Recomendaciones para desarrollar un programa de formación en simulación quirúrgica laparoscópica. Perspectivas obtenidas tras 12 años de formación de cirujanos

El uso de la simulación en cirugía ha permitido acortar las curvas de aprendizaje mediante la práctica deliberada. A pesar de que se ha incorporado previamente, aún no existen recomendaciones claras para estandarizar su desarrollo e implementación. Este manuscrito pretende compartir recomendaciones...

Full description

Autores:
Durán Espinoza, Valentina
Montero Jaras, Isabella
Miguieles Schilling, Mariana
Valencia Coronel, Brandon
Belmar Riveros, Francisca
Gaete Dañobeitia, Maria Inés
Jarry Trujillo, Cristian
Varas Cohen, Julián
Tipo de recurso:
Article of investigation
Fecha de publicación:
2023
Institución:
Universidad Autónoma de Bucaramanga - UNAB
Repositorio:
Repositorio UNAB
Idioma:
spa
OAI Identifier:
oai:repository.unab.edu.co:20.500.12749/26139
Acceso en línea:
http://hdl.handle.net/20.500.12749/26139
https://doi.org/10.29375/01237047.4514
Palabra clave:
Ejercicio de Simulación
Laparoscopía
Educación Médica
Retroalimentación
Entrenamiento Simulado
Cirugía General
Medical sciences
Life sciences
Simulation Exercise
Laparoscopy
Education Medical
Feedback
Simulation Training
General Surgery
Health sciences
Ciências médicas
Ciências da vida
Ciências da saúde
Exercício de Simulação
Laparoscopia
Educação Médica
Retroalimentação
Treinamento por Simulação
Cirurgia Geral
Ciencias médicas
Ciencias de la vida
Ciencias de la salud
Rights
License
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
id UNAB2_6df43abdac6951e3876f85025c4a8f15
oai_identifier_str oai:repository.unab.edu.co:20.500.12749/26139
network_acronym_str UNAB2
network_name_str Repositorio UNAB
repository_id_str
dc.title.spa.fl_str_mv Recomendaciones para desarrollar un programa de formación en simulación quirúrgica laparoscópica. Perspectivas obtenidas tras 12 años de formación de cirujanos
dc.title.translated.eng.fl_str_mv Recommendations to Develop a Laparoscopic Surgical Simulation Training Program. Insights Gained After 12 Years of Training Surgeons
dc.title.translated.por.fl_str_mv Recomendações para o desenvolvimento de um programa de formação em simulação cirúrgica laparoscópica. Perspectivas obtidas após 12 anos de formação de cirurgiões
title Recomendaciones para desarrollar un programa de formación en simulación quirúrgica laparoscópica. Perspectivas obtenidas tras 12 años de formación de cirujanos
spellingShingle Recomendaciones para desarrollar un programa de formación en simulación quirúrgica laparoscópica. Perspectivas obtenidas tras 12 años de formación de cirujanos
Ejercicio de Simulación
Laparoscopía
Educación Médica
Retroalimentación
Entrenamiento Simulado
Cirugía General
Medical sciences
Life sciences
Simulation Exercise
Laparoscopy
Education Medical
Feedback
Simulation Training
General Surgery
Health sciences
Ciências médicas
Ciências da vida
Ciências da saúde
Exercício de Simulação
Laparoscopia
Educação Médica
Retroalimentação
Treinamento por Simulação
Cirurgia Geral
Ciencias médicas
Ciencias de la vida
Ciencias de la salud
title_short Recomendaciones para desarrollar un programa de formación en simulación quirúrgica laparoscópica. Perspectivas obtenidas tras 12 años de formación de cirujanos
title_full Recomendaciones para desarrollar un programa de formación en simulación quirúrgica laparoscópica. Perspectivas obtenidas tras 12 años de formación de cirujanos
title_fullStr Recomendaciones para desarrollar un programa de formación en simulación quirúrgica laparoscópica. Perspectivas obtenidas tras 12 años de formación de cirujanos
title_full_unstemmed Recomendaciones para desarrollar un programa de formación en simulación quirúrgica laparoscópica. Perspectivas obtenidas tras 12 años de formación de cirujanos
title_sort Recomendaciones para desarrollar un programa de formación en simulación quirúrgica laparoscópica. Perspectivas obtenidas tras 12 años de formación de cirujanos
dc.creator.fl_str_mv Durán Espinoza, Valentina
Montero Jaras, Isabella
Miguieles Schilling, Mariana
Valencia Coronel, Brandon
Belmar Riveros, Francisca
Gaete Dañobeitia, Maria Inés
Jarry Trujillo, Cristian
Varas Cohen, Julián
dc.contributor.author.none.fl_str_mv Durán Espinoza, Valentina
Montero Jaras, Isabella
Miguieles Schilling, Mariana
Valencia Coronel, Brandon
Belmar Riveros, Francisca
Gaete Dañobeitia, Maria Inés
Jarry Trujillo, Cristian
Varas Cohen, Julián
dc.subject.spa.fl_str_mv Ejercicio de Simulación
Laparoscopía
Educación Médica
Retroalimentación
Entrenamiento Simulado
Cirugía General
topic Ejercicio de Simulación
Laparoscopía
Educación Médica
Retroalimentación
