Current assessment and future directions of surgical skills laboratories

Educational, medicolegal, and financial constraints have pushed surgical residency programs to find alternative methods to operating room teaching for surgical skills training. Several studies have demonstrated that the use of skills laboratories is effective and enhances performance; however, little is known about the facilities available to residents.

A survey was distributed to 40 general surgery program directors who, in an earlier questionnaire, indicated that they had skills laboratory facilities at their institutions. The survey included the following sections: demographics, facilities, administrative infrastructure, curriculum, learners, and opinions/thoughts of program directors.

Of the 34 program directors that completed the survey, 76% are from a university program. The average facility is 1400 square feet, and most skills laboratories are located in the hospital. Nearly all skills facilities have dry laboratories (90%), and the most common equipment is box trainers (90%). Average start-up costs were $450,000. Sixty-two percent of programs have a skills curriculum for residents. Responders agreed that skills laboratories have a high value and should be part of residency curricula.

The results of this survey provide a preliminary view of skills laboratories. There is variation in the size, location, and availability of simulators in skills laboratory facilities. Variations also exist in types of curricula formats, subspecialties who make use of the laboratory, and some administrative approaches. There is strong agreement among respondents that skills laboratories are a necessary and valuable component of residency education. Results also indicated concerns for recruiting faculty to teach in the skills laboratory, securing ongoing funding, and implementing a skills laboratory curriculum.