Elsevier

The Surgeon

Volume 11, Issue 2, April 2013, Pages 105-112
The Surgeon

Review
Surgical training 2.0: How contemporary developments in information technology can augment surgical training

https://doi.org/10.1016/j.surge.2012.12.001Get rights and content

Abstract

Background

The current surgical trainee is faced with reduced training time compared to predecessors as a result of changes in working practices. The past decade has seen marked developments in the information technology sector. This editorial will review how modern technological innovations could augment current surgical training.

Methods

We review the literature and summarize important developments in information technology that could assist the modern surgical trainee. We also look at some of the challenges faced by use of this technology.

Findings

Developments in mobile internet connectivity will improve access to online resources for the surgical trainee. Web 2.0 will revolutionise the way trainees interact with textbooks, journals, webpages and each other. Simulators could help to fill gaps created by reduced operating hours. To maximize the effectiveness of these resources they need to be accessible and incorporated into training in a structured way, ensuring patient safety and accuracy of information.

Conclusion

Contemporary developments in technology offer benefits to the surgical trainee and could fill gaps left by reduced operating times. In order to ensure efficient use of technology and patient safety, bodies such as the Royal Colleges and Training Programmes must embrace these developments.

Introduction

Increasing demands of service provision combined with fewer working hours (as a result of the European Working Time Directive (EWTD)) have resulted in reduced training time. This has led to concerns from trainees and trainers that standards are falling1, 2 due to reduction in the proportion of operations performed by junior trainees.3, 4 A greater proportion of their time is spent on service provision, with surgical trainees now spending more time dealing with acute admissions and night-time cover than in the operating theatre.3, 4, 5 Training rotations are designed to ensure patient safety is not compromised and that the next generation of surgeons is fit for purpose. Despite this, the majority of trainees feel less capable than their predecessors at a comparable stage of training.6

Since the introduction of the EWTD in 1998 there have been dramatic changes in the information technology sector, transferring many previous training roles online and potentially providing a means to ensure that standards of trainees' surgical skills and knowledge are maintained. The purpose of this editorial is to review the technological developments which are potentially changing the nature of modern surgical education and training.

Section snippets

Evolution of technology

The last decade has seen an exponential increase in ownership of smartphones and tablet computers.7, 8 One recent study of Orthopaedic surgeons found 84% of responders had smartphones.9 In September 2009, mobile phones accounted for 0.02% of UK internet traffic, however by July 2011 that had increased to 13% and by March 2012 to 28%.10, 11, 12

Smartphones provide access to a vast array of knowledge and resources at the touch of a button.7, 8, 9 The resources available vary considerably: from

Surgical skills and simulation

The proportion of operations undertaken by Surgical Trainees has reduced in the past decade.3 Trainees spend less time in theatre and more time covering nights and acute admissions.4, 5 There is therefore a need to improve the training opportunities available to trainees out-of-hours. Simulation may be able to fill this gap, for example in laparoscopic surgery where spatial awareness and instrument manipulation are core skills.33 With all new skills, there is a learning curve to develop

Knowledge acquisition

The internet has revolutionised the way in which journal articles are published and accessed. The challenge for any surgical trainee is to maximise the efficiency of their time and to use the right resources at the right time. There are over 600,000 new research articles published every year (around 2000 per day).66 Only a fraction of these will be directly relevant to an individual's current practice or level of training. These articles will reach the individual via a combination of deliberate

Conclusion

With the advent of the European Working Time Directive surgical training has changed and today's trainees face a different set of challenges from their predecessors. It is imperative that those responsible for overseeing the training of the next generation of surgeons are aware not only of the challenges faced by trainees but also of the potential benefits the advances in digital technology can make. We speculate that developments in mobile connectivity will alter the way surgical trainees

Grant support

No grant support was received for this manuscript.

Author contributions

All authors were involved in the draft, review and revision of the manuscript.

Conflict of interest

"RB is owner of ResearchActive.com, a company which develops medical apps and provides mHealth solutions. CW has been involved in writing and developing sections of AO Surgery, the online Orthopaedic decision-support system. JB and RC declare no conflicts of interest."

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