Identifying and reducing errors with surgical simulation
Identifieur interne : 004071 ( Istex/Corpus ); précédent : 004070; suivant : 004072Identifying and reducing errors with surgical simulation
Auteurs : M P Fried ; R. Satava ; S. Weghorst ; A G Gallagher ; C. Sasaki ; D. Ross ; M. Sinanan ; J I Uribe ; M. Zeltsan ; H. Arora ; H. CuellarSource :
- Quality and Safety in Health Care [ 1475-3898 ] ; 2004-10.
English descriptors
- KwdEn :
- AHRQ, Agency for Healthcare Research and Quality, ES3, endoscopic sinus surgery simulator, ESS, endoscopic sinus surgery, MIST-VR, minimally invasive surgical trainer virtual reality, PicSOr, pictorial surface orientation, VR, virtual reality, endoscopic sinus surgery, error reduction, patient safety, surgical simulation.
Abstract
The major determinant of a patient’s safety and outcome is the skill and judgment of the surgeon. While knowledge base and decision processing are evaluated during residency, technical skills—which are at the core of the profession—are not evaluated. Innovative state of the art simulation devices that train both surgical tasks and skills, without risk to patients, should allow for the detection and analysis of errors and “near misses”. Studies have validated the use of a sophisticated endoscopic sinus surgery simulator (ES3) for training residents on a procedural basis. Assessments are proceeding as to whether the integration of a comprehensive ES3 training programme into the residency curriculum will have long term effects on surgical performance and patient outcomes. Using various otolaryngology residencies, subjects are exposed to mentored training on the ES3 as well as to minimally invasive trainers such as the MIST-VR. Technical errors are identified and quantified on the simulator and intraoperatively. Through a web based database, individual performance can be compared against a national standard. An upgraded version of the ES3 will be developed which will support patient specific anatomical models. This advance will allow study of the effects of simulated rehearsal of patient specific procedures (mission rehearsal) on patient outcomes and surgical errors during the actual procedure. The information gained from these studies will help usher in the next generation of surgical simulators that are anticipated to have significant impact on patient safety.
Url:
DOI: 10.1136/qshc.2004.009969
Links to Exploration step
ISTEX:2155C32CA4A1E30AFEF106802ADAE31E47EEB8DCLe document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Identifying and reducing errors with surgical simulation</title><author><name sortKey="Fried, M P" sort="Fried, M P" uniqKey="Fried M" first="M P" last="Fried">M P Fried</name><affiliation><mods:affiliation>Department of Otolaryngology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Satava, R" sort="Satava, R" uniqKey="Satava R" first="R" last="Satava">R. Satava</name><affiliation><mods:affiliation>Department of Surgery University of Washington, Seattle, Washington, USA</mods:affiliation></affiliation></author><author><name sortKey="Weghorst, S" sort="Weghorst, S" uniqKey="Weghorst S" first="S" last="Weghorst">S. Weghorst</name><affiliation><mods:affiliation>Human Interface Technology Laboratory, University of Washington</mods:affiliation></affiliation></author><author><name sortKey="Gallagher, A G" sort="Gallagher, A G" uniqKey="Gallagher A" first="A G" last="Gallagher">A G Gallagher</name><affiliation><mods:affiliation>Emory Endosurgery Unit, Emory University School of Medicine, Atlanta, Georgia, USA</mods:affiliation></affiliation></author><author><name sortKey="Sasaki, C" sort="Sasaki, C" uniqKey="Sasaki C" first="C" last="Sasaki">C. Sasaki</name><affiliation><mods:affiliation>Department of Surgery Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA</mods:affiliation></affiliation></author><author><name sortKey="Ross, D" sort="Ross, D" uniqKey="Ross D" first="D" last="Ross">D. Ross</name><affiliation><mods:affiliation>Department of Surgery, Division of Otolaryngology, Yale University School of Medicine</mods:affiliation></affiliation></author><author><name sortKey="Sinanan, M" sort="Sinanan, M" uniqKey="Sinanan M" first="M" last="Sinanan">M. Sinanan</name><affiliation><mods:affiliation>Department of Surgery, University of Washington</mods:affiliation></affiliation></author><author><name sortKey="Uribe, J I" sort="Uribe, J I" uniqKey="Uribe J" first="J I" last="Uribe">J I Uribe</name><affiliation><mods:affiliation>Otolaryngology Surgery Simulator Center, Montefiore Medical Center, Bronx, New York</mods:affiliation></affiliation></author><author><name