Portable Neonatal Esophageal Atresia Simulator Improves MIS Acquisition Amongst Surgical Trainees: A Randomized...

Area of Science:

• Surgical Education
• Minimally Invasive Surgery (MIS)
• Medical Simulation

Background:

• Minimally invasive surgical (MIS) skills are crucial for surgical trainees, but practical training opportunities are limited.
• Pediatric surgery trainees often have insufficient exposure to thoracoscopic repair of esophageal atresia (OA/TOF).
• This study evaluates a neonatal OA/TOF simulator's utility for acquiring and retaining MIS skills.

Purpose of the Study:

• To assess the effectiveness of a neonatal OA/TOF simulator in improving minimally invasive surgical (MIS) skills.
• To evaluate the acquisition and retention of skills through self-directed learning using the simulator.
• To determine the simulator's potential for enhancing surgical training in complex, low-frequency procedures.

Main Methods:

• A randomized controlled cross-over trial involving 20 surgical trainees in New Zealand.
• Participants practiced three MIS tasks (ring transfer, needle pass, anastomotic suture) using a neonatal OA/TOF simulator.
• Modified Objective Structured Assessment of Technical Skills (OSATS) scores were measured at baseline, mid-point, and completion.

Main Results:

• Significant improvements in OSATS scores were observed for needle pass (P = .017) and anastomotic suture tasks (P < .001).
• The group with earlier simulator access showed a trend toward better performance, though not statistically significant.
• Skill acquisition diverged over time for anastomotic sutures, indicating advanced skill development.

Conclusions:

• The neonatal OA/TOF simulator effectively facilitates the acquisition and retention of MIS skills through self-directed learning.
• Findings support integrating surgical simulators into training programs to enhance MIS skills in low-risk settings.
• Simulators are particularly valuable for complex procedures with infrequent case exposure during training.