Criterion-Based Training to Reduce Surgical Errors
Annual rept. 24 Aug 2008-23 Aug 2009
MONTEFIORE MEDICAL CENTER BRONX NY
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Technical skill is at the core of surgery. Surgical training typically lasts for a specified time period or number of procedures. This approach produces surgeons with considerably variable skill levels. Also, training on patients is becoming unacceptable for patient safety. In contrast, pilots and other non-medical personnel are trained to criteria on simulators to ensure skill proficiency in their MOS prior to reporting for duty. Proficiency levels are objectively established by experienced practitioners, and the trainee is required to consistently demonstrate that level of proficiency before progressing. We propose to use a surgical simulator the ES3 to train surgical residents to criterion performance levels, and to investigate whether criterionbased training is superior to training for a fixed number of trials. Twenty-four otolaryngology residents will serve as subjects. Eight attending otolaryngologists will establish performance criteria and will serve as comparators for infra-operative assessment. Subjects will complete a battery of validated objective tests to assess visuospatial, perceptual and psychomotor abilities. An experimental group will be trained to criterion on the simulator, and then perform a procedure on a patient. A control group will train by repeatedly performing the same procedure on patients, with no simulator training. All procedures will be videotaped and objectively assessed for explicitly defined metrics. We hypothesize that prior training to established criteria will reduce surgical errors, and provide evidence for training on simulators before ever operating upon a patient.
- Personnel Management and Labor Relations
- Anatomy and Physiology
- Medicine and Medical Research