Entrenamiento Simulado
Cirugía General
Medical sciences
Life sciences
Simulation Exercise
Laparoscopy
Education Medical
Feedback
Simulation Training
General Surgery
Health sciences
Ciências médicas
Ciências da vida
Ciências da saúde
Exercício de Simulação
Laparoscopia
Educação Médica
Retroalimentação
Treinamento por Simulação
Cirurgia Geral
Ciencias médicas
Ciencias de la vida
Ciencias de la salud
dc.subject.keywords.eng.fl_str_mv Medical sciences
Life sciences
Simulation Exercise
Laparoscopy
Education Medical
Feedback
Simulation Training
General Surgery
Health sciences
dc.subject.keywords.por.fl_str_mv Ciências médicas
Ciências da vida
Ciências da saúde
Exercício de Simulação
Laparoscopia
Educação Médica
Retroalimentação
Treinamento por Simulação
Cirurgia Geral
dc.subject.lemb.spa.fl_str_mv Ciencias médicas
Ciencias de la vida
Ciencias de la salud
description El uso de la simulación en cirugía ha permitido acortar las curvas de aprendizaje mediante la práctica deliberada. A pesar de que se ha incorporado previamente, aún no existen recomendaciones claras para estandarizar su desarrollo e implementación. Este manuscrito pretende compartir recomendaciones basadas en nuestra experiencia, con más de doce años empleando y mejorando una metodología en la simulación quirúrgica laparoscópica. Temas de reflexión. Para transferir las habilidades quirúrgicas a un aprendiz, basamos nuestra metodología en un marco de tres pilares: El hardware y la infraestructura (herramientas con las que entrenar), el programa de entrenamiento (qué hacer), y la retroalimentación (cómo mejorar). La implementación de un programa rentable es factible: el hardware no necesita ser de alta fidelidad para transferir las habilidades, pero el programa necesita ser validado. Estos pilares han evolucionado a lo largo del tiempo incorporando tecnología: la presencia de expertos ha evolucionado a una modalidad remota y asincrónica mediante la grabación en vídeo de la ejecución del alumno, y permitiendo su retroalimentación. Aquel que entrega retroalimentación no tiene que ser necesariamente un clínico experto en la materia, sino una persona previamente formada como instructor. Esto permite una práctica deliberada hasta dominar la habilidad y establecer curvas de aprendizaje. Conclusiones. Se han presentado recomendaciones basadas en la experiencia de nuestro centro, explicando el marco de nuestra estrategia. Teniendo en cuenta estas sugerencias, se espera que nuestra metodología de simulación pueda ayudar al desarrollo e implementación de programas efectivos basados en la simulación a otros grupos e instituciones.
publishDate 2023
dc.date.issued.none.fl_str_mv 2023-03-12
dc.date.accessioned.none.fl_str_mv 2024-08-21T20:38:40Z
dc.date.available.none.fl_str_mv 2024-08-21T20:38:40Z
dc.type.eng.fl_str_mv Article
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_6501
dc.type.coarversion.fl_str_mv http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.driver.none.fl_str_mv info:eu-repo/semantics/article
dc.type.local.spa.fl_str_mv Artículo
dc.type.coar.none.fl_str_mv http://purl.org/coar/resource_type/c_2df8fbb1
dc.type.redcol.none.fl_str_mv http://purl.org/redcol/resource_type/ART
format http://purl.org/coar/resource_type/c_2df8fbb1
dc.identifier.issn.spa.fl_str_mv i-ISSN 0123-7047
e-ISSN 2382-4603
dc.identifier.uri.none.fl_str_mv http://hdl.handle.net/20.500.12749/26139
dc.identifier.instname.spa.fl_str_mv instname:Universidad Autónoma de Bucaramanga UNAB
dc.identifier.reponame.spa.fl_str_mv reponame:Repositorio Institucional UNAB
dc.identifier.repourl.spa.fl_str_mv repourl:https://repository.unab.edu.co
dc.identifier.doi.none.fl_str_mv https://doi.org/10.29375/01237047.4514
identifier_str_mv i-ISSN 0123-7047
e-ISSN 2382-4603
instname:Universidad Autónoma de Bucaramanga UNAB
reponame:Repositorio Institucional UNAB
repourl:https://repository.unab.edu.co
url http://hdl.handle.net/20.500.12749/26139
https://doi.org/10.29375/01237047.4514
dc.language.iso.spa.fl_str_mv spa
language spa
dc.relation.spa.fl_str_mv https://revistas.unab.edu.co/index.php/medunab/article/view/4514/3720
dc.relation.uri.spa.fl_str_mv https://revistas.unab.edu.co/index.php/medunab/issue/view/286
dc.relation.references.none.fl_str_mv Lioce L. Healthcare simulation dictionary. 2nd Edition ed: Agency for Healthcare Research and Quality; [Internet]. New York. 2020. doi: https://doi. org/10.23970/simulationv2
Khan K, Pattison T, Sherwood M. Simulation in medical education. Medical Teacher [Internet]. 2011;33(1):1-3. doi: https://doi.org/10.3109/0142159X.2010.519412
Habib BA Chadli D. History of medical simulation. Tunis Med [Internet]. 2020;98(12):892-94. Available from: https://pubmed.ncbi.nlm.nih.gov/33479991/
