title: A novel approach to contextualized surgical simulation training.
abstract: BACKGROUND
  Decontextualized benchtop simulators play a key role in surgical training. Educational theory highlights the importance of context for effective learning, yet existing full-immersion simulation facilities are prohibitively expensive. This study explored the concept of contextualized training of a key surgical procedure in a novel, low-cost, high-fidelity simulation environment [distributed simulation (DS)] and compared it with decontextualized training in a traditional benchtop simulation.
  
  
  METHODS
  Eleven novice surgeons performed a small bowel anastomosis in a benchtop simulation and in DS. Likert-type questionnaires and semistructured interviews captured surgeons' responses.
  
  
  RESULTS
  Surgeons perceived the contextualized DS training as realistic, giving surgeons the opportunity to increase their confidence, motivation, and integration of technical and nontechnical skills. Distributed simulation would be of value after benchtop training and before surgery in a real operating room.
  
  
  CONCLUSIONS
  Contextualized simulation training allows junior surgeons to gain the necessary confidence before operating in a real operating room. This article presents DS as a solution to widen access to contextualized surgical training.
authors.affiliation: Imperial College London, UK. e.kassab@imperial.ac.uk
authors.forename: Eva
authors.initials: E
authors.lastname: Kassab
authors.forename: Jimmy
authors.initials: J
authors.lastname: Kyaw Tun
authors.forename: Roger L
authors.initials: RL
authors.lastname: Kneebone
mesh_terms: D000328:Adult; D000818:Animals; D002983:Clinical Competence; D003198:Computer Simulation; D004777:Environment; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007858:Learning; D008131:London; D008297:Male; D023421:Models, Animal; D017145:Models, Educational; D011795:Surveys and Questionnaires; D006113:United Kingdom