Comparative effectiveness of telesimulation versus standard simulation for pediatric Minimally Invasive Surgery (MIS) essential skills training

J Pediatr Surg. 2023 Apr;58(4):669-674. doi: 10.1016/j.jpedsurg.2022.12.013. Epub 2022 Dec 22.

Abstract

Background: Proctored on site simulation-based surgical education has been integrated in our residents curricula since 2012. Due to COVID-19 pandemic and social distance protocols, we developed a Tele-assisted Essential Skills Training Module (T-ESTM). The aim of this study is to evaluate comparative effectiveness between Telesimulation (T) versus Standard Simulation (S) for minimally invasive surgery (MIS) essential skills training.

Methods: ESTM includes academic lectures, tutorials for ergonomics and 7 hands-on tasks scheduled into 2 sessions of 3 hours. Initial and final assessment scoring (adapted from GOALS) as well as timing for 3 of the tasks were registered. Telesimulation (T) group accessed the content online and completed their Hands-On practice through a digital communication platform. Standard Simulation (S) group attended conferences and Hands-On practice at the simulation center. Both groups were proctored by the same educators with summative and formative feedback and debriefing. Data was analyzed with the R-studio software program.

Results: Each group had 20 participants with a mean age of 28 ± 5 years. 67.5% were surgeons in training, 47.5% had performed low complexity procedures and 40% had previous experience with simulation training. We observed a significant improvement in scoring and time reduction for all assessed tasks in S and T groups (p < 0.001), with no statistically significant differences when comparing both groups. Similar performance could be achieved with both strategies.

Conclusion: Telesimulation is a reproducible and effective educational tool for remote MIS essential skills training, and should be considered as an alternative to on-site simulation programs.

Level of evidence: Level II.

Type of study: Clinical Research.

Keywords: Minimally invasive surgery; Simulation based-training; Surgical education; Telesimulation.

MeSH terms

  • Adult
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Child
  • Clinical Competence
  • Curriculum
  • Humans
  • Minimally Invasive Surgical Procedures / education
  • Pandemics
  • Simulation Training* / methods
  • Young Adult