Jandu GK, Khan A. Angélique Marguerite Le Boursier du Coudray (1712–1790) – Pioneer of simulation. J Med Biogr [Internet]. 2021;29(2):121-22. doi: https:// doi.org/10.1177/09677720211002204
Is Manual Cardiac Resuscitation. JAMA [Internet]. 1966;196(1):A36-A37. doi: https://doi.org/10.1001/ jama.1966.03100140020005
Corvetto M, Bravo MP, Montaña R, Utili F, Escudero E, Boza C, et al. Simulación en educación médica: una sinopsis. Rev. Med. Chile [Internet]. 2013;141(1):70-9. doi: http://dx.doi.org/10.4067/ S0034-98872013000100010
Carey JM, Rossler K. The How When Why of High Fidelity Simulation. StatPearls [Internet]. 2022 Available from: https://www.ncbi.nlm.nih.gov/books/ NBK559313/
Ruz C, Besa P, Irarrázaval S, Vidal C, Nazar C, Varas J, et al. High-Fidelity Hybrid Simulation Not Only Optimizes Skills Acquisition But Improves Non- Technical Skills. J. Surg. Educ [Internet]. 2020;29. doi: https://doi.org/10.1007/s44186-022-00027-y
Massoth C, Röder H, Ohlenburg H, Hessler M, Zarbock A, Pöpping DM, et al. High-fidelity is not superior to low-fidelity simulation but leads to overconfidence in medical students. BMC Med Educ [Internet]. 2019;19(1):29. doi: https://doi.org/10.1186/s12909- 019-1464-7
Fritz PZ, Gray T, Flanagan B. Review of mannequinbased high-fidelity simulation in emergency medicine. Emerg Med Australas [Internet]. 2008;20(1):1-9. doi: https://doi.org/10.1111/j.1742-6723.2007.01022.x
Cameron JL. William Stewart Halsted. Our surgical heritage. Ann Surg. [Internet]. 1997;225(5):445-58. doi: https://doi.org/10.1097/00000658-199705000-00002
Beyer L, Troyer JD, Mancini J, Bladou F, Berdah SV, Karsenty G. Impact of laparoscopy simulator training on the technical skills of future surgeons in the operating room: a prospective study. Am J Surg [Internet]. 2011;202(3):265-72. doi: https://doi.org/10.1016/j. amjsurg.2010.11.008
Beyer-Berjot L, Palter V, Grantcharov T, Aggarwal R. Advanced training in laparoscopic abdominal surgery: a systematic review. Surgery [Internet]. 2014;156(3):676- 88. doi: https://doi.org/10.1016/j.surg.2014.04.044
Yudkowsky R, Park YS, Lineberry M, Knox A, Ritter EM. Setting Mastery Learning Standards. Acad Med [Internet]. 2015;90(11):1495-500. doi: https://doi. org/10.1097/ACM.0000000000000887
Ericsson KA, Harwell KW. Deliberate Practice and Proposed Limits on the Effects of Practice on the Acquisition of Expert Performance: Why the Original Definition Matters and Recommendations for Future Research. Front Psychol [Internet]. 2019;10:2396. doi: https://doi.org/10.3389/fpsyg.2019.02396
Siddaiah-Subramanya M, Smith S, Lonie J. Mastery learning: how is it helpful? An analytical review. Adv Med Educ Pract [Internet]. 2017;8:269-75. doi: https:// doi.org/10.2147/AMEP.S131638
Boza C, León F, Buckel E, Riquelme A, Crovari F, Martínez J, et al. Simulation-trained junior residents perform better than general surgeons on advanced laparoscopic cases. Surg Endosc [Internet]. 2017;31(1):135-41. doi: https:// doi.org/10.1007/s00464-016-4942-6
McGaghie WC, Adler M, Salzman DH. Instructional Design and Delivery for Mastery Learning. Springer International Publishing [Internet]. 2020:71-88. doi: https://doi.org/10.1007/978-3-030-34811-3_4
Hutter MM, Kellogg KC, Ferguson CM, Abbott WM, Warshaw AL. The impact of the 80-hour resident workweek on surgical residents and attending surgeons. Ann Surg [Internet]. 2006;243(6):864-75. doi: https://doi. org/10.1097/01.sla.0000220042.4831
Russ JB, McKenney AS, Patel AB. An identity crisis: the need for core competencies in undergraduate medical education. Med Educ Online [Internet]. 2013;18:1-2. doi: https://doi.org/10.3402/meo.v18i0.21028
Jarry-Trujillo C, Achurra-Tirado P, Escalona-Vivas G, Crovari-Eulufi F, Varas-Cohen J. Surgical training during COVID-19: a validated solution to keep on practicing. Br J Surg [Internet]. 2020;107(11):e468-e69. doi: https://doi. org/10.1002/bjs.11923
Quezada J, Achurra P, Asbun D, Polom K, Roviello F, Buckel E, et al. Smartphone application supplements laparoscopic training through simulation by reducing the need for feedback from expert tutors. Surg Open Sci [Internet]. 2019;1(2):100-104. doi: https://doi. org/10.1016/j.sopen.2019.05.006
Quezada J, Achurra P, Jarry C, Asbun D, Tejos R, Inzunza M, et al. Minimally invasive tele-mentoring opportunity-the mito project. Surg Endosc. [Internet]. 2020;34(6):2585-92. doi: https://doi.org/10.1007/ s00464-019-07024-1
Brian R, Davis G, Park KM, Alseidi A. Evolution of laparoscopic education and the laparoscopic learning curve: a review of the literature. Laparosc Surg [Internet]. 2022;6(34):184-92. doi: https://dx.doi. org/10.21037/ls-22-29
