Development of a simulator and training curriculum for liver trauma surgery training for general surgeons

The incidence of trauma in Japan is lower than that in other countries, and trauma patients are often managed by local general surgeons. However, general surgeons rarely have access to training opportunities in the field of abdominal trauma. Therefore, the objective of this pilot study was to develop a training curriculum for general surgeons using an inexpensive abdominal trauma simulator, for liver trauma and investigate its feasibility and validity.

The abdominal cavity and organs were molded with clear silicone resin and urethane resin to reproduce the anatomical structures required for liver trauma surgery training. An assessment tool was developed to evaluate trauma management skills in the simulation and clinical environments based on the consensus of expert trauma surgeons. Board-certified acute-care and general surgeons executed liver trauma scenarios in the simulator and their performance was rated blindly using the assessment tool. Didactic materials and two sets of tests were developed based on the learning objectives for liver trauma management. Board-certified acute-care surgeons and surgical residents completed both questionnaires.

The simulator was developed at a cost of $1000; however, the cost of each trauma-training course was minimal. All participants were trained to use the simulator and rated the simulator highly. The inter-rater reliability between the two blinded raters was high (intraclass correlation coefficient = 0.88). Board-certified acute-care surgeons scored significantly better than general surgeons (P < 0.01).

We developed a training curriculum using an inexpensive simulator for liver trauma surgery and demonstrated its feasibility and validity.