6 May 2015
Simulation-based learning to acquire and maintain medical and
surgical skills has a growing role to play in the training of
doctors and surgeons according to visiting Irish University
Professor Tony Gallagher.
Professor Gallagher is attending the Royal Australian College of
Surgeons 84th Annual Scientific Congress (ASC) in Perth this week
to talk about surgical simulation for outcome-based training.
"Training must not just be an interesting educational
experience. There have been a lot of advances in the past 20 years
on how simulation should be used optimally," Professor Gallagher
"Simulation is much more than a technology learning experience
for supplanting the traditional approach of repeated practice.
Research has shown that simulation works best when it is integrated
into a curriculum.
"Learning is optimal when Trainees receive precise (i.e.
metric-based) feedback on their performance.
"Metrics should unambiguously characterise important aspects of
procedure or skilled performance.
"They are developed from a task analysis of the procedure or
skills to be learned. This means we have a detailed understanding
of what the surgeon or doctor should do. It also means that we know
what they should not do," Professor Gallagher said.
Professor Gallagher is the head of Technology Enhanced Learning
and the Director of Research at the ASSERT for Health Centre in the
College of Medicine and Health at University College Cork in
Professor Gallagher said that although a simulation-based
approach to medical education and training may be conceptually and
intellectually appealing, it represents a paradigm shift in how
doctors are education and trained.
"The practice of modern medicine has considerably challenged the
way doctors and healthcare professionals learn the practice of
medicine," Prof Gallagher said.
He will present new data from a 21-site (USA) prospective,
randomised and blinded study by the Arthroscopic Association of
North America (AANA) on simulation-based training.
The results show that orthopaedic surgeon trainees randomised to
proficiency-based progression simulation training performed 40 - 60
per cent better (with fewer errors) than two matched control
"This is the largest and best controlled clinical study of
simulation-based training ever conducted. The results have
important implications for patient safety and what we mean by
'training'," Professor Gallagher said.
"Simulation and technology enhanced learning are effective
because they offer the opportunity for the trainee to engage in
deliberate practice with metric-based performance feedback," he
"It also means that we can 'quality-assure' the performance of
graduating trainees with an 'outcome' rather than a 'process' based
approach to training.
"The US Food and Drug Administration now requires
simulation-based training as part of device approval and the UK
Department of Health has issued guidance that appears to suggest
that trainees should not be performing a procedure on a real
patient the first time they perform the procedure," Professor
Over a thousand surgeons from the Royal Australasian College of
Surgeons as well as international surgeons from the Royal College
of Surgeons of Edinburgh are gathering at the Perth Convention and
Exhibition Centre from 4-8 May for a series of workshops,
discussions, Plenaries and masterclasses across a broad range of
The ASC brings together some of the top surgical and medical
minds from across Australia, New Zealand and the rest of the world
and also pays tribute to the centenary of Gallipoli by analysing
ethics and developments in surgery over the past 100 years, in war
and peace time, as well as exploring what the future may hold in
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