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This groundbreaking simulation trial aided by Guy’s and St Thomas’ Hospital will redefine surgical training

A groundbreaking trial aided by south-east London hospitals is redefining surgical training by proving that simulation-based training improves surgical performance.

It allows doctors-in-training to train without relying on real patients or cadavers.

The Simulation in Urological Training and Education (SIMULATE) trial was led by King’s College London in collaboration with King’s College and Guy’s and St Thomas’ Hospitals and other universities, researchers and NHS Trusts.

It is the first international, multi-institutional randomized controlled trial to investigate whether surgical proficiency is better achieved with additional simulation training, and whether there are improved patient outcomes.

Prof Prokar Dasgupta, Professor of Surgery at King’s Health Partners, Chair in Robotic Surgery and Urological Innovation at King’s College London, and senior author on the paper said: “Initially a British study, the trial had to be scaled to Europe, Japan, China, United States of America and Canada.

“It was a massive international effort that was only possible due to the close collaboration with our clinical colleagues from around the world, and we are very thankful for the support they provided.

“Most importantly, the results of the trial will help redefine surgical training and directly improve patient outcomes going forward.”

Sixty five junior surgeons and over 1,000 patients took part in the trial over eighteen months.

Traditionally, surgical training relied on practice in theatres, but as minimally invasive surgery has become more commonplace, the hours required to master the complex training have increased.

Taking heed from the military and aviation industries, simulation-based training has been widely adopted for use in surgery and urology as it can provide safe and controlled environments for training without endangering patient safety.

However, this trial is the first to show that this simulation-based training does improve performance in real-life operating theatres.

Dr Abdullatif Aydin, first author of the SIMULATE trial and National Institute for Health Research Academic Clinical Fellow in Urology, said: “As training surgeons, our aim is to become good surgeons whilst providing the best possible care to our patients. For the first time, SIMULATE demonstrates that supplementary simulation-based training of surgical trainees results in better performance and less complications, when operating on patients.

“It also shows twice as many trainees become proficient in complex procedures compared to only training in the operating theatre. Our study provides the evidence-base for surgical specialties to integrate simulation in their training programmes as a means to improve surgical performance, clinical outcomes and patient safety.”

Findings from the trial have recently been accepted by European Urology, one of the world’s highest impact surgical journals. It is expected that the results of the trial will have a positive impact for advanced procedural training beyond the fields of surgery and urology.

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