needed next? Ann Surg. 2015;261(5):846–53. doi:10.1097/SLA.0000000000000826. A very important review of the current state of surgical simulation that identifies challenges to implementation in training programs, and directions for future research.

  24. Aggarwal R, Grantcharov TP, Darzi A. Framework for systematic training and assessment of technical skills. J Am Coll Surg. 2007;204(4):697–705. doi:10.1016/j.jamcollsurg.2007.01.016.

    Article  PubMed  Google Scholar 

  25. Zevin B, Levy JS, Satava RM, Grantcharov TP. A consensus-based framework for design, validation, and implementation of simulation-based training curricula in surgery. J Am Coll Surg. 2012;215(4):580–6. doi:10.1016/j.jamcollsurg.2012.05.035.

    Article  PubMed  Google Scholar 

  26. Stefanidis D. The formula for a successful laparoscopic skills curriculum. Arch Surg. 2009;144(1):77. doi:10.1001/archsurg.2008.528.

    Article  PubMed  Google Scholar 

  27. Scott DJ, Goova MT, Tesfay ST. A cost-effective proficiency-based knot-tying and suturing curriculum for residency programs. J Surg Res. 2007;141(1):7–15. doi:10.1016/j.jss.2007.02.043.

    Article  PubMed  Google Scholar 

  28. Goova MT, Hollett LA, Tesfay ST, Gala RB, Puzziferri N, Kehdy FJ, et al. Implementation, construct validity, and benefit of a proficiency-based knot-tying and suturing curriculum. J Surg Educ. 2008;65(4):309–15. doi:10.1016/j.jsurg.2008.04.004.

    Article  PubMed  Google Scholar 

  29. Mashaud LB, Arain NA, Hogg DC, Scott DJ. Development, validation, and implementation of a cost-effective intermediate-level proficiency-based knot-tying and suturing curriculum for surgery residents. J Surg Educ. 2013;70(2):193–9. doi:10.1016/j.jsurg.2012.09.008.

    Article  PubMed  Google Scholar 

  30. ∙ Gomez PP, Willis RE, Schiffer BL, Gardner AK, Scott DJ. External validation and evaluation of an intermediate proficiency-based knot-tying and suturing curriculum. J Surg Educ. 2014;71(6):839–45. doi:10.1016/j.jsurg.2014.04.013. Evaluated the use of UT southwest intermediate proficiency knot-tying and suturing curriculum at external programs- showed external validity and construct validity of the curriculum. Also showed that interns could be trained to proficiency on intermediate tasks using simulation.

  31. Barsuk JH, Cohen ER, Feinglass J, McGaghie WC, Wayne DB. Use of simulation-based education to reduce catheter-related bloodstream infections. Arch Intern Med. 2009;169(15):1420–3. doi:10.1001/archinternmed.2009.215.

    Article  PubMed  Google Scholar 

  32. Cohen ER, Feinglass J, Barsuk JH, Barnard C, O’Donnell A, McGaghie WC, et al. Cost savings from reduced catheter-related bloodstream infection after simulation-based education for residents in a medical intensive care unit. Simul Healthc. 2010;5(2):98–102. doi:10.1097/SIH.0b013e3181bc8304.

    Article  PubMed  Google Scholar 

  33. Ma IWY, Brindle ME, Ronksley PE, Lorenzetti DL, Sauve RS, Ghali WA. Use of simulation-based education to improve outcomes of central venous catheterization: a systematic review and meta-analysis. Acad Med. 2011;86(9):1137. doi:10.1097/ACM.0b013e318226a204.

    Article  PubMed  Google Scholar 

  34. Fried GM, Feldman LS, Vassiliou MC, Fraser SA, Stanbridge D, Ghitulescu G, et al. Proving the value of simulation in laparoscopic surgery. Ann Surg. 2004;240(3):518–528. doi:10.1097/01.sla.0000136941.46529.56.

  35. McCluney AL, Vassiliou MC, Kaneva PA, Cao J, Stanbridge DD, Feldman LS, et al. FLS simulator performance predicts intraoperative laparoscopic skill. In: Surgical endoscopy and other interventional techniques. 2007. p. 1991–5. doi:10.1007/s00464-007-9451-1.