Argay IM, Lawrence T, Afors K, Centini G, Lazzeri L, Habib N, et al. 1 vs 3 days laparoscopic suturing courses: is it feasible to design a valid training curriculum? Facts Views Vis Obgyn. [Internet]. 2020;12(3):163-8. Available from: https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC7580269/#:~:text=Both%203%20and%20 1%2Dday,to%20pre%2Dsurgical%20competences%20 acquisition
Moulton CA, Dubrowski A, Macrae H, Graham B, Grober E, Reznick R. Teaching surgical skills: what kind of practice makes perfect?: a randomized, controlled trial. Ann Surg [Internet]. 2006;244(3):400-9. doi: https://doi.org/10.1097/01.sla.0000234808.85789.6a
Vela J, Contreras C Jarry C, Varas J, Corvetto M. Recomendaciones generales para elaborar un programa de entrenamiento basado en simulación para desarrollar competencias en pregrado y postgrado. Simulación Clínica [Internet]. 2020;2(1):26-38. doi: https://doi. org/10.35366/92936
Jarry C, Inzunza M, Quezada J, Marino C, Zamorano E, Alvarado V, et al. Gimnasio de simulación quirúrgica: una herramienta educacional factible de entrenamiento continuo. Experiencia de un centro universitario. Simulación Clínica. [Internet]. 2019;1(1):18-24. doi: https://doi.org/10.35366/RSC191D
Kurashima Y, Hirano S. Systematic review of the implementation of simulation training in surgical residency curriculum. Surg Today [Internet]. 2017;47(7):777-82. doi: https://doi.org/10.1007/ s00595-016-1455-9
Downing SM. Validity: on the meaningful interpretation of assessment data. Med Educ. [Internet]. 2003;37(9):830-7. doi: https://doi.org/10.1046/j.1365- 2923.2003.01594.x
Cook DA, Beckman TJ. Current Concepts in Validity and Reliability for Psychometric Instruments: Theory and Application. Am J Med [Internet]. 2006;119(2):166.e7- 16. doi: https://doi.org/10.1016/j.amjmed.2005.10.036
Cook DA, Hatala R. Validation of educational assessments: a primer for simulation and beyond. Adv Simul [Internet]. 2016;1:31. doi: https://doi. org/10.1186/s41077-016-0033-y
Hennessey IA, Hewett P. Virtual reality versus box laparoscopic simulators in trainee selection and aptitude testing. Surg Laparosc Endosc Pct Tech [Internet]. 2014;24(4):318-21. doi: https://doi.org/10.1097/ SLE.0b013e3182a2f05f
Naismith LM, Cavalcanti RB. Validity of Cognitive Load Measures in Simulation-Based Training: A Systematic Review. Acad Med [Internet]. 2015;90(11 Suppl):S24-35. doi: https://doi.org/10.1097/ACM.0000000000000893
Messick S. Validity of Psychological Assesment: Validation of Inferences from Persons’ Responses and Performances As Scientific Inquiry into Score Meaning [Internet]. Educational Testing Service;1989:13-104. Available from: https://files.eric.ed.gov/fulltext/ ED380496.pdf
Varas J, Mejía R, Riquelme A, Maluenda F, Buckel E, Salinas J, et al. Significant transfer of surgical skills obtained with an advanced laparoscopic training program to a laparoscopic jejunojejunostomy in a live porcine model: feasibility of learning advanced laparoscopy in a general surgery residency. Surg Endosc [Internet]. 2012;26(12):3486-94. doi: https:// doi.org/10.1007/s00464-012-2391-4
Boerebach BC, Arah OA, Busch OR, Lombarts KM. Reliable and valid tools for measuring surgeons’ teaching performance: residents’ vs. self evaluation. J Surg Educ [Internet]. 2012;69(4):511-20. doi: https:// doi.org/10.1016/j.jsurg.2012.04.003
Fluit C, Bolhuis S, Grol R, Ham M, Feskens R, Laan R, et al. Evaluation and feedback for effective clinical teaching in postgraduate medical education: validation of an assessment instrument incorporating the CanMEDS roles. Med Teach [Internet]. 2012;34(11):893-901. doi: https://doi.org/10.3109/0142159X.2012.699114
Ross S, Hamza D, Zulla R, Stasiuk S, Nichols D. Development of and Preliminary Validity Evidence for the EFeCT Feedback Scoring Tool. J Grad Med Educ [Internet]. 2022;14(1):71-9. doi: https://doi. org/10.4300/JGME-D-21-00602.1
Gaete MI, Belmar F, Cortés M, Alseidi A, Asbun D, Durán V, et al. Remote and asynchronous training network: from a SAGES grant to an eight-country remote laparoscopic simulation training program. Surg Endosc [Internet]. 2023;37(2):1458-65. doi: https://doi. org/10.1007/s00464-022-09386-5
dc.rights.coar.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.rights.uri.*.fl_str_mv http://creativecommons.org/licenses/by-nc-nd/2.5/co/
dc.rights.local.spa.fl_str_mv Abierto (Texto Completo)
dc.rights.creativecommons.*.fl_str_mv Atribución-NoComercial-SinDerivadas 2.5 Colombia
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc-nd/2.5/co/
Abierto (Texto Completo)
Atribución-NoComercial-SinDerivadas 2.5 Colombia
