Economic and clinical implications of modern training paradigms for general surgery

Project summary

Background

Modern training methods for surgery have undergone a paradigm shift in recent decades.  Despite the increasing literature demonstrating efficacy of modern training methods – such as, for example, simulation or mental rehearsal – these have failed to achieve broad integration into surgical training programmes.  Anecdotally perceived limitations include resource availability, high financial cost, time away from the hospital and perceived relative benefit. 

Research is needed to formally identify these perceived barriers and then quantify them.  High uptake costs are often cited for lack of simulation curricula, but these do not take into account shortened learning curves, improved trainees, and impact on outcomes.  To calculate this, the costs of complications and the relationship between performance metrics (the standard measure of surgical education curricula) and clinical outcomes must be first understood.  With these tools, we will assess the implications of a simulation-based curriculum and drive improvement to surgical training and patient care.

Aims

• Identify the perceived barriers to simulation training particularly with reference to cost and clinical impact
• Establish the cost effectiveness and potential clinical impact of simulation training curricula
• Costs associated with common post-operative complications will be calculated, in order to calculate the cost impact of reduction in postoperative complications,
• Quantify the relationship between commonly used surgical performance metrics (such as OTAS, NOTECHS) and clinical outcomes
• Design a practical and cost-effective simulation training curriculum