Patient safety has become the most important outcome to achieve in medicine. Especially in fields where extensive psychomotor skills (physical movements that require fine and precise movements controlled by the brain) are required such as surgery.
It’s obvious that the policy of “see one, do one and teach one” is not acceptable anymore in view of increasing demand for patient safety.
Since there is radical technological and technical advancement, it’s important for surgeons to be updated. This implies continuous training. The methodology of making training is so solid that it translates into safe surgery for the real patients which is challenging!
However, training can be arduous and taxing! Considering that many senior surgeons will be involved in updation and training, it becomes imperative to keep the psychomotor training less complex. Keeping it Simple and Safe ( KISS principle) is a good strategy that has failed none.
There have been various proposals and strategies to make training less arduous and yet extremely safe for patients. Observerships, proctorship, immersion courses, simulators have all been incorporated in training surgeons to good advantage.
Observership is a good way to expose a newer surgical procedure or idea. But it’s not enough to prepare the surgeon to undertake the procedure safely for the patient. An immersion course where surgeons get an opportunity to participate and assist is the next step to getting trained. Getting supervised by a proctor while operating at one’s own centre can boost confidence and pave the way for safe surgical practice.
Simulators are computer generated virtual reality either in the form of a dummy or the screen where the surgeon practises procedures till they can master it. Robotic surgery is one such example where simulators can be very handy. One can practise on virtual patients before operating on real patients.
With so many tools available, what is the best way forward?
Probably, a mix of everything! And whatever is available.
As a trainer and teacher for many complex procedures in Gastrosurgery ( Bariatrics, complex hernias, laparoscopic surgery, colorectal procedures), this is what I have observed-
1. Enthusiasm is the biggest ignition point to learn something
2. Practice makes it good. Continuous practice makes for perfection!
3. Perseverance is key
4. Getting a coach or a proctor will make learning safe and simple
Willing to learn has to be combined with the right method to learn, to ensure patient safety. In the world of increasing awareness and expectation, one cannot compromise on safety. Learning, therefore, has to be structured and fool-proof.
In the real world, this may be easier said than done.
So, if there is one thing that I would recommend strongly for proper training, it is this.
Get a Mentor! Get a Coach!