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Design of vessel ligation simulator for deliberate practice
Justin L Hsu1, James R Korndorffer2, Kimberly M Brown1
1Department of Surgery, University of Texas Medical Branch, Galveston, Texas.
The Journal of Surgical Research
|April 5, 2015
Summary
Surgical residents
Area of Science:
- Surgical skill acquisition and assessment
- Biomedical engineering and simulation
Background:
- Surgical residents' technical skill development varies.
- Secure knot-tying without excessive force is a critical skill.
- A novel simulator was designed to measure forces during vessel ligation.
Purpose of the Study:
- To design a force-sensing simulator for vessel ligation.
- To establish expert-derived performance benchmarks for knot-tying.
- To quantify forces exerted by surgical trainees during knot tying.
Main Methods:
- Vessel ligations performed on a force sensor using Silastic tubing.
- Nine experts and 10 novices completed 10 ligations each.
- Two-handed and one-handed techniques were assessed; forces compared using Student t-test.
Main Results:
- Simulator demonstrated excellent internal consistency (Cronbach alpha = 0.91).
- Experts exerted significantly lower maximum forces than novices in both two-handed and one-handed ligations (P < 0.01).
- Novices showed variable performance, with some achieving expert-level force application.
Conclusions:
- Gentle knot-tying force is measurable and develops variably during surgical training.
- The simulator supports deliberate practice with real-time feedback.
- Findings align with milestone-based progression in surgical education.
