Surgical widely from digital to hands on

Surgicaltrainees work hour limitations in addition to hospital imposed educationalrestrictions are challenging traditional models of surgical education.

1 The growing number of subspecialized fellowships aswell as mandatory faculty participation and supervision further limiteducational opportunities.2 With narrowing time availability and opportunities,there is increasing pressure on trainees to acquire surgical knowledge in anefficient autonomous fashion. This has resulted in surgical trainees turning tointernet-based and digital resources for surgical education, as these resourcestend to be easily accessible, user friendly and provide a wealth of informationinstantaneously. 3,4 Limitations in surgical educational experiences havealso resulted in growing reliance on simulators to fill the void.

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There isconsensus that simulation plays an essential role in education throughoutmedical school and later training stages. 5 Surgical simulators developed so far have variedwidely from digital to hands on platforms with different levels of fidelity andresemblance to the simulated experience. Furthermore, the ultimate effect ofthese various simulators on trainee surgical knowledge and skills acquisitionremains poorly explored.            The fields of craniofacial surgerygenerally, as well as cleft surgery more specifically, have also witnessed thebirth of numerous educational simulators.

6-9 We have previously demonstrated that an online andfreely available cleft surgery digital simulator was able to reach asignificant global surgical audience shortly after release.10,11 We have also recently completed arandomized controlled trial showing that the simulator was significantly betterthan traditional textbook in teaching novice learners unilateral cleft lipmarkings. However, we have not evaluated the effect of the simulator onprocedural knowledge, confidence, and surgical skills acquisition.

We hypothesize that our digital educationalsimulator leads to improved unilateral cleft lip repair procedural knowledge,confidence, and skills acquisition.             There is increasing evidence thatsurgical trainees prefer using digital resources as an educational tool ascompared to standard textbooks. 3 Digital resources provide an easily accessible sourceof surgical knowledge and can provide three-dimensional (3D) demonstrations ofprocedures and concepts that are difficult to illustrate and display intextbooks. In an attempt to address the limitations encountered by surgicaltrainees in cleft surgery education, academic craniofacial surgeons from NewYork University Langone Health, in partnership with the non-profit organizationSmile Train and the biotechnology company Biodigital Inc. created aneducational cleft surgery simulator in October 2012.

10 The simulator is freely availableonline at, is compatible with frequently used Internetbrowsers, and is available in English, Chinese, Spanish, Portuguese and French.The educational material covered in the simulator includes 3D digitalanimations, with text and voice over surgeon commentary of normal andpathologic anatomy, surgical markings and detailed steps of essential cleftprocedures (Figure 1).


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