Aim: Simulation is endorsed by the Association of Surgeons in Training (ASiT) and the Joint Committee on Surgical Training (JCST). Our aim was to create a model that can be used for laparoscopic simulation of impalpable undescended testes. Trainees were also assessed for Non-Technical Skills for Surgeons (NOTSS).
Method: Paediatric surgical trainees from the regional training consortium were paired as a senior and junior trainee. A simple laparoscopic model presenting an intra-abdominal testis, vas and vessels was created using materials sourced in theatre (Fig 1). A scenario was created with anomalies including incorrect side, date of birth and procedure on the theatre list. Trainees had to identify this and take steps to ensure they reached the expected outcome. The senior trainee was assessed on their teaching ability to take the junior trainee though the steps of a first stage orchidopexy. Assessment included laparoscopic skills and NOTSS - professionalism, interpersonal and communication skills and consent.
Main results: 10 paediatric surgical trainees participated in the simulation exercise with 5 supervising faculty members. 7 trainees had previous laparoscopic experience and all 10 stated that the simulated model was appropriate for training purposes. Feedback suggested that the model was very good to excellent with excellent fidelity and one to one faculty teaching. Trainees felt that the scenario simulated real life and they were able to demonstrate NOTSS. The overall cost per model was under £5. The model was reusable. The same model was also used for laparoscopic hernia simulation. Trainees expressed interest in participating in more such structured skills and NOTSS simulation training.
Conclusion: Operative skills simulation is a useful training adjunct to traditional methods and can be achieved using very simple cost effective methods. Skills training can be effectively combined with NOTSS.
Fig 1 Model showing intra-abdominal testis with vas and vessels