SIM CENTER RESEARCH PROJECTS
Research of Best Practices for Implementation of Formal Suturing Training for Surgery Clerkship (09-00381)
Principal Investigator: James R. Korndorffer, Jr., MD; Jesse Clanton; Paul Ikemire; Eric Simms
The Simulation Center has historically researched the functionality and efficacy of different methods of simulation training for laparoscopic skill.
This year with the availability of a state-of-the-art simulation center that expands the reach of training to other modalities we can explore the efficacy of simulation training for these different skills. This particular research project focuses on Suturing and Knot Tying training performed in a controlled surgical training curriculum. Using written reference material, live personal training, video tutorials and self-practice review our current project will investigate the proficiency levels of different users groups in combination with variables of different training methods. Our goal is to determine the optimal curriculum for Suturing and Knot Tying training that could help provide a bedrock of technical skill for medical students and new interns while also providing retention training for residents.
The project will also review the next generation advancements in surgical procedures, tools, skill tracking systems, medical interventions and simulation center training across the nation that may have great impact on curriculum and may establish certain best practices for surgical simulation training.
Medical Error Root Cause Analysis using Simulation
Principal Investigator: Doug Slakey, MD; James R. Korndorffer, Jr., MD
Sponsored by: The Doctors Company
Simulation is commonly used for root cause analysis in high performance industries but has not been described for use with medical error. Research at the Sim Center is being performed to develop a method to use simulation for root cause analysis of adverse surgical outcomes. Pilot work has begun using closed claims database of a major medical indemnity corporation. A single case has been chosen, essential data abstracted from the record and a paper and electronic medical record was developed. The naive participants were chosen, the scenario confederates were selected and scripted, and the appropriate environment within the Sim Center was developed.
The scenario has been run four times and preliminary data shows that simulation can be used for root cause analysis of adverse surgical outcomes. Future work will be performed to evaluate if corrective measures can then be implemented to minimize the potential risk for recurrence of the event and improve patient safety.
Do Motion Metrics Lead to Improved Skill Acquisition on Simulators? (Multi-Institution)
Principal Investigator: Dimitrios Stefanidis, MD, PhD; James R. Korndorffer, Jr., MD
Sponsored by: Society of American Gastrointestinal Endoscopic Surgeons (SAGES)
For maximal trainee benefit, simulators have to provide accurate performance assessment. Most currently available simulators base performance assessment on task duration and errors. Besides these robust, practical, easily obtainable, traditional metrics of performance, other metrics like motion efficiency may supplement, if not augment, performance assessment.
In past studies, we demonstrated that most novices achieve expert-derived goals of speed after they achieve expert levels of motion. While this may indicate that speed is a more robust metric, 40% of participants reached motion goals after speed, and therefore had their training duration extended. Whether this contribution of the motion metrics in extending the training duration translates also into improved learning and skill transfer to the operating room (OR) is unclear.
To assess this we are evaluating if training to expert-derived levels of speed and motion will lead to improved learning and will translate to better operating room (OR) performance of notices compared to training to goals of speed or motion alone, thus leading to potential improved patient safety in the OR.
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