The need for simulation in surgical education in developing countries. The wind of change. Review article

Operative skills are the heart and soul of surgical practice. An extensive amount of literature has been devoted to the art and science of acquiring these skills which start by mastering basic skills until automaticity has been achieved. The current model of surgical education is purely based on sheer volume of patients, restrictions in the maximum number of working hours for trainees and increased pressures of operating room efficiency. This leads to limited teaching time. Adding to the scenario is the emphasis on patient safety and greater awareness of medico-legal consequences following medical errors. All this has significantly hampered the learning experience of surgical trainees and limited the expert surgeon's ability to fulfil trainees' learning needs during complex procedures. Thus, learning strategies outside the operating room were required to provide an ideal environment for learning without putting patients' health at risk. This has led to increased use of simulators in modern surgical training. The situation is even more worrisome in developing countries where the availability of these facilities is either extremely limited or nonexistent. The current narrative review was planned to go over the importance of simulation in surgical education and to question its utility in developing countries.