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Advancing Future Surgeons: Utilization of Surgical Simulation in Medical Student Surgery Clerkships
Benjamin Thomae1, Parul Rai1, Kristof S Gutowski1
1Division of Plastic Surgery, Ann & Robert H. Lurie Children's Hospital, Chicago, Illinois.
Objective:
This study evaluates the current integration of simulation-based training (SBT) within core surgical clerkships and sub-internships at U.S. medical schools, comparing usage and identifying areas for improvement.
Design:
A cross-sectional survey was distributed to third-year surgery clerkship directors and fourth-year general surgery sub-internship directors across U.S. allopathic and osteopathic medical schools. The survey inquired about the use of SBT, including the types of simulations, their frequency, and skill emphasis. Data were analyzed using descriptive statistics and Fisher's exact test.
Setting:
Data collection was completed via an anonymous Qualtrics survey.
Participants:
A total of 73 responses were received from 53 of the total 191 institutions contacted, representing a 28% response rate. Respondents included core surgical clerkship directors (n = 46, 63%) and sub-internship directors (n = 27, 37%).
Results:
The survey revealed that 81% of core clerkships incorporate SBT, compared to 32% of sub-internships (p < 0.001). Core clerkships predominantly utilize low-fidelity models (89%), such as suture pads and basic task trainers, with limited use of high-fidelity models (34%) utilizing advanced technology and effort to create more immersive experiences. Sub-internships primarily use low-fidelity models (100%), but with less integration of SBT overall. Programs incorporating SBT emphasize non-technical skills training more in core clerkships (77%) than in sub-internships (33%) (p = 0.05).
Conclusions:
SBT is relatively well-established in core surgery clerkships but underutilized in sub-internships, presenting an opportunity to enhance surgical preparedness. Expanding both low- and high-fidelity SBT in sub-internships could address competency gaps noted by program directors. Similarly, increasing SBT for non-technical skills in sub-internships may better prepare students for surgical residency. Future research should explore long-term outcomes and barriers to broader SBT use, particularly for development and use of high-fidelity simulations.
