An interactive 3D simulation software platform gives surgical residents the unique opportunity to practice diagnostic and patient management skills, and then have their skills evaluated, according to a new study appearing in the August issue of the Journal of the American College of Surgeons. Using an online virtual world called Second Life™, a multidisciplinary team of researchers from Imperial College, St. Mary’s Hospital, London, UK, developed three virtual reality environments—a standard hospital ward, an intensive care unit, and an emergency room.The findings could help establish a new tool to assess and train surgical residents.

In addition to performing operations, surgeons must also effectively manage post-surgical patients in the emergency room, on the hospital floor unit, or in the intensive care unit. Until now, new doctors could only develop these skills by practicing directly on patients.

For the study, the scientists created modules for three common surgical scenarios: gastrointestinal bleeding, acute inflammation of the pancreas, and bowel obstruction. Each of these scenarios, which could be accessed through a laptop or personal computer, was designed to put the residents through their paces at three different levels of complexity.

The study involved 63 surgeons—including interns and junior and senior residents, as well as attending surgeons whose performance was used as a benchmark. Each surgeon assessed and managed a series of virtual patients via this 3D interactive surgical world. The process involved taking a patient history, performing a physical, interpreting labs, diagnosing the disease, using chest X rays and CT scans, and implementing an appropriate management plan.

Using a validated rating scale, researchers then evaluated and rated each surgeon’s performance for each case he or she performed. The results showed significant gaps in performance between interns and attending physicians, as well as between junior and senior residents.

In future research, surgical residents and interns will train on this program with the goal of using simulation training to help residents become more effective at managing patient safety.