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113 Pitfalls in introducing novel high-fidelity procedural simulation
  1. J Willers1,
  2. S Down2,
  3. R Willers3,
  4. J Pereira2
  1. 1Worthing Hospital, UK
  2. 2University of East Anglia, UK
  3. 3Brighton Hospital, UK

Abstract

Background High fidelity simulation models for surgical procedural training has not been available for complex oncoplastic breast cancer operations until recently when a mastopexy model was developed.1 As its utility as an effective wider teaching tool(as opposed to a single procedure workshop trainer) has not been established yet, it was decided to explore this.

Methodology Four mastopexy models were dissected and assessed by faculty and students of the Masters Degree in Oncoplastic Breast Surgery at the Royal College of Surgeons, all of whom are practising breast surgeons. Modifications requested were: higher fidelity skin to increase the difficulty of de-epithelisation to a realistic level, decreasing breast size from 2 L to a more average 1.2 L and insertion of a tumour in the upper outer quadrant. A batch of 16 models were produced to these specifications and mounted on PVC fascia boards (which doubled as whiteboards).These were employed at a further Masters study day for technical training in oncoplastic breast conservation procedures including breast reduction surgery, and verbal and questionnaire feedback sought.

Results There were no problems with batch producing the breasts or adding the modifications. Teachers feedback: “the faculty were very impressed with the models, and would like to use them at an international training workshop later this year”. The students gave constructive feedback and this was reflected in the questionnaire Likert scales. Issues identified and potential refinements are tabulated below.

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Abstract 113 Table 1

Conclusions High fidelity breast surgery practical training was partially achieved with the availability of a high-fidelity breast model. Future refinements to optimise surgical training using these models can be summarised as increasing the time available for practising procedures and utilising larger breast models to facilitate level 2 oncoplastic procedures such as breast reduction, in addition to re-creating the chest wall anatomy to facilitate pre-operative mark-up of the specimens.

Reference

  1. Johann Willers, Ricardo Bonomi, Fabio Rapisarda, Dibendu Betal. Development of a high fidelity oncoplastic breast simulation model. BMJ STEL 2015;1(Suppl 2):A39

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