Simulation in postgraduate plactic surgery education and training
Nel, Corne Pieter Gustav
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Simulation can play an important role in building a safer health care system and may have the potential to address a number of challenges facing postgraduate medical training. Simulation-based learning is becoming widely established within medical education and offers benefits to inexperienced residents learning procedural skills in a climate of decreasing clinical exposure. Simulation in health care is increasingly being used for teaching and training and the development of competencies related to patient safety and teamwork. The ability to perform clinical procedures safely on patients is a key skill and requires a combination of various skills and competencies – some of which may be obtained by introducing simulation into registrars’ training. An in-depth study was done on simulation in postgraduate plastic surgery education and training. The problem that was addressed in this study was the lack of clarity about whether, and, if so, to what extent simulation can contribute by playing a role, and will be of value in postgraduate plastic surgery education and training, and whether it would enhance the effectiveness of learning at various cognitive levels. The research was therefore aimed at identifying the contribution that simulation can make to plastic surgery education and training. The methods used to achieve this aim included a literature study, Delphi survey and semistructured interviews. The conceptualisation and contextualisation of simulation-based education and training in plastic surgery were accomplished through the literature study that focussed on the role and value of simulation, the features and uses of simulation that lead to effective learning and theory underlying a process to developing and formulating guidelines. Through the Delphi questionnaire, the Delphi experts had to indicate the importance of simulation as one of the methods to train a plastic surgeon. They, if they wished to do so, had to complete a questionnaire regarding what type of simulation modality is/can be applicable as far as simulation is concerned and had to indicate the cognitive level of training that is/can be addressed by simulation. The identification of a number of outcomes that may be reached by applying simulation as a possible method, including suggestions on the type of simulation modality to be used, as well as the possible cognitive level, was established by this method. In this study, the purpose of the individual semi-structured interviews with role-players in clinical simulation was to investigate and establish clarification on simulation in postgraduate plastic surgery education and training. It informed decisions on the development of the proposed guidelines by the in-depth overview of the contribution that simulation can make and recommendations as far as the challenges to the implementation of simulation into plastic surgery education and training. The results and findings of the research (prepared in manuscript/article format), contributed to achieving the aim of the research, and were used for the creation of a framework structure that can be applied to propose/suggest guidelines with recommendations for the implementation of simulation in postgraduate plastic surgery education and training. For simulation to be introduced as a teaching method and a learning opportunity for residents with a view to impact on plastic surgery education and training, it should include (i) a clear set of recommendations on how simulation can enhance the effectiveness of learning; (ii) a description of the contribution, including the role and value of simulation, based on a scientific research process; (iii) the development of an argument to enhance plastic surgery training by including simulation in education and training programmes; and (iv) the development of a framework structure that can be applied to propose guidelines for teaching through simulation as part of training programmes for evidence-based plastic surgery education and practice. The outcome of the study will serve as a directive for postgraduate plastic surgery education and training by means of suggested guidelines including recommendations on how simulation may be utilised to improve students’ knowledge, skills and professional conduct. In conclusion, the researcher recommends that further research may be undertaken, by an interdisciplinary group within the discipline of plastic surgery, based on a systematic review of evidence and within the parameters of sufficient resources, finances, expertise and knowledge, skills and competencies, to compile valid and usable guidelines on simulation by the profession for the profession. This research is seen as the first step taken in this process or direction.