  36. Sroka G, Feldman LS, Vassiliou MC, Kaneva PA, Fayez R, Fried GM. Fundamentals of laparoscopic surgery simulator training to proficiency improves laparoscopic performance in the operating room-a randomized controlled trial. Am J Surg. 2010;199(1):115–20. doi:10.1016/j.amjsurg.2009.07.035.

    Article  PubMed  Google Scholar 

  37. Derossis AM, Bothwell J, Sigman HH, Fried GM. The effect of practice on performance in laparoscopic simulator. Surg Endosc. 1998;12:1117–20. doi:10.1007/s004649900796.

    Article  CAS  PubMed  Google Scholar 

  38. ∙ Dawe SR, Pena GN, Windsor JA, Broeders JAJL, Cregan PC, Hewett PJ, et al. Systematic review of skills transfer after surgical simulation-based training. Br J Surg. 2014;101(9):1063–76. doi:10.1002/bjs.9482. Showed that proficiency in simulation-based training relates to clinical performance (skills transfer), with simulation trained participants having improved performance in patient-based setting compared to those without simulation training.

  39. Zendejas B, Brydges R, Hamstra SJ, Cook DA. State of the evidence on simulation-based training for laparoscopic surgery: a systematic review. Ann Surg [Internet]. 2013;257(4):586–93. doi:10.1097/SLA.0b013e318288c40b.

    Article  PubMed  Google Scholar 

  40. Scott DJ, Ritter EM, Tesfay ST, Pimentel EA, Nagji A, Fried GM. Certification pass rate of 100% for fundamentals of laparoscopic surgery skills after proficiency-based training. Surg Endosc Other Interv Tech. 2008;22(8):1887–93. doi:10.1007/s00464-008-9745-y.

    Article  Google Scholar 

  41. Ritter EM, Scott DJ. Design of a proficiency-based skills training curriculum for the fundamentals of laparoscopic surgery. Surg Innov. 2007;14:107–12. doi:10.1177/1553350607302329.

    Article  PubMed  Google Scholar 

  42. Castellvi AO, Hollett LA, Minhajuddin A, Hogg DC, Tesfay ST, Scott DJ. Maintaining proficiency after fundamentals of laparoscopic surgery training: a 1-year analysis of skill retention for surgery residents. Surgery. 2009;146(2):387–93. doi:10.1016/j.surg.2009.05.009.

    Article  PubMed  Google Scholar 

  43. Nagendran M, Ks G, Aggarwal R, Loizidou M, Br D. Virtual reality training for surgical trainees in laparoscopic surgery. Cochrane Database Syst Rev. 2013;8:1–45. doi:10.1002/14651858.CD006575.pub3.

    Google Scholar 

  44. Derevianko AY, Schwaitzberg SD, Tsuda S, Barrios L, Brooks DC, Callery MP, et al. Malpractice carrier underwrites fundamentals of laparoscopic surgery training and testing: a benchmark for patient safety. Surg Endosc Other Interv Tech. 2010;24(3):616–23. doi:10.1007/s00464-009-0617-x.

    Article  Google Scholar 

  45. Harris JD, Hosford CC, Sticca RP. A comprehensive analysis of surgical procedures in rural surgery practices. Am J Surg. 2010;200(6):820–6. doi:10.1016/j.amjsurg.2010.07.029.

    Article  PubMed  Google Scholar 

  46. Decker MR, Dodgion CM, Kwok AC, Hu YY, Havlena JA, Jiang W, et al. Specialization and the current practices of general surgeons. J Am Coll Surg. 2014;218(1):8–15. doi:10.1016/j.jamcollsurg.2013.08.016.

    Article  PubMed  Google Scholar 

  47. Accreditation Council for Graduate Medical Education. Surgery and pediatric surgery program requirements. RRC News for Surgery 2008.

  48. SAGES. SAGES fundamentals of endoscopic surgery (FES) required by american board of surgery, fes elevates the standards and training for minimally invasive surgery. PR Web [Internet]. 2014

  49. ∙ Dietl CA, Russell JC. Effects of technological advances in surgical education on quantitative outcomes from residency programs. J Surg Educ. 2016;73(5):819–30. doi:10.1016/j.jsurg.2016.03.016. Systematic review of current technology and simulation in surgical education and their impact on performance on training metrics.