http://purl.org/coar/access_right/c_abf2
dc.format.mimetype.spa.fl_str_mv application/pdf
dc.publisher.grantor.spa.fl_str_mv Universidad Autónoma de Bucaramanga UNAB
dc.publisher.faculty.spa.fl_str_mv Facultad Ciencias de la Salud
dc.source.spa.fl_str_mv Vol. 25 Núm. 3 (2022): diciembre 2022 - marzo 2023: Innovación, Cirugía, Educación; 470-479
institution Universidad Autónoma de Bucaramanga - UNAB
bitstream.url.fl_str_mv https://repository.unab.edu.co/bitstream/20.500.12749/26139/1/Art%c3%adculo.pdf
https://repository.unab.edu.co/bitstream/20.500.12749/26139/2/license.txt
https://repository.unab.edu.co/bitstream/20.500.12749/26139/3/Art%c3%adculo.pdf.jpg
bitstream.checksum.fl_str_mv 93cf0874709e6301ab39e21c113d4605
737346e09d47a3db691f1370de49426a
b20b89839f9616d08cfedf5018bb987a
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
MD5
repository.name.fl_str_mv Repositorio Institucional | Universidad Autónoma de Bucaramanga - UNAB
repository.mail.fl_str_mv repositorio@unab.edu.co
_version_ 1814277362490015744
spelling Durán Espinoza, Valentinaddcaff0d-ff6a-4449-af92-917b5c024117Montero Jaras, Isabella0ee3a6c1-1f55-4da9-b904-cba3464f6cb3Miguieles Schilling, Mariana9946af9e-0ade-40bb-b896-06e03c6949abValencia Coronel, Brandon083bbac1-3ef8-4a8f-80f6-8af2c084d218Belmar Riveros, Franciscae78d1493-430c-4b89-b13c-42c32c9e626dGaete Dañobeitia, Maria Inésc46fc65e-e1f9-40e0-8860-501596066465Jarry Trujillo, Cristianeab945e2-61b8-4b54-8e4a-ef9e76924fa8Varas Cohen, Julián9d58700f-4cb7-4433-8d2c-677845ee5a812024-08-21T20:38:40Z2024-08-21T20:38:40Z2023-03-12i-ISSN 0123-7047e-ISSN 2382-4603http://hdl.handle.net/20.500.12749/26139instname:Universidad Autónoma de Bucaramanga UNABreponame:Repositorio Institucional UNABrepourl:https://repository.unab.edu.cohttps://doi.org/10.29375/01237047.4514El uso de la simulación en cirugía ha permitido acortar las curvas de aprendizaje mediante la práctica deliberada. A pesar de que se ha incorporado previamente, aún no existen recomendaciones claras para estandarizar su desarrollo e implementación. Este manuscrito pretende compartir recomendaciones basadas en nuestra experiencia, con más de doce años empleando y mejorando una metodología en la simulación quirúrgica laparoscópica. Temas de reflexión. Para transferir las habilidades quirúrgicas a un aprendiz, basamos nuestra metodología en un marco de tres pilares: El hardware y la infraestructura (herramientas con las que entrenar), el programa de entrenamiento (qué hacer), y la retroalimentación (cómo mejorar). La implementación de un programa rentable es factible: el hardware no necesita ser de alta fidelidad para transferir las habilidades, pero el programa necesita ser validado. Estos pilares han evolucionado a lo largo del tiempo incorporando tecnología: la presencia de expertos ha evolucionado a una modalidad remota y asincrónica mediante la grabación en vídeo de la ejecución del alumno, y permitiendo su retroalimentación. Aquel que entrega retroalimentación no tiene que ser necesariamente un clínico experto en la materia, sino una persona previamente formada como instructor. Esto permite una práctica deliberada hasta dominar la habilidad y establecer curvas de aprendizaje. Conclusiones. Se han presentado recomendaciones basadas en la experiencia de nuestro centro, explicando el marco de nuestra estrategia. Teniendo en cuenta estas sugerencias, se espera que nuestra metodología de simulación pueda ayudar al desarrollo e implementación de programas efectivos basados en la simulación a otros grupos e instituciones.The use of simulation in surgery has made it possible to shorten learning curves through deliberate practice. Although it has been incorporated long ago, there are still no clear recommendations to standardize its development and implementation. This manuscript aims to share recommendations based on our experience of more than twelve years of employing and improving a methodology in laparoscopic surgical simulation. Topics for Reflection. To transfer surgical skills to a trainee, we base our methodology on a three-pillar framework: The hardware and infrastructure (tools to train with), the training program itself (what to do), and the feedback (how to improve). Implementing a cost-effective program is feasible: the hardware does not need to be high fidelity to transfer skills, but the program needs to be validated. These pillars have evolved over time by incorporating technology: the on-site guidance from experts has changed to a remote and asynchronous modality by video recording the trainee’s execution, and by enabling remote and asynchronous feedback. The feedback provider does not necessarily have to be an expert