sortKey="Zeltsan, M" sort="Zeltsan, M" uniqKey="Zeltsan M" first="M" last="Zeltsan">M. Zeltsan</name><affiliation><mods:affiliation>Otolaryngology Surgery Simulator Center, Montefiore Medical Center</mods:affiliation></affiliation></author><author><name sortKey="Arora, H" sort="Arora, H" uniqKey="Arora H" first="H" last="Arora">H. Arora</name><affiliation><mods:affiliation>Albert Einstein College of Medicine, Bronx, New York</mods:affiliation></affiliation></author><author><name sortKey="Cuellar, H" sort="Cuellar, H" uniqKey="Cuellar H" first="H" last="Cuellar">H. Cuellar</name><affiliation><mods:affiliation>Otolaryngology Surgery Simulator Center, Montefiore Medical Center</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:2155C32CA4A1E30AFEF106802ADAE31E47EEB8DC</idno><date when="2004" year="2004">2004</date><idno type="doi">10.1136/qshc.2004.009969</idno><idno type="url">https://api.istex.fr/document/2155C32CA4A1E30AFEF106802ADAE31E47EEB8DC/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">004071</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Identifying and reducing errors with surgical simulation</title><author><name sortKey="Fried, M P" sort="Fried, M P" uniqKey="Fried M" first="M P" last="Fried">M P Fried</name><affiliation><mods:affiliation>Department of Otolaryngology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Satava, R" sort="Satava, R" uniqKey="Satava R" first="R" last="Satava">R. Satava</name><affiliation><mods:affiliation>Department of Surgery University of Washington, Seattle, Washington, USA</mods:affiliation></affiliation></author><author><name sortKey="Weghorst, S" sort="Weghorst, S" uniqKey="Weghorst S" first="S" last="Weghorst">S. Weghorst</name><affiliation><mods:affiliation>Human Interface Technology Laboratory, University of Washington</mods:affiliation></affiliation></author><author><name sortKey="Gallagher, A G" sort="Gallagher, A G" uniqKey="Gallagher A" first="A G" last="Gallagher">A G Gallagher</name><affiliation><mods:affiliation>Emory Endosurgery Unit, Emory University School of Medicine, Atlanta, Georgia, USA</mods:affiliation></affiliation></author><author><name sortKey="Sasaki, C" sort="Sasaki, C" uniqKey="Sasaki C" first="C" last="Sasaki">C. Sasaki</name><affiliation><mods:affiliation>Department of Surgery Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA</mods:affiliation></affiliation></author><author><name sortKey="Ross, D" sort="Ross, D" uniqKey="Ross D" first="D" last="Ross">D. Ross</name><affiliation><mods:affiliation>Department of Surgery, Division of Otolaryngology, Yale University School of Medicine</mods:affiliation></affiliation></author><author><name sortKey="Sinanan, M" sort="Sinanan, M" uniqKey="Sinanan M" first="M" last="Sinanan">M. Sinanan</name><affiliation><mods:affiliation>Department of Surgery, University of Washington</mods:affiliation></affiliation></author><author><name sortKey="Uribe, J I" sort="Uribe, J I" uniqKey="Uribe J" first="J I" last="Uribe">J I Uribe</name><affiliation><mods:affiliation>Otolaryngology Surgery Simulator Center, Montefiore Medical Center, Bronx, New York</mods:affiliation></affiliation></author><author><name sortKey="Zeltsan, M" sort="Zeltsan, M" uniqKey="Zeltsan M" first="M" last="Zeltsan">M. Zeltsan</name><affiliation><mods:affiliation>Otolaryngology Surgery Simulator Center, Montefiore Medical Center</mods:affiliation></affiliation></author><author><name sortKey="Arora, H" sort="Arora, H" uniqKey="Arora H" first="H" last="Arora">H. Arora</name><affiliation><mods:affiliation>Albert Einstein College of Medicine, Bronx, New York</mods:affiliation></affiliation></author><author><name sortKey="Cuellar, H" sort="Cuellar, H" uniqKey="Cuellar H" first="H" last="Cuellar">H. Cuellar</name><affiliation><mods:affiliation>Otolaryngology Surgery Simulator Center, Montefiore Medical Center</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Quality and Safety in Health Care</title><title level="j" type="abbrev">Qual Saf Health Care</title><idno type="ISSN">1475-3898</idno><idno type="eISSN">1475-3901</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2004-10">2004-10</date><biblScope unit="volume">13</biblScope><biblScope unit="supplement">suppl 1</biblScope><biblScope unit="page" from="i19">i19</biblScope></imprint><idno type="ISSN">1475-3898</idno></series><idno type="istex">2155C32CA4A1E30AFEF106802ADAE31E47EEB8DC</idno><idno type="DOI">10.1136/qshc.2004.009969</idno><idno type="href">qhc-13-i19.pdf</idno><idno type="PMID">15465950</idno><idno type="local">0130019</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1475-3898</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>AHRQ, Agency