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Resident’s Forum
Surgical Simulation and Digital Tools for Surgical Training During the COVID-19 Pandemic
FR-Técnicas de simulación quirúrgica y herramientas digitales como alternativa en la formación quirúrgica durante la pandemia COVID-19
M. Luque-Luna, D. Morgado-Carrasco
Corresponding author
morgadodaniel8@gmail.com

Corresponding author.
Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The COVID-19 pandemic has reduced opportunities for residency training and surgical training in particular in various specialities&#44; including dermatology&#46; Surgical skills can be negatively affected if not practiced during this critical learning period&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Numerous specialities have incorporated surgical simulation into resident training programs in recent years&#44;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> providing the opportunity to practice on cadaveric models or artificial tissues&#44; experiment&#44; and acquire and refine skills under the guidance and appraisal of a tutor&#46; Simulation can be combined with digital technologies to further enhance learning and assessment opportunities&#46; Despite their usefulness&#44; however&#44; these models been used very little in dermatology training&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Garc&#237;a-Lozano et al&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> recently described a program created to teach surgical techniques to dermatology residents during the COVID-19 pandemic&#46; The program involves the use of illustrative web-based videos on surgical techniques and problem-solving scenarios in which residents design flaps using a simulator bust model &#40;Diaphanous Zsa Zsa&#44; DermSurg Scientific&#41;&#46; Prior to this&#44; Nicholas et al&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> conducted a cross-sectional study to assess the perceived usefulness of surgical simulation using the Il Duoma simulator bust model &#40;IL Duomo&#44; DermSurg Scientific&#41; during a 2-day training symposium attended by residents and staff&#46; Over 90&#37; of the participants surveyed were of the opinion that simulators are a powerful and helpful educational tool and thought they should be mandatory in residency training programs&#44; especially during the early months&#46; Liu et al&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> conducted a prospective multicenter study evaluating the impact of instructional videos on types of flaps and surgical techniques followed by surgical simulation for first- and second-year dermatology residents&#46; The residents were assessed using the validated Objective Structured Assessment of Technical Skills &#40;OSATS&#41; instrument before and after the program and completed a questionnaire on self-reported level of operative confidence and perceived value of this new training approach&#46; The median OSATS score increased from 27 before the program to 46 afterwards &#40;<span class="elsevierStyleItalic">P</span>&#160;&#60;&#160;&#46;001&#41; and the questionnaires showed high levels of satisfaction and increased confidence among the residents&#46; The procedures can be recorded with a GoPro-type camera attached to the resident&#39;s forehead during simulation&#44; helping them to visualize and analyze in detail the intervention in first person together with a member of staff to identify techniques that need improvement &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Simulation can also be very useful for practicing aesthetic dermatology procedures&#44; with studies showing successful results for simulations based on bust models or cadaveric material&#44; such as pig heads&#44; to practice botulinum toxin injection&#46; Similar animal models have also been used to teach procedures such as laser and chemical peels&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Other simulation modalities such as advanced virtual and augmented reality simulations have proven very effective in other surgical specialties&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The COVID-19 pandemic will undoubtedly change medical education delivery&#46; The combination of stimulation-based training and digital tools could revolutionize the teaching of dermatologic surgery&#44; while reducing associated risks and favoring the acquisition of uniform skills among residents&#46;</p></span>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Step 1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">Review surgical techniques and anatomy using digital tools&#58; online videos and presentations&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Step 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Perform surgical simulation using animals&#44; cadavers&#44; and artificial material such as human bust models&#46; Record the procedure with a camera attached to the trainee&#8217;s forehead&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Step 3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Watch the recording with a staff member and other residents&#46; Discuss positive aspects and areas for improvement&#46; Assessment&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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Article information
ISSN: 15782190
Original language: English
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