Superior Technology is Not Enough! Exploring the Implementation Gap in Simulation-based Training.

Superior Technology is Not Enough! Exploring the Implementation Gap in Simulation-based Training.

A significant amount of resources, time, and effort has gone into the development of highest-quality simulation training technology to better impart the skills necessary for safe laparoscopic surgery.

Newly published studies have identified a gap between the acquisition of such technologies, and their integrated, effective implementation within training regimens. Hence, research is moving on from the continued development of simulation tools, and onto their effective use and integration into training curricula.

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Survey results in Scandinavia from an investigation into this implementation gap reported that despite trainee access to simulation-based training, it was not often used, and training rarely adhered to the recommended education guidelines. Since the data simultaneously indicated high satisfaction with the benefits of best-practice simulation training and majority support of its mandatory introduction into all training programs, the problem seemingly lies with the delivery methods and ineffective assessment rather than the technology itself.

Surgical training is shifting into competency-based, rather than time-based curricula. Thus, training structures need additional support to ensure proficiency-based requirements are met. Of the surveyed surgeons-in-training, just 10.7%, 15%, and 37.2% of trainees in their respective surgical specialties were required to practice until competency standards were satisfied. Better use of assessment strategies, such as Test-Enhanced Learning should be considered alongside the requirement to train until proficiency.

Further factors contributing to poor engagement with simulation courses were identified as lack of time, poor course flexibility, and general access to training equipment. A standardised, wide-scale delivery of digital training programs, with included tele-mentoring was suggested in order to democratise access to educational material and provide efficient mentoring support. This approach has further benefits of better flexibility, and incorporates the recommendation to opt for more ‘bite-sized’ distributed practice rather than standard of longer, massed practice.

Additionally, in exploring the key criticism of high costs in simulation-based training, less complex box-trainer models were suggested in light of their affordability, portability, and accessibility. Box-trainers have been proven to match learning outcomes when compared to higher-cost VR trainers, with a suggested superiority in trainee satisfaction and skills time.

The issue of engaging trainees in laparoscopic simulation programs is an opportunity to lobby for a mandatory, standardised inclusion of simulation-based training into current training requirements, with the further potential to resolve issues around access discrepancies, and training flexibility. If you would like to further explore the range and benefits of adaptable simulation trainers, please visit .