Systematic review of skills transfer after surgical simulation-based training.
BACKGROUND
Simulation-based training assumes that skills are directly transferable to the patient-based setting, but few studies have correlated simulated performance with surgical performance.


METHODS
A systematic search strategy was undertaken to find studies published since the last systematic review, published in 2007. Inclusion of articles was determined using a predetermined protocol, independent assessment by two reviewers and a final consensus decision. Studies that reported on the use of surgical simulation-based training and assessed the transferability of the acquired skills to a patient-based setting were included.


RESULTS
Twenty-seven randomized clinical trials and seven non-randomized comparative studies were included. Fourteen studies investigated laparoscopic procedures, 13 endoscopic procedures and seven other procedures. These studies provided strong evidence that participants who reached proficiency in simulation-based training performed better in the patient-based setting than their counterparts who did not have simulation-based training. Simulation-based training was equally as effective as patient-based training for colonoscopy, laparoscopic camera navigation and endoscopic sinus surgery in the patient-based setting.


CONCLUSIONS
These studies strengthen the evidence that simulation-based training, as part of a structured programme and incorporating predetermined proficiency levels, results in skills transfer to the operative setting.
Australian Safety and Efficacy Register of New Interventional Procedures - Surgical (ASERNIP-S), Royal Australasian College of Surgeons, University of Adelaide, Queen Elizabeth Hospital, Adelaide, South Australia.
S R
SR
Dawe
G N
GN
Pena
J A
JA
Windsor
J A J L
JA
Broeders
P C
PC
Cregan
P J
PJ
Hewett
G J
GJ
Maddern
D002983:Clinical Competence / Q000592:standards*; D002986:Clinical Trials as Topic; D003198:Computer Simulation; D004724:Endoscopy / Q000193:education* / Q000592:standards; D013502:General Surgery / Q000193:education* / Q000592:standards; D006801:Humans; D010535:Laparoscopy / Q000193:education* / Q000592:standards; D014163:Transfer, Psychology