Simulación Médico-Quirúrgica: "Primun non Nocere" at "Errare humanum est". Segunda Parte.

Abstract

For the first time in over 100 years, there is a revolution in surgical education. One of the most important core technologies generating this revolution is simulation science. The old paradigm of "see one, do one, teach one" has now changed to "see several, learn the skills and simulation, do one, teach one". This means, that medical simulation includes not only the new applied technology of simulators but also new curricula, objective assessment methods, and standard criterion-based requirements. Worldwide attention has focused on the problem of medical errors and the need to improve patient safety; and the paradigm shift to outcomes-based education with its requirements for assessment and demonstration of competence. Main contribution to medical education is that simulation training has been shown to reduce the error in practice, reduces training time for residents and reduces response times to a clinical situation. This is very important in surgical education, as the complexity of modern surgical practice and the cognitive overload and technical subject to which are trainees practitioners and residents alike places in jeopardy of developing areas of Incompetence. With dynamic simulators, has increased the ability to develop complex training methods and new sophisticated routines to model that competence deficiency. The concept is: surgical skills. These can be achieved quickly and competently by residents through the use of advanced simulation, bringing great perioperative and economic benefits for the training institution. The current trend in USA is using it as an objective method of training and assessment for the acquisition of surgical license exams administered by the American Board of Surgery and the American Board of Colon and Rectal Surgery. Therefore, the development of training methods that test both the technical knowledge and clinical acumen are essential for aspects such as patient safety and financial goals. In the future, schools of surgery must consider the creation of Surgical Skills Center.