Medical educational and training has developed in an attempt to meet the current challenges. The role of simulation has increased significantly over the previous decade, with Simulated Patients and models used in the re-enactment of a clinical setting within a controlled environment to learn and practise skills which can either be technical or non-technical (e.g. communication, leadership and teamwork). The aim is to demonstrate competence and confidence as well as reducing the risk of error when operating on patients.
Simulation offers a safe environment in which to augment psychomotor skills in a controlled and efficient manner without posing a risk to patients or to learners. The Chief Medical Officer’s Annual Report in 2008, Sir Liam Donaldson stated that “Simulation-based training should be fully integrated and funded within training programmes for clinicians at all stages”. The General Medical Council (GMC) has also stressed the importance of simulation in training, whilst the Food and Drug Administration (FDA) stated, as far back as year 2004, that simulation should be an important part of any carotid artery stenting programme. Trainees can hone their surgical skills safely, free of time and service pressures.
The step after simulation training should not be straight to patients (unless of course you have A) passed your learning curve and B) have fully consented the patient on the associated risks of the learning curve for the procedure you are attempting to perform). This is where fresh frozen human cadaver training has its best use: all the benefits of training on a human patient, but without the risks and limitations.
Step by step we build technical capability, spacial understanding, motor skills and muscle memory:
4. Cadaver training
5. Live patient operating to Achieve surgical proficiency.