for Healthcare Research and Quality</term><term>ES3, endoscopic sinus surgery simulator</term><term>ESS, endoscopic sinus surgery</term><term>MIST-VR, minimally invasive surgical trainer virtual reality</term><term>PicSOr, pictorial surface orientation</term><term>VR, virtual reality</term><term>endoscopic sinus surgery</term><term>error reduction</term><term>patient safety</term><term>surgical simulation</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The major determinant of a patient’s safety and outcome is the skill and judgment of the surgeon. While knowledge base and decision processing are evaluated during residency, technical skills—which are at the core of the profession—are not evaluated. Innovative state of the art simulation devices that train both surgical tasks and skills, without risk to patients, should allow for the detection and analysis of errors and “near misses”. Studies have validated the use of a sophisticated endoscopic sinus surgery simulator (ES3) for training residents on a procedural basis. Assessments are proceeding as to whether the integration of a comprehensive ES3 training programme into the residency curriculum will have long term effects on surgical performance and patient outcomes. Using various otolaryngology residencies, subjects are exposed to mentored training on the ES3 as well as to minimally invasive trainers such as the MIST-VR. Technical errors are identified and quantified on the simulator and intraoperatively. Through a web based database, individual performance can be compared against a national standard. An upgraded version of the ES3 will be developed which will support patient specific anatomical models. This advance will allow study of the effects of simulated rehearsal of patient specific procedures (mission rehearsal) on patient outcomes and surgical errors during the actual procedure. The information gained from these studies will help usher in the next generation of surgical simulators that are anticipated to have significant impact on patient safety.</div></front></TEI><istex><corpusName>bmj</corpusName><author><json:item><name>M P Fried</name><affiliations><json:string>Department of Otolaryngology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, USA</json:string></affiliations></json:item><json:item><name>R Satava</name><affiliations><json:string>Department of Surgery University of Washington, Seattle, Washington, USA</json:string></affiliations></json:item><json:item><name>S Weghorst</name><affiliations><json:string>Human Interface Technology Laboratory, University of Washington</json:string></affiliations></json:item><json:item><name>A G Gallagher</name><affiliations><json:string>Emory Endosurgery Unit, Emory University School of Medicine, Atlanta, Georgia, USA</json:string></affiliations></json:item><json:item><name>C Sasaki</name><affiliations><json:string>Department of Surgery Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA</json:string></affiliations></json:item><json:item><name>D Ross</name><affiliations><json:string>Department of Surgery, Division of Otolaryngology, Yale University School of Medicine</json:string></affiliations></json:item><json:item><name>M Sinanan</name><affiliations><json:string>Department of Surgery, University of Washington</json:string></affiliations></json:item><json:item><name>J I Uribe</name><affiliations><json:string>Otolaryngology Surgery Simulator Center, Montefiore Medical Center, Bronx, New York</json:string></affiliations></json:item><json:item><name>M Zeltsan</name><affiliations><json:string>Otolaryngology Surgery Simulator Center, Montefiore Medical Center</json:string></affiliations></json:item><json:item><name>H Arora</name><affiliations><json:string>Albert Einstein College of Medicine, Bronx, New York</json:string></affiliations></json:item><json:item><name>H Cuellar</name><affiliations><json:string>Otolaryngology Surgery Simulator Center, Montefiore Medical Center</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>AHRQ, Agency for Healthcare Research and Quality</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>ES3, endoscopic sinus surgery simulator</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>ESS, endoscopic sinus surgery</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>MIST-VR, minimally invasive surgical trainer virtual reality</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>PicSOr, pictorial surface orientation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>VR, virtual reality</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>error