Microsurgery: Advances, Simulations and Applications


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A major concern is that because simulation is changing rapidly, evaluation is difficult to keep up to the development of simulators, leading to the adoption of sometimes poorly evaluated simulators. Kneebone 26 argues that during practice of procedural skills by novices using simulation, the simulated environment should recreate the actual circumstances of performance in real practice, taking into account the aspects of stress and anxiety. Kneebone and Baillie 27 also mention that simply becoming an expert on a technical skill by isolated practice on a simulator might lead to misleading confidence, because it does not prepare trainees for the unpredictability of real clinical practice.

Although it is important for novices to experience the performance of technical skills in simulated clinical practice circumstances, if they have not achieved a minimum level of practical skills competence they will not be able to perform in the complex contextualized simulation environment, losing in that way the opportunity to improve their practical skills. Therefore, it will be more beneficial if trainees develop a certain level of competence through practice on simulators and then experience practising these skills in a contextualized simulation environment.

As mentioned above, there is an ongoing argument in the literature regarding the direction that simulation should take in the training of healthcare professionals. Simulation should not take a direction towards a focus on isolated acquisition of technical skills disregarding the clinical context, neither should focus only on the recreation of the clinical environment and its dynamics disregarding technical skills. Continuous research and technological advancements offer today a large number of available simulators and types of simulation.

Every type of simulation has to be validated appropriately before it is used for the purposes of training, and the appropriate type must be chosen depending on our educational goals and considering the background knowledge and competency level of trainees. In order for simulation training to be effective, it has to be successfully integrated in a surgical curriculum and aligned with clinical practice.


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Technical skills are very important in clinical practice, especially in a field such as surgery, and expertise demands sustained deliberate practice. In a contemporary healthcare education environment that offers a decreasing amount of opportunities for practice at the workplace, simulation offers an attractive solution for the practice of practical skills. The complex and unpredictable clinical environment, though, demands more than technical skills and a simulator, a machine, cannot teach a novice communication skills, professionalism and teamwork, therefore simulation must mirror the clinical environment and recreate the circumstances of real clinical practice.

Volume 83 , Issue 9. If you do not receive an email within 10 minutes, your email address may not be registered, and you may need to create a new Wiley Online Library account. If the address matches an existing account you will receive an email with instructions to retrieve your username. Tools Request permission Export citation Add to favorites Track citation. Share Give access Share full text access. Share full text access. Please review our Terms and Conditions of Use and check box below to share full-text version of article. Abstract The reduction in time for training at the workplace has created a challenge for the traditional apprenticeship model of training.

Introduction Surgical training has traditionally been based on long apprenticeships, during which trainees learned in the workplace by practising on patients, supervised by their mentors. The role of simulators in surgical education Various types of simulators have been introduced in surgical training, which can be categorized according to the technology being used 9 , 10 or according to the varying complexity of the skill being simulated 4 Fig.

Figure 1 Open in figure viewer PowerPoint. Figure 2 Open in figure viewer PowerPoint.

The chest model will help residents practice microsurgery techniques used in breast reconstruction

Figure 3 Open in figure viewer PowerPoint. The role of the simulation environment Contemporary educational theory has recognized the importance of context in learning. The role of simulation in surgical education Simulation has many potential benefits for healthcare education, therefore the challenge is how to utilize simulation to achieve the best possible results.

Conclusion Continuous research and technological advancements offer today a large number of available simulators and types of simulation. Complexity, risk and simulation in learning procedural skills. Crossref Google Scholar. Article Information. Correspondence Nicholas C.


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Keywords: aneurysm ; surgical rehearsal platform ; education ; quality improvement ; vascular disorders Page Count: — View in gallery Study design. View in gallery A: Preoperative CT angiogram depicting a pericallosal artery aneurysm. View in gallery Intraoperative view A and SRP B comparison demonstrating usefulness of the surgical rehearsal platform. View in gallery SRP A and intraoperative view B demonstrating how preoperative planning is used for clip selection and rehearsal.

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Microsurgery: Advances, Simulations and Applications - CRC Press Book

View in gallery Total surgical time for the SRP group 14 cases and the control group 11 cases. View in gallery Number of clip placement attempts per clip used. View in gallery Surgical time per clip used. Study design. View raw image Close.

Number of clip placement attempts per clip used. Neurosurgery 11 : Suppl 2 52 — 58 , false. CNSQ 12 : 16 — 17 , false. Neurosurgery 73 : Suppl 1 — , J Neurosurg : — , Neurosurgery 72 : Suppl 1 — , Surg Clin North Am 90 : — , Surg Innov 20 : — , Childs Nerv Syst 29 : — , Neurosurgery 71 : — , Austin Neurosurg Open Access 1 : , false. Neurosurgery 73 : Suppl 1 94 — 99 , Virtual Real Walth Cross 13 : 69 — 85 , Neurosurgery 67 : — , Surg Clin North Am 90 : xiii — xv , false.

World Neurosurg 76 : — , PubMed Citation Articles by A.

Simulation training in neurosurgery: advances in education and practice

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    Microsurgery: Advances, Simulations and Applications Microsurgery: Advances, Simulations and Applications
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