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Pig foot or technology? Surgical practice in the third millennium

Pursued by irrepressible technological progress, all fields ranging from cooking to health are becoming increasingly technologically dependent. Among those who still today are asking, whether this progress is positive or not, it is mandatory to state that technology has made great strides in recent decades and has led to the improvement of many other areas. If on one hand we are witnessing the slow disappearance of dexterity, of man's thought (but also of error), on the other, not only the technique but also the possibility of doing certain things has impractically improved.

Technology is rapidly challenging the oldest traditions of surgical learning thanks to electronic devices that allow students to learn techniques and concepts from other colleagues who probably will never meet.

Surgical training has always involved an apprenticeship between trainer and trainee. Historically, a transition from assistant through supervised operating to independent operator was made on the simple basis of case volume and attendance in theatre.

With the modernization of the health system, medical education is also changing. The social and working role of doctors and health workers is perceived differently from society. “See one, do one, teach one” is one way to paraphrase what has been the traditional teaching method of surgical education but now, putting patient safety in the forefront, and raises the ethical issues of learning interactions and procedures on live patients.

Technologies such as podcasts and videos with flipped classrooms, mobile devices with apps, video games, simulations and wearable devices (google glass) are some of the techniques available to address the changing educational environment.

How can electronic media improve the teaching and learning experience of medicine? Surely, the most relevant data is the possibility of being able to practice with and on highly sensitive instruments that imitate in a plausible way the different types of human tissues on which it will operate. Here there are some of the most useful and modern methods and tools currently used for practice:

  • Box trainers: The FLS Laparoscopic Trainer Box is a device for surgical residents and practicing surgeons that facilitates the development of psychomotor skills and dexterity required during the performance of basic laparoscopic surgery.

  • Animal models: These simulators involve the use of a live, anesthetized animal. This is the most realistic, non-patient environment for laparoscopic training. However, as regards this method of exercise, the negative aspects are more relevant than positive ones. For example, ethical rules, logistical difficulties and disproportionate costs mean that the use of laboratory animals or parts of them is now abandoned in favor of technology.

  • Full procedural simulators: This type of device is available for various types of operations: from laparoscopy to hernias, from bronchoscopy to cardiac surgery. The advantages of these simulators are clear and evident: they allow a precise vision of the whole procedural apparatus that goes from diagnosis to post-operative care.

  • Virtual reality simulators: VR simulation refers to the recreation of environments or objects as a complex, computer-generated image. Virtual reality, in part still under development, is certainly one of the most promising avenues and one of the main objectives of medicine development both in the surgical field and in the diagnostic field. If on the one hand it allows a complete and spatial vision of the problem, on the other it is a technology that is easy to use, within everyone's reach and fast.

The surgical training future is nothing less than an App (iOS and Android), a synthetic skin pad and virtual reality. Easy to use and flexible to your daily plans, all at an affordable price. This is the way technology creeps into surgical learning methods; all the students today have a smartphone and why not use it for educational purposes?

In addition to what Dr. Robert M. Wah, MD, Former President American Medical Association says, that medical education is changing in three ways (better decision-making, customized learning, inspiring deeper dives) it is possible to state that with the improvement of medical-surgical practice for students thanks to the contribution technologically, the standards and results of surgical interventions should be raised.

Improved dexterity, greater experience already cultivated during the study period means that in the future the surgeon has a reduced performance anxiety, stress and a greater awareness of the capacity. Starting, for example, from sutures, for students it is really important to have the opportunity to practice not only during lessons but whenever and wherever they want.

The future is here!

Articolo a cura di: Marco Terrana

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