One Size Fits All? the New Surgical Innovation Philosophy

Vivian De Ruijter, Pietro Riva, Natasha Waters, MD, Bernard Dallemagne, MD, Lee Swanstrom, MD, Jacques Marescaux, MD, Silvana Perretta, MD. IRCAD-IHU, University of Strasbourg, France.

INTRODUCTION: The growing importance of novel technologies in medical science and healthcare demands tighter collaborations between engineering and medicine. Professionals from both worlds have to master a wide range of clinical knowledge and technical skills to succeed in the field of minimally invasive surgery (MIS) and surgical device development. Due to lacking practical experiences, medical students, and particularly young engineers often possess a solid theoretical background which they are not able to translate into a clear understanding of healthcare needs for which a solution must be developed. The key element to overcome this gap is to mix and expose early in their training students from both backgrounds to the real challenges of surgical techniques and technologies. The aim of this study is to explore an innovative teaching method designed to bring together medical and engineering students and provide them with a structured, step-by-step,concentrated learning experience in the field of MIS.

METHODS AND PROCEDURES: for two consecutive years (August 2012-2013), a yearly 5-day intensive summer school for young professionals in medicine and engineering was organized at the IRCAD-IHU institute in Strasbourg, France. The program offered a total of 20 hours of hands-on training in open surgery, laparoscopy, flexible endoscopy, and robotic surgery. The training consisted of a series of progressive structured exercises involving first box trainers, ex-vivo tissue and virtual simulators, then experimental animal models. The LASTT© method was administered to participants at day 1 and 5 to objectively measure students’ learning curve and psychomotor skills development in the following domains (1) camera navigation, (2) laparoscopic forceps handling and (3) bi-manual coordination. A 1-to-5 Likert scale satisfaction survey was administered to all students to determine if they judged the course to be a profitable learning experience

RESULTS: Sixty students (30 medical students, and 30 engineering students, mean age 23.8; SD 2.84) from 15 countries participated in this study. A significant (P <0.001) improvement of psychomotor skills in exercise 1, 2, and 3 throughout the course was seen for both medical participants (49.8%, 24.1%, 17.2% respectively) and engineering participants (22.4%, 24.1%, 17.2% respectively). Overall, the medical students performed significantly better in all of the exercises compared to the engineering students. There was no significant correlation between the two groups and their demographic characteristics. An overall mean satisfaction rate of 4.71 (SD 0.10) and 4.94 (SD 0.09) was awarded to the training method by the engineering and medical participants respectively.

CONCLUSION: The method proved to be successful in improving MIS psychomotor skills, demonstrating that with a structured training method the students’ performances could be enhanced by 25% in only 5 days, regardless of their background. The method was very well received by all participants who identified it as a potential important strategic tool to succeed in future identification of clinical needs and medical device development related to the surgical field.

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