Abstract Title | The Mobile Surgical Simulator - Views of Junior Surgical Trainees


  1. Christopher Buckle
  2. Wasim Mahmalji
  3. Jeremy Nettleton
  4. Munir Ahmed


Simulators and Simulation




Princess Royal University Hospital, Orpington, UK


Training time for surgeons is declining as a result of various factors. These factors include the often perceived “lost” training time between cases on operating lists when little practical training can occur.


In this environment of reduced training hours a variety of novel methods are required to provide the intensity of experience needed to become a competent and safe surgeon.  Simulators and simulation play a role in achieving this goal, particularly in the development of basic surgical skills in junior trainees1.


The views of junior surgical trainees on the use of simulation to maximise training between cases on operating lists has not been described.


“Lost” theatre time between cases represents a significant hidden reduction in available training time for the acquisition of basic surgical skills for junior trainees. The provision of a mobile surgical simulator within the theatre department is a simple solution to this problem helping to maximise training opportunities. It is also a solution universally supported by trainees.

Summary of Work

An anonymous questionnaire (see details) was sent to junior surgical trainees (Post graduate years 2-4) at a single district general hospital to explore their views on their current surgical exposure, time lost between cases in theatre and the use of the mobile surgical simulator (see details).


Take-home Messages

The mobile surgical simulator can be a beneficial resource for trainees to reduce the impact of “lost” theatre time on training.


South London Healthcare NHS Trust

Summary of Results

A total of 14 trainees responded to the questionnaire. Trainees reported between 12 – 20 hours per week of allocated theatre time.  Of this time a mean of 4 hours was “lost” between cases. This represented a 22% loss in available theatre training time for each trainee (Fig 1). All (n=14) trainees reported that the mobile surgical simulator would be beneficial in acquiring basic surgical skills (suturing, knot tying, familiarity with surgical instruments) between cases and that they would use the mobile surgical simulator during this “lost” time.




1. Edwards S. Medical Education England Review of the Impact of the European Working Time Directive (EWTD) on the Quality of Postgraduate Training, Consultation Response. Royal College of Surgeons of England. 2010 Feb.


2. Purcell Jackson G, Tarpley JL. How long does it take to train a surgeon? BMJ. 2009 Nov 5;339(nov05 1):b4260–b4260.

Summary of Work



Training level:   F2 / CT1 / CT2

Specialty:      General / Breast / ENT / Orthopaedics / Urology / Other...................

How many hours a week do you spend in theatre?

  <4                   4-8                 8-12               12-16                        16-20                   >20

Of the time specified above, in hours how much is spent:

  Observing....               Assisting....           Operating Under Supervision....          Operating Independently....

Of the time specified above, in hours how much is lost between cases (patient delay etc)?

Are you confident naming basic surgical equipment?

Are you confident naming and knowing the properties of different sutures?

Are you confident in knot tying?

Do you think a Mobile Surgical Simulator (MMS) would be beneficial in teaching the above between cases?

Would you make use of the MSS between cases?

What else would you like to see on the MSS?

Any other Comments?



The Mobile Surgical Simulator

Laparoscopic box trainer and basic laparoscopic tools
Suture and knot tying rig and instruments
Basic Surgical Skills DVD
Small surgical DVD and book library

Take-home Messages
Summary of Results

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