Surgical skills school (lt. ChiM – Chirurgijos igudziu mokykla) – Lithuania (LiMSA)

Name of the activity: Surgical skills school (lt. ChiM – Chirurgijos igudziu mokykla)

Country/NMO: Lithuania (LiMSA)

Program: Medical Education Systems

Type of the activity: Education

General description:

ChiM – Surgical Skills School is a scientific-workshop based events aimed to facilitate professional growth and collaboration of medical students and specialists interested in varying surgical fields. We hope, that ChiM will become one of the most desirable surgical series events for students providing the participants with the opportunity to gather experience from surgeons, young doctors and fellow students. Participants will be given the chance to learn through simulation-based workshops which will help them understand the technicalities of varying techniques ranging from handling different types of instruments, knot tying to laparoscopic and other advanced skills. We hope that with such practice the students will find it easier to further advance their skills during their training and will apply the knowledge into practice when appropriate and when allowed by their supervisors. During the events, participants will get acquainted with the specifics of various surgical disciplines and will learn the operating theatre conduct and teamwork. The School will take place in a formal location provided by the Lithuanian University Health Sciences. The focal point of ChiM – Surgical Skills School are practical competences of the aspiring surgeon, thus entire event will be mainly focused on practical skills, workshops and the practice of safety in surgery.

Focus area:

Students’ involvement in medical education | Non-formal/informal education

Problem statement:

Average student has a lot of knowledge in the field of anatomy and surgical disciplines, however, there is a big gap between the theories learnt and practical skills acquired which leaves the young specialists with the fear of failure and errors when they commence their work. Meaning that one of the major challenges the students are facing today is the lack of practical skills and simulation-based learning in the curricula that would help to adapt the theoretical knowledge in practice. Despite the fact that the advancement in medical education and the curricula is strongly promoted by many parties (administration of the universities, student organizations, and specialists) students do not get exposed to practical simulation based learning in varying disciplines of surgery which could be detrimental in deciding future career path and obtaining a well-rounded education for a future surgeon.
In such healthcare professional training system, resident doctors often start learning to close wounds on live patients in the operating theatre without any previous practical experience. This creates a stressful environment for the trainee and causes a potential risk for error occurrence, increasing the complication risk. The core of this project is to give students the opportunity to learn first, and then apply the skills in the operating theatre.
We as the organizing committee believe, that extracurricular simulation based training programmes will ensure smooth skill transition from simulation to real life situations in which fewer errors and complications will occur due to proper early training. And as and additional aim we hope to foster and easier decision making in regards of surgical career choice for the students as they will get the technical training, possibility to test their skills and exchange the experiences with the current specialists.

Target groups and beneficiaries:

Students, young doctors, specialists.

Objectives and indicators of success:

Project goals:
1. To bring and promote communication between students interested in surgery and specialists through organizing 1 major event (3-day national/international, 60 students) per year and at least 6 minor sessions per year (1-2 day local/national, 10-30 students) .
2. To introduce medical students to safe and sound techniques early in their career during the sessions (with the assistance of young doctors and specialists, trained students) ;
3. To incorporate theoretical and practical knowledge in the training of future physicians in the field of surgery (simulation based learning and evidence based teaching methods applied for each session, 2:1 or at least 5:1 student:teacher ratio applied);
4. To develop competences of future specialists in varying surgical disciplines (student knowledge evaluation and self-evaluation before and after the training, follow up evaluation after 6/12 mths);
Project tasks:
1. To provide students with knowledge about surgical tactics, proper behaviour of the surgeon, essential surgical skills;
2. To promote students‘ critical and spatial thinking;
3. To ensure teaching according to the latest research data;
4. To provide participants with the opportunity to learn practical skills for their future surgical practice;
5. To ensure high quality education of surgical practical skills;
6. To facilitate student decision-making in the area of future work and research;
7. To learn team-working skills;
8. To give the student the opportunity to test new virtual reality technology and smart surgical training tools.

Methodology:

Organizing 1 major event (3-day national/international, 60 students) per year and at least 6 minor sessions per year (1-2 day local/national, 10-30 students). The training will be provided applying simulation based learning and the courses will range from basic surgical skills (knot-tying and simple suturing skills, OR conduct) to advanced surgical skills (vascular anastomosis training, skin local flap training, laparoscopic skills development and training, C-section simulation, perineal tear repair training and others).
For major events the students will be selected based on the following criteria: motivational letter, answering surgical questions correctly, year of their training and current skills. Students selected for the major 3-day training will undergo intense basic to advanced skills training which will be supervised and facilitated by specialists, young doctors and trained students.
For minor events participants will be selected based on the same criteria (mentioned in major event selection paragraph). Courses will be either basic or advanced. The selected students will be provided with a 12-hour course where, the coordinator will present a short lecture and demonstrate the task using live camera streaming. The students will be attended individually after the demonstration of the task. During basic training practical sessions students learn about and try gowning, gloving, handling instruments, different suturing and knot tying techniques. Whereas during advanced training students are provided with more complex situations in specific areas (vascular surgery, cardiac surgery, urology, abdominal surgery, obstetrics and gynaecology, orthopaedics and trauma, plastic and reconstructive surgery) where they can apply their suturing, knot tying knowledge.
For each session (major or minor event) students will self-evaluate their skills before and after the sessions, during the sessions they will be evaluated by the teachers (trained students, young doctors, specialists), and follow up self-evaluation questionnaire will be provided 6/12mths after the training. The feedback from the teachers will be provided individually. Participants will be provided with handbook containing main information covered during the teaching sessions.

Plans for evaluation:

1. Over 3 years we will measure the number of yearly events organized. The aim is to facilitate 1 major event and 6 minor events per annum and have at least 150 students participating in them.
2. 2:1 or at least 5:1 student : teacher ratio for each teaching sessions where simulation based techniques will be applied with personal feedback given at the time of the training and written evaluation after the course.
3. Workshop handbooks for each session: 1 major event handbook (with its review for each new event) and 5 minor event handbooks (with its yearly review)
4. Self-evaluation questionnaire for students before and after the training, follow up evaluation after 6/12 mths with the analysis of results.