  50. Wilcox V, Trus T, Salas N, Martinez J, Dunkin BJ. A proficiency-based skills training curriculum for the sages surgical training for endoscopic proficiency (STEP) program. J Surg Educ [Internet]. 2014;71(3):282–8. doi:10.1016/j.jsurg.2013.10.004.

    Article  PubMed  Google Scholar 

  51. SAGES. Program description: fundamentals of endoscopic surgery. 2017. http://www.fesprogram.org/about/program-description-2/. Accessed 2 May 2017.

  52. Hazey JW, Marks JM, Mellinger JD, Trus TL, Chand B, Delaney CP, et al. Why fundamentals of endoscopic surgery (FES)? Surg Endosc Other Interv Tech. 2014;28(3):701–3. doi:10.1007/s00464-013-3299-3.

    Article  Google Scholar 

  53. Vassiliou MC, Dunkin BJ, Fried GM, Mellinger JD, Trus T, Kaneva P, et al. Fundamentals of endoscopic surgery: creation and validation of the hands-on test. Surg Endosc Other Interv Tech. 2014;28(3):704–11. doi:10.1007/s00464-013-3298-4.

    Article  Google Scholar 

  54. ∙ Ritter E, Taylor Z, Wolf K, Franklin B, Placek S, Korndorffer J, et al. Simulation based mastery learning for endoscopy using the endoscopy training system: a strategy to improve endoscopic skills and prepare for the Fundamentals of Endoscopic Surgery (FES) manual skills exam. Surg Endosc. 2017 (in press). Aimee can you give a brief summary of why this is important please- since I can’t actually find a copy anywhere.

  55. Dawe SR, Windsor JA, Broeders JA, Cregan PC, Hewett PJ, Maddern GJ. A systematic review of surgical skills transfer after simulation-based training: laparoscopic cholecystectomy and endoscopy. Ann Surg. 2014;259(2):236–48. doi:10.1097/SLA.0000000000000245.

    Article  PubMed  Google Scholar 

  56. Dulan G, Rege RV, Hogg DC, Gilberg-Fisher KM, Arain NA, Tesfay ST, et al. Developing a comprehensive, proficiency-based training program for robotic surgery. Surg (United States). 2012;152(3):477–88. doi:10.1016/j.surg.2012.07.028.

    Google Scholar 

  57. Dulan G, Rege RV, Hogg DC, Gilberg-Fisher KM, Arain NA, Tesfay ST, et al. Proficiency-based training for robotic surgery: construct validity, workload, and expert levels for nine inanimate exercises. Surg Endosc Other Interv Tech. 2012;26(6):1516–21. doi:10.1007/s00464-011-2102-6.

    Article  Google Scholar 

  58. Arain NA, Dulan G, Hogg DC, Rege RV, Powers CE, Tesfay ST, et al. Comprehensive proficiency-based inanimate training for robotic surgery: reliability, feasibility, and educational benefit. Surg Endosc Other Interv Tech. 2012;26(10):2740–5. doi:10.1007/s00464-012-2264-x.

    Article  Google Scholar 

  59. Eckert M, Cuadrado D, Steele S, Brown T, Beekley A, Martin M. The changing face of the general surgeon: national and local trends in resident operative experience. Am J Surg. 2010;199(5):652–6. doi:10.1016/j.amjsurg.2010.01.012.

    Article  PubMed  Google Scholar 

  60. Fonseca AL, Evans LV, Gusberg RJ. Open surgical simulation in residency training: a review of its status and a case for its incorporation. J Surg Educ. 2013;70:129–37. doi:10.1016/j.jsurg.2012.08.007.

    Article  PubMed  Google Scholar 

  61. Kuhls DA, Risucci DA, Bowyer MW, Luchette FA. Advanced surgical skills for exposure in trauma: a new surgical skills cadaver course for surgery residents and fellows. J Trauma Acute Care Surg [Internet]. 2013;74(2):664–70. doi:10.1097/TA.0b013e31827d5e20.