reduction</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>patient safety</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>surgical simulation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>endoscopic sinus surgery</value></json:item></subject><language><json:string>eng</json:string></language><abstract>The major determinant of a patient’s safety and outcome is the skill and judgment of the surgeon. While knowledge base and decision processing are evaluated during residency, technical skills—which are at the core of the profession—are not evaluated. Innovative state of the art simulation devices that train both surgical tasks and skills, without risk to patients, should allow for the detection and analysis of errors and “near misses”. Studies have validated the use of a sophisticated endoscopic sinus surgery simulator (ES3) for training residents on a procedural basis. Assessments are proceeding as to whether the integration of a comprehensive ES3 training programme into the residency curriculum will have long term effects on surgical performance and patient outcomes. Using various otolaryngology residencies, subjects are exposed to mentored training on the ES3 as well as to minimally invasive trainers such as the MIST-VR. Technical errors are identified and quantified on the simulator and intraoperatively. Through a web based database, individual performance can be compared against a national standard. An upgraded version of the ES3 will be developed which will support patient specific anatomical models. This advance will allow study of the effects of simulated rehearsal of patient specific procedures (mission rehearsal) on patient outcomes and surgical errors during the actual procedure. The information gained from these studies will help usher in the next generation of surgical simulators that are anticipated to have significant impact on patient safety.</abstract><qualityIndicators><score>7.82</score><pdfVersion>1.2</pdfVersion><pdfPageSize>612 x 792 pts (letter)</pdfPageSize><refBibsNative>false</refBibsNative><keywordCount>10</keywordCount><abstractCharCount>1584</abstractCharCount><pdfWordCount>6241</pdfWordCount><pdfCharCount>42053</pdfCharCount><pdfPageCount>8</pdfPageCount><abstractWordCount>235</abstractWordCount></qualityIndicators><title>Identifying and reducing errors with surgical simulation</title><pmid><json:string>15465950</json:string></pmid><genre.original><json:string>other</json:string></genre.original><genre><json:string>other</json:string></genre><host><volume>13</volume><pages><first>i19</first></pages><issn><json:string>1475-3898</json:string></issn><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1475-3901</json:string></eissn><title>Quality and Safety in Health Care</title></host><publicationDate>2004</publicationDate><copyrightDate>2004</copyrightDate><doi><json:string>10.1136/qshc.2004.009969</json:string></doi><id>2155C32CA4A1E30AFEF106802ADAE31E47EEB8DC</id><score>1</score><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/2155C32CA4A1E30AFEF106802ADAE31E47EEB8DC/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/2155C32CA4A1E30AFEF106802ADAE31E47EEB8DC/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/2155C32CA4A1E30AFEF106802ADAE31E47EEB8DC/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Identifying and reducing errors with surgical simulation</title><respStmt xml:id="ISTEX-API" resp="Références bibliographiques récupérées via GROBID" name="ISTEX-API (INIST-CNRS)"></respStmt></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>BMJ Publishing Group Ltd</publisher><availability><p>BMJ</p></availability><date>2004-10-01</date></publicationStmt><notesStmt><note>Correspondence to:
Dr Marvin P Fried
Montefiore Medical Center, Department of Otolaryngology, 3400 Bainbridge Ave 3rd Floor, Bronx, NY 10467; mfried@montefiore.org</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Identifying and reducing errors with surgical simulation</title><author><persName><forename type="first">M P</forename><surname>Fried</surname></persName><affiliation>Department of Otolaryngology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, USA</affiliation></author><author><persName><forename type="first">R</forename><surname>Satava</surname></persName><affiliation>Department of Surgery University of Washington, Seattle, Washington, USA</affiliation></author><author><persName><forename type="first">S</forename><surname>Weghorst</surname></persName><affiliation>Human Interface Technology Laboratory, University of Washington</affiliation></author><author><persName><forename type="first">A