Accessibility and satisfaction's analysis of simulation-based training in surgery for residents and surgical fellows in France - 21/07/24

Doi : 10.1016/j.jviscsurg.2024.07.001

Gabriel Saiydoun ^a,^b, Maxime Vallée ^c,^d, Saadé Saade ^e, Clément Colombier ^f, Krystel Nyango Timoh ^g,^h, Philine de Vries ⁱ, Cyril Perrenot ^j, Nicolas Berte ^k,^l, Arnaud Delafontaine ^m,^n,⁎
^a Department of Cardiac Surgery, University Hospital Pitié Salpetrière, AP–HP, Paris, France
^b Department of Cardiac Surgery, University Hospital Henri-Mondor, AP–HP, Créteil, France
^c Department of Urology, University Hospital of Poitiers, Poitiers, France
^d Inserm U1070, “pharmacologie des anti-infectieux”, pôle biologie santé, UFR médecine-pharmacie, University of Poitiers, bâtiment B36 TSA, 51106 Poitiers, France
^e Department of Cardiac Surgery, hôpitaux universitaires de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France
^f Cardiothoracic and vascular surgery Department, University Hospital of Poitiers, Poitiers, France
^g France Inserm, Department of Obstetrics and Gynecology, LTSI – UMR 1099, University Rennes 1, Rennes University Hospital, Rennes, France
^h Laboratoire d’anatomie et d’organogenèse, faculté de médecine, CHU de Rennes, Rennes, France
ⁱ EA4685, CHU de Brest, University of Brest, 29200 Brest, France
^j Department of digestive surgery, Robert-Debré Hospital, Reims Hospital, Reims, France
^k Department of Pediatric Surgery, University Hospital of Nancy, Nancy, France
^l Nancy's School of Surgery, University of Lorraine, Virtual Hospital of Lorraine, Nancy, France
^m Laboratoire d’anatomie fonctionnelle, faculté des sciences de la motricité, route de Lennik, 808, CP 619, 1070 Bruxelles, Belgium
ⁿ Laboratoire d’anatomie, de biomécanique et d’organogenèse, faculté de médecine, route de Lennik, 808, CP 619, 1070 Bruxelles, Belgium

^⁎Corresponding author.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Sunday 21 July 2024

Summary

Background

In surgery, simulated-based training improves the knowledge and interpersonal skills needed for surgeons to improve their performance and meet the “never the first time on a patient” imperative. The objective is to evaluate the effects of a 2017 reform on surgeon's accessibility to simulation-based training, five years after the implementation of the program, and to gauge surgeon satisfaction.

Methods

A 27-item national online survey was sent to all surgical residents and fellows in the 13 surgical specialties.

Results

Among 523 responses, 405 (77.4%) were residents and 118 (22.6%) were surgical fellows. Two hundred forty-seven (47.2%) of surgical residents and fellows stated they did not have a simulation structure or simulation program in the town of their university hospital center. Two hundred thirty-five (44.9%) reported having simulation training programs and 41 (7.8%) reported having easy and free access to their simulation structure. Regarding simulation-based training, 44.6% of surgical residents and fellows had never received training in technical skills on simulators, 82.2% had never received training in teamwork or interprofessional skills and 76.1% had never received training in behavioral or relational skills. There was a significant difference between the degree of satisfaction of residents at the beginning and at the end of the study (P=0.02).

Conclusion

Simulation is a well-established educational tool, but there are still strong inequalities between universities. Despite the national deployment of simulation-based teaching programs and institutional efforts, surgical simulation is insufficiently developed in France, and learner satisfaction is poor.

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Keywords : Residents, Surgical fellows, Simulated-based training, Surgical education, Accessibility, Satisfaction