    Article  PubMed  Google Scholar 

  62. Bowyer MW, Kuhls DA, Haskin D, Sallee RA, Henry SM, Garcia GD, et al. Advanced surgical skills for exposure in trauma (ASSET): the first 25 courses. J Surg Res. 2013;183(2):553–8. doi:10.1016/j.jss.2013.02.005.

    Article  PubMed  Google Scholar 

  63. Jacobs LM, Burns KJ, Kaban JM, Gross RI, Cortes V, Brautigam RT, et al. Development and evaluation of the advanced trauma operative management course. J Trauma. 2003;55(3):471–9. doi:10.1097/01.TA.0000059445.84105.26.

    Article  PubMed  Google Scholar 

  64. Jacobs LM, Burns KJ, Luk SS, Marshall WT 3rd. Follow-up survey of participants attending the advanced trauma operative management (ATOM) course. J Trauma [Internet]. 2005;58(6):1140–3. doi:10.1097/01.TA.0000171549.40895.2D.

    Article  PubMed  Google Scholar 

  65. Arriaga AF, Bader AM, Wong JM, Lipsitz SR, Berry WR, Ziewacz JE, et al. Simulation-based trial of surgical-crisis checklists. N Engl J Med. 2013;368(3):246–53. doi:10.1056/NEJMsa1204720.

    Article  CAS  PubMed  Google Scholar 

  66. Telem DA, Buch KE, Ellis S, Coakley B. Integration of a formalized handoff system into the surgical curriculum. Arch Surg. 2011;146(1):89. doi:10.1001/archsurg.2010.294.

    Article  PubMed  Google Scholar 

  67. Capella J, Smith S, Philp A, Putnam T, Gilbert C, Fry W, et al. Teamwork training improves the clinical care of trauma patients. J Surg Educ. 2010;67(6):439–43. doi:10.1016/j.jsurg.2010.06.006.

    Article  PubMed  Google Scholar 

  68. Arora S, Aggarwal R, Sevdalis N, Moran A, Sirimanna P, Kneebone R, et al. Development and validation of mental practice as a training strategy for laparoscopic surgery. Surg Endosc Other Interv Tech. 2010;24(1):179–87. doi:10.1007/s00464-009-0624-y.

    Article  Google Scholar 

  69. Arora S, Aggarwal R, Sirimanna P, Moran A, Grantcharov T, Kneebone R, et al. Mental practice enhances surgical technical skills. Ann Surg. 2011;253(2):265–70. doi:10.1097/SLA.0b013e318207a789.

    Article  PubMed  Google Scholar 

  70. ∙ Stefanidis D, Anton NE, McRary G, Howley LD, Pimentel M, Davis C, et al. Implementation results of a novel comprehensive mental skills curriculum during simulator training. Am J Surg. 2017;213(2):353–61. doi:10.1016/j.amjsurg.2016.06.027. Pilot study that evaluates the effectiveness of a novel mental skills curriculum to enhance surgical performance, which supports its use in surgical simulation-based training.

  71. ∙ Stefanidis D, Anton NE, Howley LD, Bean E, Yurco A, Pimentel ME, et al. Effectiveness of a comprehensive mental skills curriculum in enhancing surgical performance: results of a randomized controlled trial. Am J Surg. 2017;213(2):318–24. doi:10.1016/j.amjsurg.2016.10.016. Randomized controlled trial that evaluated the effectiveness of a novel mental skills curriculum with surgical novices, which indicated that the curriculum was effective at enhancing surgical skill retention over time.

  72. Arora S, Sevdalis N, Nestel D, Woloshynowych M, Darzi A, Kneebone R. The impact of stress on surgical performance: a systematic review of the literature. Surgery. 2010;147(3):318–330. doi:10.1016/j.surg.2009.10.007.

  73. Ericsson KA. Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med. 2004;79(10):870–81.

    Google Scholar 

  74. Coker CA, Fishman MG. Motor skill learning for effective coaching and performance. In: Williams JM, editor. Applied sport psychology: personal growth to peak performance. New York: McGraw Hill; 2010. p. 21–41.