G</forename><surname>Gallagher</surname></persName><affiliation>Emory Endosurgery Unit, Emory University School of Medicine, Atlanta, Georgia, USA</affiliation></author><author><persName><forename type="first">C</forename><surname>Sasaki</surname></persName><affiliation>Department of Surgery Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA</affiliation></author><author><persName><forename type="first">D</forename><surname>Ross</surname></persName><affiliation>Department of Surgery, Division of Otolaryngology, Yale University School of Medicine</affiliation></author><author><persName><forename type="first">M</forename><surname>Sinanan</surname></persName><affiliation>Department of Surgery, University of Washington</affiliation></author><author><persName><forename type="first">J I</forename><surname>Uribe</surname></persName><affiliation>Otolaryngology Surgery Simulator Center, Montefiore Medical Center, Bronx, New York</affiliation></author><author><persName><forename type="first">M</forename><surname>Zeltsan</surname></persName><affiliation>Otolaryngology Surgery Simulator Center, Montefiore Medical Center</affiliation></author><author><persName><forename type="first">H</forename><surname>Arora</surname></persName><affiliation>Albert Einstein College of Medicine, Bronx, New York</affiliation></author><author><persName><forename type="first">H</forename><surname>Cuellar</surname></persName><affiliation>Otolaryngology Surgery Simulator Center, Montefiore Medical Center</affiliation></author></analytic><monogr><title level="j">Quality and Safety in Health Care</title><title level="j" type="abbrev">Qual Saf Health Care</title><idno type="pISSN">1475-3898</idno><idno type="eISSN">1475-3901</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2004-10"></date><biblScope unit="volume">13</biblScope><biblScope unit="supplement">suppl 1</biblScope><biblScope unit="page" from="i19">i19</biblScope></imprint></monogr><idno type="istex">2155C32CA4A1E30AFEF106802ADAE31E47EEB8DC</idno><idno type="DOI">10.1136/qshc.2004.009969</idno><idno type="href">qhc-13-i19.pdf</idno><idno type="PMID">15465950</idno><idno type="local">0130019</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2004-10-01</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>The major determinant of a patient’s safety and outcome is the skill and judgment of the surgeon. While knowledge base and decision processing are evaluated during residency, technical skills—which are at the core of the profession—are not evaluated. Innovative state of the art simulation devices that train both surgical tasks and skills, without risk to patients, should allow for the detection and analysis of errors and “near misses”. Studies have validated the use of a sophisticated endoscopic sinus surgery simulator (ES3) for training residents on a procedural basis. Assessments are proceeding as to whether the integration of a comprehensive ES3 training programme into the residency curriculum will have long term effects on surgical performance and patient outcomes. Using various otolaryngology residencies, subjects are exposed to mentored training on the ES3 as well as to minimally invasive trainers such as the MIST-VR. Technical errors are identified and quantified on the simulator and intraoperatively. Through a web based database, individual performance can be compared against a national standard. An upgraded version of the ES3 will be developed which will support patient specific anatomical models. This advance will allow study of the effects of simulated rehearsal of patient specific procedures (mission rehearsal) on patient outcomes and surgical errors during the actual procedure. The information gained from these studies will help usher in the next generation of surgical simulators that are anticipated to have significant impact on patient safety.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>ABR</head><item><term>AHRQ, Agency for Healthcare Research and Quality</term></item><item><term>ES3, endoscopic sinus surgery simulator</term></item><item><term>ESS, endoscopic sinus surgery</term></item><item><term>MIST-VR, minimally invasive surgical trainer virtual reality</term></item><item><term>PicSOr, pictorial surface orientation</term></item><item><term>VR, virtual reality</term></item></list></keywords></textClass><textClass xml:lang="en"><keywords scheme="keyword"><list><head>KWD</head><item><term>error reduction</term></item><item><term>patient safety</term></item><item><term>surgical simulation</term></item><item><term>endoscopic sinus surgery</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2004-10-01">Created</change><change