clinician in the subject, but a person previously trained to be a trainer. This allows for deliberate practice until mastery has been reached and learning curves are consolidated. Conclusions. Recommendations based on the experience of our center have been presented, explaining the framework of our strategy. Considering these suggestions, it is hoped that our simulation methodology can aid the development and implementation of effective simulationbased programs for other groups and institutions.O uso de simulação em cirurgia tornou possível encurtar as curvas de aprendizagem por meio da prática deliberada. Embora tenha sido incorporado anteriormente, ainda não há recomendações claras para padronizar seu desenvolvimento e implementação. Este manuscrito pretende compartilhar recomendações com base em nossa experiência, com mais de doze anos usando e aprimorando uma metodologia em simulação cirúrgica laparoscópica. Temas de reflexão. Para transferir habilidades cirúrgicas para um aprendiz, baseamos nossa metodologia em uma estrutura de três pilares: o hardware e a infraestrutura (ferramentas para treinar), o programa de treinamento (o que fazer) e feedback (como melhorar). A implementação de um programa rentável é viável: o hardware não precisa ser de alta fidelidade para transferir as habilidades, mas o programa precisa ser validado. Esses pilares evoluíram ao longo do tempo incorporando a tecnologia: a presença de especialistas evoluiu para uma modalidade remota e assíncrona por meio da gravação em vídeo do desempenho do aluno e permitindo seu feedback. Quem dá feedback não precisa ser necessariamente um clínico especialista na área, mas sim uma pessoa previamente treinada como instrutor. Isso permite a prática deliberada até que a habilidade seja dominada e estabeleça curvas de aprendizado. Conclusões. Foram apresentadas recomendações baseadas na experiência do nosso centro, explicando o enquadramento da nossa estratégia. Levando em consideração essas sugestões, espera-se que nossa metodologia de simulação possa ajudar outros grupos e instituições a desenvolver e implementar programas eficazes baseados em simulação.application/pdfspahttps://revistas.unab.edu.co/index.php/medunab/article/view/4514/3720https://revistas.unab.edu.co/index.php/medunab/issue/view/286Lioce L. Healthcare simulation dictionary. 2nd Edition ed: Agency for Healthcare Research and Quality; [Internet]. New York. 2020. doi: https://doi. org/10.23970/simulationv2Khan K, Pattison T, Sherwood M. Simulation in medical education. Medical Teacher [Internet]. 2011;33(1):1-3. doi: https://doi.org/10.3109/0142159X.2010.519412Habib BA Chadli D. History of medical simulation. Tunis Med [Internet]. 2020;98(12):892-94. Available from: https://pubmed.ncbi.nlm.nih.gov/33479991/Jandu GK, Khan A. Angélique Marguerite Le Boursier du Coudray (1712–1790) – Pioneer of simulation. J Med Biogr [Internet]. 2021;29(2):121-22. doi: https:// doi.org/10.1177/09677720211002204Is Manual Cardiac Resuscitation. JAMA [Internet]. 1966;196(1):A36-A37. doi: https://doi.org/10.1001/ jama.1966.03100140020005Corvetto M, Bravo MP, Montaña R, Utili F, Escudero E, Boza C, et al. Simulación en educación médica: una sinopsis. Rev. Med. Chile [Internet]. 2013;141(1):70-9. doi: http://dx.doi.org/10.4067/ S0034-98872013000100010Carey JM, Rossler K. The How When Why of High Fidelity Simulation. StatPearls [Internet]. 2022 Available from: https://www.ncbi.nlm.nih.gov/books/ NBK559313/Ruz C, Besa P, Irarrázaval S, Vidal C, Nazar C, Varas J, et al. High-Fidelity Hybrid Simulation Not Only Optimizes Skills Acquisition But Improves Non- Technical Skills. J. Surg. Educ [Internet]. 2020;29. doi: https://doi.org/10.1007/s44186-022-00027-yMassoth C, Röder H, Ohlenburg H, Hessler M, Zarbock A, Pöpping DM, et al. High-fidelity is not superior to low-fidelity simulation but leads to overconfidence in medical students. BMC Med Educ [Internet]. 2019;19(1):29. doi: https://doi.org/10.1186/s12909- 019-1464-7Fritz PZ, Gray T, Flanagan B. Review of mannequinbased high-fidelity simulation in emergency medicine. Emerg Med Australas [Internet]. 2008;20(1):1-9. doi: https://doi.org/10.1111/j.1742-6723.2007.01022.xCameron JL. William Stewart Halsted. Our surgical heritage. Ann Surg. [Internet]. 1997;225(5):445-58. doi: https://doi.org/10.1097/00000658-199705000-00002Beyer L, Troyer JD, Mancini J, Bladou F, Berdah SV, Karsenty G. Impact of laparoscopy simulator training on the technical skills of future surgeons in the operating room: a prospective study. Am J Surg [Internet]. 