The Utility of Simulation Technology in the Education of Plastic Surgery Residents: A Systematic Review and Meta-analysis
Krystof Stanek*1, Jose A. Foppiani2, Angelica Hernandez Alvarez2, Allan Weidman2, Lauren Valentine2, Irena Oh5, Khaled Albakri4, Umar Choudry3, Samuel Lin2, Carolyn Rogers-Vizena1
1Plastic Surgery, Boston Children's Hospital, Boston, MA; 2Plastic Surgery, Beth Israel Deaconess Medical Center, Boston, MA; 3Plastic Surgery, University of Minnesota, Minneapolis, MN; 4Faculty of Medicine, The Hashemite University, Zarqa, Jordan; 5Georgetown University School of Medicine, Washington,
The drive to improve surgical proficiency through advanced simulation-based training methods has gained significant momentum. This meta-analysis aims to systematically evaluate the available evidence regarding the impact of surgical simulation applicable to plastic surgery on residents"˜ performance.
A systematic review of PubMed, Web of Science, and Cochrane was performed following the PRISMA protocol. An inverse-variance random-effects model to combine study estimates was utilized to account for between-study variability. Objective Structured Assessment of Technical Skills (OSATS) scores and subjective confidence scores were used to assess the impact of the simulation training with positive changes from baseline indicating better outcomes.
A total of 18 studies were included pooling 367 postgraduate surgical trainees who participated in various simulations. The completion of simulation training was associated with a statistically significant improvement in subjective confidence scores with a summary mean change from baseline of 1.44 units (95% CI: 0.93 to 1.94, P < 0.001) and in OSATS scores, with an average increase of 1.24 units (95% CI: 0.87 to 1.62, P < 0.001) on a 1-to-5 scale. Additionally, participants reported high satisfaction scores for the simulations they engaged in (mean = 4.76 units, 95% CI = 4.61 to 4.91, P = 0.006) on a subjective 1-to-5 scale.
Participation in surgical simulation has resulted in a marked improvement in both objective and subjective scoring metrics for surgical trainees. A variety of simulation devices are available for honing various surgical skills, with the potential for even more advancements to come. To maximize the benefits of these effective teaching methods, incorporating simulation tools into training curricula should be a priority.
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