when="2004-10">Published</change><change xml:id="refBibs-istex" who="#ISTEX-API" when="2016-3-14">References added</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/2155C32CA4A1E30AFEF106802ADAE31E47EEB8DC/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article xml:lang="en" article-type="other"><front><journal-meta><journal-id journal-id-type="hwp">qhc</journal-id><journal-id journal-id-type="nlm-ta">Qual Saf Health Care</journal-id><journal-title>Quality and Safety in Health Care</journal-title><abbrev-journal-title abbrev-type="publisher">Qual Saf Health Care</abbrev-journal-title><issn pub-type="ppub">1475-3898</issn><issn pub-type="epub">1475-3901</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="other">0130019</article-id><article-id pub-id-type="doi">10.1136/qshc.2004.009969</article-id><article-id pub-id-type="other">qhc;13/suppl_1/i19</article-id><article-id pub-id-type="pmid">15465950</article-id><article-id pub-id-type="other">i19</article-id><article-id pub-id-type="other">qshc.2004.009969</article-id><article-categories><subj-group subj-group-type="heading"><subject content-type="original">ORIGINAL ARTICLE</subject></subj-group></article-categories><title-group><article-title>Identifying and reducing errors with surgical simulation</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Fried</surname><given-names>M P</given-names></name><xref rid="AFF1">1</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Satava</surname><given-names>R</given-names></name><xref rid="AFF2">2</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Weghorst</surname><given-names>S</given-names></name><xref rid="AFF3">3</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Gallagher</surname><given-names>A G</given-names></name><xref rid="AFF4">4</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Sasaki</surname><given-names>C</given-names></name><xref rid="AFF5">5</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Ross</surname><given-names>D</given-names></name><xref rid="AFF6">6</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Sinanan</surname><given-names>M</given-names></name><xref rid="AFF7">7</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Uribe</surname><given-names>J I</given-names></name><xref rid="AFF8">8</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Zeltsan</surname><given-names>M</given-names></name><xref rid="AFF9">9</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Arora</surname><given-names>H</given-names></name><xref rid="AFF10">10</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Cuellar</surname><given-names>H</given-names></name><xref rid="AFF11">11</xref></contrib><aff id="AFF1"><label>1</label>Department of Otolaryngology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, USA</aff><aff id="AFF2"><label>2</label>Department of Surgery University of Washington, Seattle, Washington, USA</aff><aff id="AFF3"><label>3</label>Human Interface Technology Laboratory, University of Washington</aff><aff id="AFF4"><label>4</label>Emory Endosurgery Unit, Emory University School of Medicine, Atlanta, Georgia, USA</aff><aff id="AFF5"><label>5</label>Department of Surgery Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA</aff><aff id="AFF6"><label>6</label>Department of Surgery, Division of Otolaryngology, Yale University School of Medicine</aff><aff id="AFF7"><label>7</label>Department of Surgery, University of Washington</aff><aff id="AFF8"><label>8</label>Otolaryngology Surgery Simulator Center, Montefiore Medical Center, Bronx, New York</aff><aff id="AFF9"><label>9</label>Otolaryngology Surgery Simulator Center, Montefiore Medical Center</aff><aff id="AFF10"><label>10</label>Albert Einstein College of Medicine, Bronx, New York</aff><aff id="AFF11"><label>11</label>Otolaryngology Surgery Simulator Center, Montefiore Medical Center</aff></contrib-group><author-notes><corresp>Correspondence to:
Dr Marvin P Fried
