Skills training skills training

The General Surgery Residency Program at the University of Nebraska Medical Center has an extensive surgical skills training program in place. This comprehensive skills training program consists of open surgical skills training, minimally invasive skills training, and simulation skills acquisition.

Open Surgical Skills
The open surgical skills training is undertaken in the Advanced Anatomy laboratory that simulates the real operating room and uses lightly embalmed cadavers. The laboratory has the same instruments and equipment (ligasure, electocautery, staples, etc.) that are used in the operating room. The lightly embalmed cadavers are different from the regular cadavers and closely resemble live tissue. Residents practice open surgical procedures appropriate for their level on these cadavers under Faculty guidance. The procedures are chosen from the list of Residency Review Committee (RRC) mandated operations that need to be undertaken during the residency. The skills training curriculum is being expanded on an annual basis. Thirty-eight sessions are scheduled for the 2013-2014 academic year, an increase of 8 sessions over the past two years.

Simulation
The 8000 square feet state-of-the-art Sorrell Simulation Center is an integral part of our residency training. Since its opening in 2008 we have gradually increased the number of simulation-based training sessions. Residents get the opportunity to become proficient in many procedures that are currently available. Simulation also plays a key role in the intern orientation curriculum.

We are continuously seeking to improve our simulation-based trained facilities. Some of the recent additions include:

  1. The recent opening of the state-of-the-art Ryan Surgical Simulation Suite. http://www.unmc.edu/surgery/ryan_surgical_suite.htm
  2. Addition of Endoscopy simulator to train, improve and maintain endoscopy skills. Residents will be able to practice and improve their upper and lower endoscopy skills
  3. A new endoscopy curriculum to facilitate training in endoscopy
  4. We are in the process of obtaining additional simulators that will allow training in a wide variety of laparoscopic procedures such as: colectomies, anti-reflux operations, hernia repairs.
  5. Addition of a new curriculum in the future to develop cross-collaborative multi-departmental simulation exercises.

We are acutely aware of the enormous influence that simulation can play in the training of the current generation of residents. Our proactive efforts will ensure that we stay abreast and provide our residents with the best training opportunities in simulation. 

Minimally Invasive Surgical Techniques
Minimally invasive surgical techniques are taught in wet laboratory sessions using cadavers. This includes teaching both laparoscopic, endoscopic and thoracoscopic procedures. Several sessions are available for residents to practice prior to taking the Fundamentals of Laparoscopic (FLS) Surgery exam. These training sessions ensure that the residents are kept abreast with the current and evolving new minimally invasive surgical techniques. The Sorrell Clinical Simulation Center also provides the opportunity to acquire skills training. Through this comprehensive skills training curriculum we aim to train residents to be technically proficient in all aspects and approaches to surgery.

Fundamentals of Laparoscopic Surgery
The Fundamentals of Laparoscopic Surgery (FLS) program is a SAGES/ACS jointly supported educational module and assessment tool designed to teach the fundamental knowledge, judgment and technical skills required in basic laparoscopic surgery. Learning and applying these fundamentals will help ensure a minimal standard of care for patients undergoing laparoscopic surgery. FLS also offers a proctored exam that gives surgical residents and fellows the opportunity to assess and document those skills.

Fundamentals of Endoscopic Surgery
The Fundamentals of Endoscopic SurgeryTM (FES) program is a comprehensive educational and assessment tool designed to teach and evaluate the fundamental knowledge, clinical judgment and technical skills required in the performance of basic gastrointestinal (GI) endoscopic surgery (endoscopy). Our goal is to provide participants with an opportunity to learn the fundamentals of endoscopic surgery in a consistent, scientifically accepted format, and to test cognitive and technical skills – all with the goal of improving the quality of patient care.

UNMC was recently designated as one of three testing centers for FES in the nation. Obtaining this designation is another milestone on our path to becoming a regional and national leader in education.

Date

 

Residents

 

Faculty

 

Procedures

             
June 25th   I   Ly   Intubation, Cricothyroidtomy, Tracheostomy & Paracentesis
June 26th   I   Ly   Central line placement, chest tube placement & Thoracentesis
Aug 7th   I   Are/Ly   Open appendectomy, cholecystectomy, gastrostomy & jejunostomy
Aug 14th   II   Are   Incisional hernia repair- onlay/underlay
Aug 21st   I   Langenfeld   Endoscopy
Aug 28th   II   Langenfeld   Endoscopy
Sept 4th   III   Are/Goede   Simulation
Sept 11th   III   Are/Langenfeld   Low anterior resection, APR
Sept 18th   III   Thoracic   Lobectomy & pneumonectomy
Sept 25th   IV   Are/Ly   Pancreaticoduodenectomy
Oct 16th   I   Vascular   Vascular exposures & anastomosis work shop
Oct 30th   II   MIS/Kothari   Lap cholecystectomy & appendectomy
Nov 6th   III   MIS/Goede   Lap hernia repairs
Nov 13th   IV   Thoracic   Lobectomy & pneumonectomy
Dec 4th   I   MIS   Lap cholecystectomy & appendectomy
Dec 11th   II   Are/Goede   Simulation
Feb 5th   IV   Thoracic   Lobectomy & pneumonectomy
Feb 12th   I   Are   Inguinal & femoral hernia repair
Feb 19th   III   Vascular   Vascular exposures & anastomosis work shop
Feb 26th   V   MIS/Langenfeld   Lap colon
Mar 5th   IV   MIS/Oleynikov   Lap Nissen & splenectomy
Mar 19th   I   Are/Ly   Bowel anastomosis work shop
Mar26th   II   Vascular   Vascular exposures & anastomosis work shop
April 16th   III   Thoracic   Lobectomy & pneumonectomy
April 23rd   IV   Are/Ly   Right hepatectomy, left hepatectomy, left lateral segmentectomy & caudate lobectomy
April 30th   I   Are/Langenfeld   Right hemicolectomy
May 7th   II   Are/Ly   Bowel anastomosis workshop
May 14th   V   MIS/Oleynikov   Lap Nissen/splenectomy
May 21st   IV   Are/Langenfeld   Low anterior resection & APR
May 28th   I   Are/Goede   Simulation
June 4th   II   Are/Langenfeld   Right hemicolectomy
June 11th   III   Are/Ly   Distal pancreatectomy & splenectomy
June 18th   IV   MIS/McBride   Lap bariatrics



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