Page last updated at 23:58 GMT, Thursday, 14 May 2009 00:58 UK

Simulators 'make surgeons better'

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Butcher Joe Brennan and trainee surgeon Mr Tom Palser battle it out on a simulator, under the eye of Prof Mike Larvin at the Royal College of Surgeons

Using simulators to train surgeons makes them quicker and better, a study shows.

The Danish research comes after calls to introduce strict guidelines for NHS doctors.

Unlike many other countries the use of simulators is not a formal part of the training process.

But the Copenhagen University Hospital team said it should be after monitoring the performance of 24 junior doctors carrying out keyhole surgery.

The researchers put the obstetrics and gynaecology medics in two groups - one which had the traditional training of working alongside doctors and tutoring and another which supplemented this with seven hours simulator training.

This can potentially improve patient safety and improve operation room efficiency
Christian Rifbjerg Larsen, lead researcher

They found that those that used the computer simulators were twice as quick, taking just 12 minutes to complete the operation on a patient.

They also carried out better procedures, according to a points system used to judge the quality of the work.

Lead researcher Christian Rifbjerg Larsen said: "Simulator training should be incorporated into the curriculum for all surgical trainees before they embark on patient procedures.

"This can potentially improve patient safety and improve operation room efficiency."

The publication of the study in the British Medical Journal comes after Sir Liam Donaldson, England's chief medical officer, called for more simulation training in the NHS.

In his annual report in March, he said simulators "reduce errors and make surgery much safer".

Guidelines

Simulators are already used in the NHS for everything from practising surgery to administering drugs.

But unlike other countries, such as Israel, there are no strict guidelines about how much time doctors should spend on them.

The British Medical Association is also keen on increased use of simulators, although it has said real-life training with consultants should not be compromised.

Roger Kneebone, an expert in surgical education at Imperial College London, agreed.

He said: "Simulation offers obvious benefits. Sophisticated virtual reality simulators can provide anatomically realistic recreations of many operations."

But he added trainee surgeons also needed to develop communication and leadership skills as well as be ready for the unexpected - all of which required different training to simulators.

Health Minister Lord Darzi said high quality training is essential.

"In my own career as a surgeon I have seen the huge benefits which innovations in surgical simulation have made possible so I am pleased but not surprised by these findings which we welcome.

"We are working with NHS colleagues to develop a new strategy for simulation-based training in order to ensure the best training for doctors and the best quality of care for our patients."

Practical training

The Royal College of Surgeons (RCS) has recently opened a new clinical skills unit, where a range of simulation techniques are taught, from simple plastic models, on which trainees can practice stitching, to a simulated operating theatre suite.

College President, John Black said: "The skills centre will change the way surgical training is delivered in the UK.

"Traditionally, measuring performance in the operating theatre has concentrated on the surgeons alone.

"While technical ability and dexterity are critical to the success of operations so too are team-working, communication skills and leadership qualities.

"We have learned from other highly skilled industries, including the airline industry, that many errors are due to human factors and this is also true in surgery.

"We have, therefore, responded by placing greater emphasis on training the whole surgical team."



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