    Google Scholar 

  75. Bresser F, Wilson C. What is coaching? In: Passmore J, editor. Excellence in coaching: the industry guide. London: Kogan Page Limited; 2010. p. 9–27.

    Google Scholar 

  76. ∙ Min H, Morales DR, Orgill D, Smink DS, Yule S. Systematic review of coaching to enhance surgeons’ operative performance. Surg (United States). 2015;158(5):1168–91. doi:10.1016/j.surg.2015.03.007. Comprehensive review of coaching interventions with surgeons and trainees, which can help inform future coaching interventions.

  77. ∙ Stefanidis D, Anderson-Montoya B, Higgins R V, Pimentel ME, Rowland P, Scarborough MO, et al. Developing a coaching mechanism for practicing surgeons. Surg (United States). 2016;160(3):536–45. doi:10.1016/j.surg.2016.03.036. Study of a novel coaching mechanism for practicing surgeons, which identified several nontechnical and technical skills to improve through coaching.

  78. Reznick RK. Teaching and testing technical skills. Am J Surg. 1993;165(March):4.

    Google Scholar 

  79. ∙ Mackenzie H, Cuming T, Miskovic D, Wyles SM, Langsford L, Anderson J, et al. Design, delivery, and validation of a trainer curriculum for the national laparoscopic colorectal training program in England. Ann Surg. 2015;261(1):149–56. doi:10.1097/SLA.0000000000000437. Study of the effectiveness of a train the trainer course for a laparoscopic colorectal training program, which is designed to standardize trainer instruction. The researchers found that this train the trainer course effectively enhanced short- and long-term training performance.

  80. ∙∙ Timberlake MD, Mayo HG, Scott L, Weis J, Gardner AK. What do we know about intraoperative teaching?: A systematic review. Ann Surg. 2017 Jan; doi:10.1097/SLA.0000000000002131. An important review to identify important characteristics of effective intraoperative teaching to inform future interventions to enhance faculty instruction.

  81. Rogers SO, Gawande AA, Kwaan M, Puopolo AL, Yoon C, Brennan TA, et al. Analysis of surgical errors in closed malpractice claims at 4 liability insurers. Surgery. 2006;140(1):25–33. doi:10.1016/j.surg.2006.01.008.

    Article  PubMed  Google Scholar 

  82. ∙ Siu J, Maran N, Paterson-Brown S. Observation of behavioural markers of non-technical skills in the operating room and their relationship to intra-operative incidents. Surgeon. 2016;14(3):119–28. doi:10.1016/j.surge.2014.06.005. Study of OR team members’ nontechnical skills that influence surgical safety, which found that a significant number of avoidable incidents that compromise surgical safety are related to poor nontechnical skills.

  83. Steinemann S, Berg B, Skinner A, Ditulio A, Anzelon K, Terada K, et al. In situ, multidisciplinary, simulation-based teamwork training improves early trauma care. J Surg Educ. 2011;68(6):472–7. doi:10.1016/j.jsurg.2011.05.009.

    Article  PubMed  Google Scholar 

  84. ∙ Arriaga AF, Gawande AA, Raemer DB, Jones DB, Smink DS, Weinstock P, et al. Pilot testing of a model for insurer-driven, large-scale multicenter simulation training for operating room teams. Ann Surg. 2014;259(3):403–10. doi:10.1097/SLA.0000000000000342. Pilot study of a teamwork training program for OR teams implemented during simulation training, which was widely acknowledged to be realistic and relevant to participants’ clinical practice.

  85. ACGME Program Requirements. 2016. https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/440_general_surgery_2016.pdf. Accessed 5 May 2017.

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Correspondence to Susan Steinemann.

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Dr. Steinemann is President Elect for Association for Surgical Education and Vice Chair of American College of Surgeons Committee on Medical Student Education. Drs. Gardner and Perone and Mr. Anton declare no conflicts of interest relevant to this manuscript.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical collection on Surgical Education.

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Perone, J.A., Anton, N.E., Gardner, A.K. et al. Simulation Training in Surgical Education. Curr Surg Rep 5, 20 (2017). https://doi.org/10.1007/s40137-017-0182-5

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