Virtual reality (VR) simulation training is revolutionizing surgical education. When surgery professor Dr. Hulda Einarsdottir stepped into her position as Director of Surgical Simulation at Yale University School of Medicine in 2014, she had ambitious goals. 

With Dr. Einarsdottir’s stepped approach to training, approximately 40 residents completed the branded “LapKey” training last year. Twenty more residents will complete it this year. In a few years, every single resident will have done VR simulation training. How did she make it such a success and what was her approach? Dr. Einarsdottir explains six ideas that helped her develop a successful VR simulation training.

1 – The branded LapKey program fostered familiarity.
I adapted my residency program from the Surgical Science validated curriculum, and I branded it the LapKey program. This encouraged recognition and familiarity among my residents, I called it the “LapKey” because this program is, in effect, my residents’ key to developing proficiency in laparoscopic surgery skills. VR simulation training is not a prerequisite to surgical privileges, but its value in the OR is slowly being recognized.

Simulation training is invaluable to residents, but I would tell directors who are incorporating simulation training… to learn from my mistakes!

2 – Gradual introduction of skills
Initially, I assigned a long list of simulation exercises for students to master. The list overwhelmed residents so I designed a program that would build surgical skills more gradually. In the first year, I assigned basic exercises, like knot tying. In the second year, we assigned more simulation exercises for students to master. Then in the Third year we tackled more complicated simulation procedural modules.

3 – Train together, side by side.
I often see residents working together, side by side on our two LapSims. They can compare notes, advise each other and keep each other company as they perfect their skills. It’s a great advantage, it gives students a boost and keeps them motivated.

 4 – Unrestricted access to simulation training devices.
Our simulation center is open 24/7 to allow residents the flexibility to train when it works best. It’s hard for them to find dedicated time to train. Sometimes, a late-night simulation training session works best.

5 – Give access to procedural module training.
VR simulation training offers more than just skill training. The surgical procedure modules walk residents through each step of a particular surgery, for example an appendectomy. SO the residents get a sense of what real surgery is going to be like. It’s incredibly useful, and an experience the box trainer can’t provide. I think the simulated surgical training helps motivate residents as they learn each of the steps needed to successfully complete an entire procedure.

6 – Certification upon program completion.
I award a certificate to every resident who passes all simulation exercises and completes the LapKey simulation curriculum. We are going to include the certificate in the resident’s file of off-site scores, evaluations, and letters of recommendation. This way, VR simulation training becomes part of their recognized record of performance.

 

 

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