2011;202(3):265-72. doi: https://doi.org/10.1016/j. amjsurg.2010.11.008Beyer-Berjot L, Palter V, Grantcharov T, Aggarwal R. Advanced training in laparoscopic abdominal surgery: a systematic review. Surgery [Internet]. 2014;156(3):676- 88. doi: https://doi.org/10.1016/j.surg.2014.04.044Yudkowsky R, Park YS, Lineberry M, Knox A, Ritter EM. Setting Mastery Learning Standards. Acad Med [Internet]. 2015;90(11):1495-500. doi: https://doi. org/10.1097/ACM.0000000000000887Ericsson KA, Harwell KW. Deliberate Practice and Proposed Limits on the Effects of Practice on the Acquisition of Expert Performance: Why the Original Definition Matters and Recommendations for Future Research. Front Psychol [Internet]. 2019;10:2396. doi: https://doi.org/10.3389/fpsyg.2019.02396Siddaiah-Subramanya M, Smith S, Lonie J. Mastery learning: how is it helpful? An analytical review. Adv Med Educ Pract [Internet]. 2017;8:269-75. doi: https:// doi.org/10.2147/AMEP.S131638Boza C, León F, Buckel E, Riquelme A, Crovari F, Martínez J, et al. Simulation-trained junior residents perform better than general surgeons on advanced laparoscopic cases. Surg Endosc [Internet]. 2017;31(1):135-41. doi: https:// doi.org/10.1007/s00464-016-4942-6McGaghie WC, Adler M, Salzman DH. Instructional Design and Delivery for Mastery Learning. Springer International Publishing [Internet]. 2020:71-88. doi: https://doi.org/10.1007/978-3-030-34811-3_4Hutter MM, Kellogg KC, Ferguson CM, Abbott WM, Warshaw AL. The impact of the 80-hour resident workweek on surgical residents and attending surgeons. Ann Surg [Internet]. 2006;243(6):864-75. doi: https://doi. org/10.1097/01.sla.0000220042.4831Russ JB, McKenney AS, Patel AB. An identity crisis: the need for core competencies in undergraduate medical education. Med Educ Online [Internet]. 2013;18:1-2. doi: https://doi.org/10.3402/meo.v18i0.21028Jarry-Trujillo C, Achurra-Tirado P, Escalona-Vivas G, Crovari-Eulufi F, Varas-Cohen J. Surgical training during COVID-19: a validated solution to keep on practicing. Br J Surg [Internet]. 2020;107(11):e468-e69. doi: https://doi. org/10.1002/bjs.11923Quezada J, Achurra P, Asbun D, Polom K, Roviello F, Buckel E, et al. Smartphone application supplements laparoscopic training through simulation by reducing the need for feedback from expert tutors. Surg Open Sci [Internet]. 2019;1(2):100-104. doi: https://doi. org/10.1016/j.sopen.2019.05.006Quezada J, Achurra P, Jarry C, Asbun D, Tejos R, Inzunza M, et al. Minimally invasive tele-mentoring opportunity-the mito project. Surg Endosc. [Internet]. 2020;34(6):2585-92. doi: https://doi.org/10.1007/ s00464-019-07024-1Brian R, Davis G, Park KM, Alseidi A. Evolution of laparoscopic education and the laparoscopic learning curve: a review of the literature. Laparosc Surg [Internet]. 2022;6(34):184-92. doi: https://dx.doi. org/10.21037/ls-22-29Argay IM, Lawrence T, Afors K, Centini G, Lazzeri L, Habib N, et al. 1 vs 3 days laparoscopic suturing courses: is it feasible to design a valid training curriculum? Facts Views Vis Obgyn. [Internet]. 2020;12(3):163-8. Available from: https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC7580269/#:~:text=Both%203%20and%20 1%2Dday,to%20pre%2Dsurgical%20competences%20 acquisitionMoulton CA, Dubrowski A, Macrae H, Graham B, Grober E, Reznick R. Teaching surgical skills: what kind of practice makes perfect?: a randomized, controlled trial. Ann Surg [Internet]. 2006;244(3):400-9. doi: https://doi.org/10.1097/01.sla.0000234808.85789.6aVela J, Contreras C Jarry C, Varas J, Corvetto M. Recomendaciones generales para elaborar un programa de entrenamiento basado en simulación para desarrollar competencias en pregrado y postgrado. Simulación Clínica [Internet]. 2020;2(1):26-38. doi: https://doi. org/10.35366/92936Jarry C, Inzunza M, Quezada J, Marino C, Zamorano E, Alvarado V, et al. Gimnasio de simulación quirúrgica: una herramienta educacional factible de entrenamiento continuo. Experiencia de un centro universitario. Simulación Clínica. [Internet]. 2019;1(1):18-24. doi: https://doi.org/10.35366/RSC191DKurashima Y, Hirano S. Systematic review of the implementation of simulation training in surgical residency curriculum. Surg Today [Internet]. 2017;47(7):777-82. doi: https://doi.org/10.1007/ s00595-016-1455-9Downing SM. Validity: on the meaningful interpretation of assessment data. Med Educ. [Internet]. 2003;37(9):830-7. doi: https://doi.org/10.1046/j.1365- 2923.2003.01594.xCook DA, Beckman TJ. Current Concepts in Validity and Reliability for Psychometric Instruments: Theory and Application. Am J Med [Internet]. 2006;119(2):166.e7- 16. doi: https://doi.org/10.1016/j.amjmed.2005.10.036Cook DA, Hatala R. Validation of educational assessments: a primer for simulation and beyond. Adv Simul [Internet]. 