Montefiore Medical Center, Department of Otolaryngology, 3400 Bainbridge Ave 3rd Floor, Bronx, NY 10467; <ext-link xlink:href="mfriedmontefiore.org" ext-link-type="email" xlink:type="simple">mfried@montefiore.org</ext-link></corresp></author-notes><pub-date pub-type="ppub"><month>10</month><year>2004</year></pub-date><pub-date pub-type="epub"><day>1</day><month>10</month><year>2004</year></pub-date><volume>13</volume><volume-id pub-id-type="other">13</volume-id><volume-id pub-id-type="other">13</volume-id><issue>suppl 1</issue><issue-id pub-id-type="other">qhc;13/suppl_1</issue-id><issue-id pub-id-type="other" content-type="supplement">suppl_1</issue-id><issue-id pub-id-type="other">13/suppl_1</issue-id><issue-title>Simulation and team training</issue-title><fpage>i19</fpage><permissions><copyright-statement>Copyright 2004 Quality and Safety in Health Care</copyright-statement><copyright-year>2004</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="qhc-13-i19.pdf"></self-uri><abstract xml:lang="en"><p>The major determinant of a patient’s safety and outcome is the skill and judgment of the surgeon. While knowledge base and decision processing are evaluated during residency, technical skills—which are at the core of the profession—are not evaluated. Innovative state of the art simulation devices that train both surgical tasks and skills, without risk to patients, should allow for the detection and analysis of errors and “near misses”. Studies have validated the use of a sophisticated endoscopic sinus surgery simulator (ES3) for training residents on a procedural basis. Assessments are proceeding as to whether the integration of a comprehensive ES3 training programme into the residency curriculum will have long term effects on surgical performance and patient outcomes. Using various otolaryngology residencies, subjects are exposed to mentored training on the ES3 as well as to minimally invasive trainers such as the MIST-VR. Technical errors are identified and quantified on the simulator and intraoperatively. Through a web based database, individual performance can be compared against a national standard. An upgraded version of the ES3 will be developed which will support patient specific anatomical models. This advance will allow study of the effects of simulated rehearsal of patient specific procedures (mission rehearsal) on patient outcomes and surgical errors during the actual procedure. The information gained from these studies will help usher in the next generation of surgical simulators that are anticipated to have significant impact on patient safety.</p></abstract><kwd-group kwd-group-type="ABR" xml:lang="en"><kwd>AHRQ, Agency for Healthcare Research and Quality</kwd><kwd>ES3, endoscopic sinus surgery simulator</kwd><kwd>ESS, endoscopic sinus surgery</kwd><kwd>MIST-VR, minimally invasive surgical trainer virtual reality</kwd><kwd>PicSOr, pictorial surface orientation</kwd><kwd>VR, virtual reality</kwd></kwd-group><kwd-group kwd-group-type="KWD" xml:lang="en"><kwd>error reduction</kwd><kwd>patient safety</kwd><kwd>surgical simulation</kwd><kwd>endoscopic sinus surgery</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Identifying and reducing errors with surgical simulation</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Identifying and reducing errors with surgical simulation</title></titleInfo><name type="personal"><namePart type="given">M P</namePart><namePart type="family">Fried</namePart><affiliation>Department of Otolaryngology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">R</namePart><namePart type="family">Satava</namePart><affiliation>Department of Surgery University of Washington, Seattle, Washington, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">S</namePart><namePart type="family">Weghorst</namePart><affiliation>Human Interface Technology Laboratory, University of Washington</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">A G</namePart><namePart type="family">Gallagher</namePart><affiliation>Emory Endosurgery Unit, Emory University School of Medicine, Atlanta, Georgia, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C</namePart><namePart type="family">Sasaki</namePart><affiliation>Department of Surgery Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">D</namePart><namePart type="family">Ross</namePart><affiliation>Department of Surgery, Division of Otolaryngology, Yale University School of Medicine</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M</namePart><namePart type="family">Sinanan</namePart><affiliation>Department of Surgery, University of Washington</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J I</namePart><namePart type="family">Uribe</namePart><affiliation>Otolaryngology Surgery Simulator Center, Montefiore Medical Center, Bronx, New York</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M</namePart><namePart type="family">Zeltsan</namePart><affiliation>Otolaryngology Surgery Simulator Center, Montefiore Medical Center</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">H</namePart><namePart type="family">Arora</namePart><affiliation>Albert Einstein College of Medicine, Bronx, New York</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">H</namePart><namePart type="family">Cuellar</namePart><affiliation>Otolaryngology