Design, development and implementation of a surgical simulation pathway curriculum for biliary disease

Area of Science:

• Medical Education
• Surgical Simulation
• Patient Care Pathways

Background:

• Surgical education initially prioritized technical skills but now includes non-technical skills like communication and teamwork.
• Surgical residents need proficiency in both technical and non-technical skills throughout the patient care continuum (pre-, intra-, and postoperatively).

Purpose of the Study:

• To implement and assess a novel biliary disease-based surgical simulation curriculum for junior residents.
• To evaluate the feasibility of a patient-focused simulation approach in an academic medical center.

Main Methods:

• A 3-day immersive module featured clinical care pathway simulation sessions.
• Residents encountered a standardized patient (SP) with biliary colic, performed a laparoscopic cholecystectomy on a porcine model, and completed a follow-up SP visit.
• Performance was assessed using standardized forms, with additional hands-on, didactic, and SP sessions.

Main Results:

• The biliary surgical simulation pathway curriculum was successfully implemented.
• The 3-day module accommodated six junior surgical residents and involved 4-hour sessions led by faculty.
• Implementation costs were approximately $17,500 USD.

Conclusions:

• Simulation training directly linked to hospital responsibilities is crucial for immediate performance improvement and error reduction.
• This patient-focused pathway curriculum demonstrates feasibility for junior resident training at an academic medical center.
• This approach supports higher-quality resident training and should be considered for future use.