To the Editor: Reznick and MacRae (Dec. 21 issue)1 report onthe current status of simulation in surgical-skills trainingand its various applications. Another potential use of simulationis as a part of the curriculum for medical students, with anaim to introduce hands-on skills training and evaluation earlyin their career. During surgical clerkships, only 67% of surveyedstudents thought that the surgical teaching and exposure theyhad received was adequate,2 and the majority of the exposureinvolved minor, "less risky" parts of surgical procedures, suchas tying knots or cutting sutures. Perhaps the exposure of studentsto surgical simulation would allow them to appreciate theirown technical ability, would reveal whether they were interestedin participating in technical procedures, and would thereforeinfluence their choice of residency training.
Vani Dandolu, M.D. Jordan Newmark, M.D. Temple University Hospital Philadelphia, PA 19140
References
Reznick RK, MacRae H. Teaching surgical skills -- changes in the wind. N Engl J Med 2006;355:2664-2669. [Free Full Text]
Ek EW, Ek ET, Mackay SD. Undergraduate experience of surgical teaching and its influence on career choice. ANZ J Surg 2005;75:713-718. [CrossRef][ISI][Medline]
The authors reply: Drs. Dandolu and Newmark outline anotherpotential application of training using surgical simulation.Although our article concentrated primarily on postgraduatetraining, we wholeheartedly agree that undergraduate studentsalso benefit from training in a surgical-skills laboratory setting.In our institution, a trial program of skills training was implementedat one of the four major teaching academies. Other studentsdemanded to be included, and we now offer laboratory-based skillstraining to every medical student at the beginning of the surgicalclerkship. This type of training benefits not only future surgicalresidents but also all future physicians who require technicalskills in their practice.
We would like to address one other issue relating to our article.Since its publication, we have heard from several colleagueswho have correctly pointed out that William Stewart Halsted,the great American surgeon, was never knighted.
Helen MacRae, M.D. Richard Reznick, M.D. University of Toronto Toronto, ON M5G 1L5, Canada richard.reznick{at}utoronto.ca
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