The Future of Surgical Simulation

TLDR: There are few new methodologies that leverage off nonmedical simulation to develop curricula which provide quantitative assessment of skills performance and to set benchmarks for performance which must be met: full life-cycle curriculum development and proficiency-based progression (PBP) training and assessment, which should become the standards for creating skills courses as well as training and assessing skills performance.

Abstract: By defining the current status of simulation, we are able to project a reasonable estimation of the next generation in simulation. There are few new methodologies that leverage off nonmedical simulation to develop curricula which provide quantitative assessment of skills performance and to set benchmarks for performance which must be met: full life-cycle curriculum development and proficiency-based progression (PBP) training and assessment, which should become the standards for creating skills courses as well as training and assessing skills performance. In addition, it is anticipated that crowdsourcing video review (using crowd-sourced structured assessment of technical skills (C-SATS)), which has demonstrated validity for video review of initial performance, high-stakes test, and maintenance of certification in near-real time, will provide valuable evidence to hospital privileging committees, surgeon proficiency improvement, and, most important, feedback to surgeons for self-improvement learning. Simulators are beginning to move out of simple skills and tasks, with development of new full procedures as well as adding haptics (sense of touch). The unknown is the role of immersive virtual reality (VR) using head-mounted displays and whether they will remain a novelty or become affordable and mainstream. Unless there are sources of funding for further innovations in education and simulation, progress will be relatively slow.