What do a surgeon and a pilot have in common? The answer is simulation training. At least if Dr. Gallis would forecast the future - and he is not alone in that opinion.
The healthcare simulation industry has already witnessed tremendous growth in the last decades, especially in the North-American and Asian-Pacific market. I spoke to Dr. Gallis, Vascular Surgeon at the University Hospital in Regensburg in Germany about his thoughts on simulation training and the future.
Hi, Dr. Gallis. Tell me about your first experience of simulation training?
The very first time I trained on a simulator, I did a balloon dilatation, and I was very excited about the results. I did make some mistakes, but more importantly, there were no patient complications. After doing only a few cases, I realized that being able to train on a simulator regularly would truly improve my skills and make me a better surgeon.
It became clear to me that simulation training would be a great asset to our hospital, especially for the younger surgeons. I became very passionate about the simulator and the idea of implementing simulation training in our day-to-day practice. After having a few fruitful discussions with my colleagues and the director of the Department of Vascular & Endovascular Surgery, we came to the conclusion that purchasing the Mentice simulator would definitely be the right decision.
Do you think the interest in simulation training is widespread among surgeons?
Yes, there is a huge interest in simulation training among surgeons. Right now, there is a shift happening in the healthcare industry where surgeon pioneers are paving the way for simulation training and the possibilities for residents and surgeons to train safely away from patients. Colleges around the globe are experiencing a lack of training opportunities prior to surgery that don’t have an impact on patients. Today, many surgeons have to wait for a scheduled surgery to be able to train on the endovascular procedures.
On the other hand, some physicians claim that investing in a simulator is far too expensive. But I think simulation training will become an obligatory part of the education and that residents won’t be allowed to operate on a real patient unless they have trained on the simulator for a dedicated number of hours. As a matter of fact, we already see this in some countries. In Japan, for example, simulation training is implemented in mandatory courses.
What are the advantages of simulation training for surgeons in your opinion?
One of the main advantages of simulation training is that you are allowed to make mistakes. You know the phrase “learning by doing” - it means that you learn from experiences resulting directly from your own actions. As a physician, you are also a human. But unlike, an engineer, for example the margin for errors is considerably lower - if it exists at all. You are simply not allowed to make mistakes when operating on a real patient, because it may be a matter of life and death. This is why simulation training is such a crucial tool for surgeons.
A simulator provides the opportunity for surgeons to train on procedures beforehand, to experiment and make mistakes without having to worry about the consequences for the patient, while at the same time improving skills and knowledge. There are so many steps included in endovascular surgery that are all equally important to carry out a successful operation. With a simulator, you can train on the procedure as many times as you want; you can try out different techniques, instruments, catheters, and materials to find the best possible way to do the operation.
For me personally, I like to train on the simulator one or two days prior to an operation. It helps me understand what will be better for the patient, and then, on the operation day, I will know exactly what to do in order to avoid mistakes.
How has the endovascular landscape changed over the past few decades?
A lot has happened. There have been extensive technological advancements in surgeries and treatments. Nowadays, most of the operations can be done with the endovascular technique. Instead of doing incisions, surgeons can put a stent in a cardiac or cerebral vessel to treat a stenosis or a stroke, or in the abdominal or thoracic aorta to treat aneurysms with the help of a catheter.
Many times, the endovascular technique is better for the patient. When you avoid open surgery, procedures can be done with local anesthesia. Not having to be put to sleep and stay in the hospital, saves a lot of trauma and stress for the patient. In addition to shorter recovery time, minimally invasive surgery reduces the risk of infection, excessive bleeding, reaction to anesthesia and the need for rehabilitation. From an economic point of view, this is also beneficial for the hospital.
Can you see any trends in the endovascular field? What is your experience?
From my point of view, and what I have noticed the most when meeting with patients, is that today, patients are much better prepared for their appointments. Often, the patients have already discussed the available options with their general practitioners. The general practitioners are up to date with the developments in the endovascular field and what is new in endovascular surgery. The patients have done their research and know which treatments are available. Even if the patents we receive are mostly elderly, around 60 or 70 years old, they come to us prepared with all the background information. Nine times out of ten, they ask if they can have their surgery done with the endovascular technique.
What are your thoughts on simulation training and the future?
I firmly believe that simulation training is the future for surgeons. I definitely think simulation training will become a obligatory and integrated part of the education. Every physician who believes in good education will discover that simulation training provides an excellent opportunity to become a better surgeon. I also think that in the future, every hospital will have a simulator in their department for residents and surgeons to train on - it might even become a deal breaker when choosing education and workplace.
Because when you think of it, simulation for surgeons works the exact same way as for pilots. A pilot is not allowed to fly an airplane without having to train for a decided number of hours. I am sure the majority of patients would want to trust their surgeon as much as they trust their pilot, as both flying and undergoing surgery are quite delicate situations!
I think you are right Dr. Gallis! Thank you so much for talking to me. It will be most interesting to see what the future holds when it comes to simulation training.
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