Systematic review of skills transfer after surgical simulation-based training

Br J Surg. 2014 Aug;101(9):1063-76. doi: 10.1002/bjs.9482. Epub 2014 May 15.


Background: Simulation-based training assumes that skills are directly transferable to the patient-based setting, but few studies have correlated simulated performance with surgical performance.

Methods: A systematic search strategy was undertaken to find studies published since the last systematic review, published in 2007. Inclusion of articles was determined using a predetermined protocol, independent assessment by two reviewers and a final consensus decision. Studies that reported on the use of surgical simulation-based training and assessed the transferability of the acquired skills to a patient-based setting were included.

Results: Twenty-seven randomized clinical trials and seven non-randomized comparative studies were included. Fourteen studies investigated laparoscopic procedures, 13 endoscopic procedures and seven other procedures. These studies provided strong evidence that participants who reached proficiency in simulation-based training performed better in the patient-based setting than their counterparts who did not have simulation-based training. Simulation-based training was equally as effective as patient-based training for colonoscopy, laparoscopic camera navigation and endoscopic sinus surgery in the patient-based setting.

Conclusion: These studies strengthen the evidence that simulation-based training, as part of a structured programme and incorporating predetermined proficiency levels, results in skills transfer to the operative setting.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Clinical Competence / standards*
  • Clinical Trials as Topic
  • Computer Simulation*
  • Endoscopy / education*
  • Endoscopy / standards
  • General Surgery / education*
  • General Surgery / standards
  • Humans
  • Laparoscopy / education*
  • Laparoscopy / standards
  • Transfer, Psychology*