In-vivo skill-training can range from very standardized procedures such as microsurgical vessel anastomosis to complex simulations involving transplantation, intestine surgery, intraabdominal bleeding complications or endoscopic surgery training ( 4– 8). However, more complex clinical situations may require an in-vivo environment such as animal training to safely learn essential surgical skills. Here, simple clinical scenarios are simulated to train the key components of a specific basic skill, as for example suturing exercises on skin-like plastic devices. The concept of surgical simulation has been introduced to medical schools to simulate vital clinical situations in a structured and realistic environment ( 2, 3). For this purpose, supplemental education of key surgical techniques in animal models may provide a safe, realistic, and instructive training to augment clinical experiences and enhance patient safety. However, due to the restricted working hours enforced for residents, these traditional on-the-job training paradigms could be insufficient to learn key surgical skills and thus alternative approaches required ( 1). Essential surgical skills have traditionally been taught on-the-job, where intensive resident programs provided sufficient clinical exposure. Reproducibility of key surgical techniques with high-quality is of uttermost importance to ensure patient well-being, prevent secondary morbidity and its consequences. Animal models may therefore supplement the training of tomorrow's surgeons to overcome limited hands-on experience until virtual simulations can provide such educational tools. Perceived public acceptance was rated intermediate by medical staff and students (4.26 1–low, 10 high).Ĭonclusion: Training in animals is well-established and was rated worth attending in a majority of a representative cohort to acquire key surgical skills, in light of reduced clinical exposure. Survey results illustrated that 69% of the participants had no experience, but 66% would attend training under experienced supervision. Cost-analysis revealed single-training costs between 307€ and 5,861€ depending on model and discipline.
Results: 915 articles were analyzed, thereof 91 studies described in-vivo animal training models, predominantly for laparoscopy (30%) and microsurgery (24%). A survey on their acceptance was conducted among faculty and medical students. Costs were analyzed from multiple German and Austrian training programs.
Methods: Animal models were identified by literature research. This study reviews surgical training models, their costs and survey results illustrating academic acceptance. We hypothesize that supplemental simulations in animal models provide a realistic training to augment clinical experiences. Due to new working directives, resident duty hours have been restricted and evidence exists that pure on-the-job training provides insufficient exposure. 8Department of Anesthesiology, The University of Texas Medical Branch, Galveston, TX, United Statesīackground: Modern surgery demands high-quality and reproducibility.7Department of General, Visceral and Transplantation Surgery, University Hospital of Heidelberg, Heidelberg, Germany.6Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Hospital Ludwigshafen, Department of Plastic and Hand Surgery, University of Heidelberg, Ludwigshafen, Germany.
Bergmeister 1,2,3 *, Martin Aman 1,2, Anne Kramer 2,3,4, Thilo L.
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