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Simulation in Plastic Surgery Training and Education: The Path Forward

Rosen, Joseph M. M.D.; Long, Sarah A. B.A.; McGrath, Dennis M. M.A.; Greer, Sarah E. M.D.

Plastic and Reconstructive Surgery: February 2009 - Volume 123 - Issue 2 - p 729-738
doi: 10.1097/PRS.0b013e3181958ec4
Special Topic: Original Articles

Summary: Computer-based training simulators have been used extensively, most notably in flight simulation. Over the past 20 years, surgical simulators have been developed, initially for training of minimally invasive surgery and more recently for open surgical simulation. The key effort in today’s surgical simulation field is to develop metrics to evaluate how well the skills learned in a simulator translate to improvement in real surgical skills, execution of procedures, and team cooperation in the operating room. The American College of Surgeons has begun implementing a phased approach to introduce simulation in training and education for general surgery. The authors believe that a similar training plan should be mandated for plastic surgery, to take advantage of the use of computers, virtual reality, and simulation in the training of plastic surgery residents and to explore the value of this technology for continuing medical education and maintenance of certification. This article gives a brief background and history of surgical simulation and its technology, followed by a detailed description of the three phases of the American College of Surgeons’ plan and how the authors propose that each phase be implemented, with modifications as applicable for trainees in plastic surgery.


Lebanon and Hanover, N.H.

From the Sections of Plastic Surgery and General Surgery, Dartmouth-Hitchcock Medical Center, and Dartmouth College; and Thayer School of Engineering.

Received for publication January 22, 2008; accepted June 3, 2008.

Disclosure: No funding supported this work. None of the authors has a financial interest in any of the technologies or products mentioned.

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Joseph M. Rosen, M.D., Department of Surgery, Section of Plastic Surgery, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, N.H. 03756,

©2009American Society of Plastic Surgeons