2016;1:31. doi: https://doi. org/10.1186/s41077-016-0033-yHennessey IA, Hewett P. Virtual reality versus box laparoscopic simulators in trainee selection and aptitude testing. Surg Laparosc Endosc Pct Tech [Internet]. 2014;24(4):318-21. doi: https://doi.org/10.1097/ SLE.0b013e3182a2f05fNaismith LM, Cavalcanti RB. Validity of Cognitive Load Measures in Simulation-Based Training: A Systematic Review. Acad Med [Internet]. 2015;90(11 Suppl):S24-35. doi: https://doi.org/10.1097/ACM.0000000000000893Messick S. Validity of Psychological Assesment: Validation of Inferences from Persons’ Responses and Performances As Scientific Inquiry into Score Meaning [Internet]. Educational Testing Service;1989:13-104. Available from: https://files.eric.ed.gov/fulltext/ ED380496.pdfVaras J, Mejía R, Riquelme A, Maluenda F, Buckel E, Salinas J, et al. Significant transfer of surgical skills obtained with an advanced laparoscopic training program to a laparoscopic jejunojejunostomy in a live porcine model: feasibility of learning advanced laparoscopy in a general surgery residency. Surg Endosc [Internet]. 2012;26(12):3486-94. doi: https:// doi.org/10.1007/s00464-012-2391-4Boerebach BC, Arah OA, Busch OR, Lombarts KM. Reliable and valid tools for measuring surgeons’ teaching performance: residents’ vs. self evaluation. J Surg Educ [Internet]. 2012;69(4):511-20. doi: https:// doi.org/10.1016/j.jsurg.2012.04.003Fluit C, Bolhuis S, Grol R, Ham M, Feskens R, Laan R, et al. Evaluation and feedback for effective clinical teaching in postgraduate medical education: validation of an assessment instrument incorporating the CanMEDS roles. Med Teach [Internet]. 2012;34(11):893-901. doi: https://doi.org/10.3109/0142159X.2012.699114Ross S, Hamza D, Zulla R, Stasiuk S, Nichols D. Development of and Preliminary Validity Evidence for the EFeCT Feedback Scoring Tool. J Grad Med Educ [Internet]. 2022;14(1):71-9. doi: https://doi. org/10.4300/JGME-D-21-00602.1Gaete MI, Belmar F, Cortés M, Alseidi A, Asbun D, Durán V, et al. Remote and asynchronous training network: from a SAGES grant to an eight-country remote laparoscopic simulation training program. Surg Endosc [Internet]. 2023;37(2):1458-65. doi: https://doi. org/10.1007/s00464-022-09386-5http://creativecommons.org/licenses/by-nc-nd/2.5/co/Abierto (Texto Completo)Atribución-NoComercial-SinDerivadas 2.5 Colombiahttp://purl.org/coar/access_right/c_abf2Vol. 25 Núm. 3 (2022): diciembre 2022 - marzo 2023: Innovación, Cirugía, Educación; 470-479Ejercicio de SimulaciónLaparoscopíaEducación MédicaRetroalimentaciónEntrenamiento SimuladoCirugía GeneralMedical sciencesLife sciencesSimulation ExerciseLaparoscopyEducation MedicalFeedbackSimulation TrainingGeneral SurgeryHealth sciencesCiências médicasCiências da vidaCiências da saúdeExercício de SimulaçãoLaparoscopiaEducação MédicaRetroalimentaçãoTreinamento por SimulaçãoCirurgia GeralCiencias médicasCiencias de la vidaCiencias de la saludRecomendaciones para desarrollar un programa de formación en simulación quirúrgica laparoscópica. Perspectivas obtenidas tras 12 años de formación de cirujanosRecommendations to Develop a Laparoscopic Surgical Simulation Training Program. Insights Gained After 12 Years of Training SurgeonsRecomendações para o desenvolvimento de um programa de formação em simulação cirúrgica laparoscópica. Perspectivas obtidas após 12 anos de formação de cirurgiõesArticleinfo:eu-repo/semantics/articleArtículohttp://purl.org/coar/resource_type/c_2df8fbb1http://purl.org/coar/resource_type/c_6501http://purl.org/redcol/resource_type/ARThttp://purl.org/coar/version/c_970fb48d4fbd8a85Universidad Autónoma de Bucaramanga UNABFacultad Ciencias de la SaludORIGINALArtículo.pdfArtículo.pdfArtículoapplication/pdf745787https://repository.unab.edu.co/bitstream/20.500.12749/26139/1/Art%c3%adculo.pdf93cf0874709e6301ab39e21c113d4605MD51open accessLICENSElicense.txtlicense.txttext/plain; charset=utf-8183https://repository.unab.edu.co/bitstream/20.500.12749/26139/2/license.txt737346e09d47a3db691f1370de49426aMD52open accessTHUMBNAILArtículo.pdf.jpgArtículo.pdf.jpgIM Thumbnailimage/jpeg13359https://repository.unab.edu.co/bitstream/20.500.12749/26139/3/Art%c3%adculo.pdf.jpgb20b89839f9616d08cfedf5018bb987aMD53open access20.500.12749/26139oai:repository.unab.edu.co:20.500.12749/261392024-08-21 22:00:52.761open accessRepositorio Institucional | Universidad Autónoma de Bucaramanga - UNABrepositorio@unab.edu.coTGFzIHB1YmxpY2FjaW9uZXMgZGUgbGEgcmV2aXN0YSBNZWRVTkFCIGVzdMOhbiBiYWpvIHVuYSBMaWNlbmNpYSBkZSBBdHJpYnVjacOzbiBkZSBCaWVuZXMgQ29tdW5lcyBDcmVhdGl2b3MgKENyZWF0aXZlIENvbW1vbnMsIENDKSB0aXBvIDQuMCwgY29uIGRlcmVjaG9zIGRlIGF0cmlidWNpw7NuIHkgbm8gY29tZXJjaWFs