Simulation in postgraduate plactic surgery education and training

[摘要] Simulation can play an important role in building a safer health care system and may havethe potential to address a number of challenges facing postgraduate medical training.Simulation-based learning is becoming widely established within medical education andoffers benefits to inexperienced residents learning procedural skills in a climate ofdecreasing clinical exposure. Simulation in health care is increasingly being used forteaching and training and the development of competencies related to patient safety andteamwork. The ability to perform clinical procedures safely on patients is a key skill andrequires a combination of various skills and competencies �?some of which may be obtainedby introducing simulation into registrars' training.An in-depth study was done on simulation in postgraduate plastic surgery education andtraining. The problem that was addressed in this study was the lack of clarity about whether,and, if so, to what extent simulation can contribute by playing a role, and will be of valuein postgraduate plastic surgery education and training, and whether it would enhance theeffectiveness of learning at various cognitive levels. The research was therefore aimed atidentifying the contribution that simulation can make to plastic surgery education andtraining. The methods used to achieve this aim included a literature study, Delphi survey and semistructuredinterviews. The conceptualisation and contextualisation of simulation-basededucation and training in plastic surgery were accomplished through the literature studythat focussed on the role and value of simulation, the features and uses of simulation thatlead to effective learning and theory underlying a process to developing and formulatingguidelines. Through the Delphi questionnaire, the Delphi experts had to indicate theimportance of simulation as one of the methods to train a plastic surgeon. They, if theywished to do so, had to complete a questionnaire regarding what type of simulationmodality is/can be applicable as far as simulation is concerned and had to indicate thecognitive level of training that is/can be addressed by simulation. The identification of anumber of outcomes that may be reached by applying simulation as a possible method, including suggestions on the type of simulation modality to be used, as well as the possiblecognitive level, was established by this method. In this study, the purpose of the individualsemi-structured interviews with role-players in clinical simulation was to investigate andestablish clarification on simulation in postgraduate plastic surgery education and training.It informed decisions on the development of the proposed guidelines by the in-depthoverview of the contribution that simulation can make and recommendations as far as thechallenges to the implementation of simulation into plastic surgery education and training. The results and findings of the research (prepared in manuscript/article format), contributedto achieving the aim of the research, and were used for the creation of a frameworkstructure that can be applied to propose/suggest guidelines with recommendations for theimplementation of simulation in postgraduate plastic surgery education and training. Forsimulation to be introduced as a teaching method and a learning opportunity for residentswith a view to impact on plastic surgery education and training, it should include (i) a clearset of recommendations on how simulation can enhance the effectiveness of learning; (ii)a description of the contribution, including the role and value of simulation, based on ascientific research process; (iii) the development of an argument to enhance plastic surgerytraining by including simulation in education and training programmes; and (iv) thedevelopment of a framework structure that can be applied to propose guidelines forteaching through simulation as part of training programmes for evidence-based plasticsurgery education and practice. The outcome of the study will serve as a directive for postgraduate plastic surgery educationand training by means of suggested guidelines including recommendations on howsimulation may be utilised to improve students' knowledge, skills and professional conduct.In conclusion, the researcher recommends that further research may be undertaken, by aninterdisciplinary group within the discipline of plastic surgery, based on a systematic reviewof evidence and within the parameters of sufficient resources, finances, expertise andknowledge, skills and competencies, to compile valid and usable guidelines on simulationby the profession for the profession. This research is seen as the first step taken in thisprocess or direction.

[发布机构] University of the Free State