Surgery Simulator Center, Montefiore Medical Center</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="other" displayLabel="other"></genre><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">2004-10</dateIssued><dateCreated encoding="w3cdtf">2004-10-01</dateCreated><copyrightDate encoding="w3cdtf">2004</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">The major determinant of a patient’s safety and outcome is the skill and judgment of the surgeon. While knowledge base and decision processing are evaluated during residency, technical skills—which are at the core of the profession—are not evaluated. Innovative state of the art simulation devices that train both surgical tasks and skills, without risk to patients, should allow for the detection and analysis of errors and “near misses”. Studies have validated the use of a sophisticated endoscopic sinus surgery simulator (ES3) for training residents on a procedural basis. Assessments are proceeding as to whether the integration of a comprehensive ES3 training programme into the residency curriculum will have long term effects on surgical performance and patient outcomes. Using various otolaryngology residencies, subjects are exposed to mentored training on the ES3 as well as to minimally invasive trainers such as the MIST-VR. Technical errors are identified and quantified on the simulator and intraoperatively. Through a web based database, individual performance can be compared against a national standard. An upgraded version of the ES3 will be developed which will support patient specific anatomical models. This advance will allow study of the effects of simulated rehearsal of patient specific procedures (mission rehearsal) on patient outcomes and surgical errors during the actual procedure. The information gained from these studies will help usher in the next generation of surgical simulators that are anticipated to have significant impact on patient safety.</abstract><note type="author-notes">Correspondence to:
Dr Marvin P Fried
Montefiore Medical Center, Department of Otolaryngology, 3400 Bainbridge Ave 3rd Floor, Bronx, NY 10467; mfried@montefiore.org</note><subject lang="en"><genre>ABR</genre><topic>AHRQ, Agency for Healthcare Research and Quality</topic><topic>ES3, endoscopic sinus surgery simulator</topic><topic>ESS, endoscopic sinus surgery</topic><topic>MIST-VR, minimally invasive surgical trainer virtual reality</topic><topic>PicSOr, pictorial surface orientation</topic><topic>VR, virtual reality</topic></subject><subject lang="en"><genre>KWD</genre><topic>error reduction</topic><topic>patient safety</topic><topic>surgical simulation</topic><topic>endoscopic sinus surgery</topic></subject><relatedItem type="host"><titleInfo><title>Quality and Safety in Health Care</title></titleInfo><titleInfo type="abbreviated"><title>Qual Saf Health Care</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">1475-3898</identifier><identifier type="eISSN">1475-3901</identifier><identifier type="PublisherID-hwp">qhc</identifier><identifier type="PublisherID-nlm-ta">Qual Saf Health Care</identifier><part><date>2004</date><detail type="title"><title>Simulation and team training</title></detail><detail type="volume"><caption>vol.</caption><number>13</number></detail><detail type="supplement"><number>suppl 1</number></detail><extent unit="pages"><start>i19</start></extent></part></relatedItem><identifier type="istex">2155C32CA4A1E30AFEF106802ADAE31E47EEB8DC</identifier><identifier type="DOI">10.1136/qshc.2004.009969</identifier><identifier type="href">qhc-13-i19.pdf</identifier><identifier type="PMID">15465950</identifier><identifier type="local">0130019</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright 2004 Quality and Safety in Health Care</accessCondition><recordInfo><recordContentSource>BMJ</recordContentSource></recordInfo></mods></metadata><annexes><json:item><original>true</original><mimetype>image/jpeg</mimetype><extension>jpeg</extension><uri>https://api.istex.fr/document/2155C32CA4A1E30AFEF106802ADAE31E47EEB8DC/annexes/jpeg</uri></json:item></annexes><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Ticri/CIDE/explor/HapticV1/Data/Istex/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 004071 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Istex/Corpus/biblio.hfd -nk 004071 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Ticri/CIDE
|area= HapticV1
|flux= Istex
|étape= Corpus
|type= RBID
|clé= ISTEX:2155C32CA4A1E30AFEF106802ADAE31E47EEB8DC
|texte= Identifying and reducing errors with surgical simulation
}}
| This area was generated with Dilib version V0.6.23. |  |