Introduction:
The change in working time regulations has reduced the number of available training hours for surgeons. Simulation provides an alternative learning tool, enabling an enhanced cognitive and technical understanding of a procedure. Kinosis Ltd. have created a novel simulator application, Touch Surgery, structured around a cognitive task-analysis framework aimed at surgical rehearsal.
Methods:
A randomised control trial was created. The trainee cohort was taught to perform a flexor tendon repair. The control group was taught using the current Royal College of Surgeons curriculum, supplemented by footage from Hand Surgery Intl., whilst the Touch Surgery group used the interactive app, only. Each group’s surgical performance was recorded and marked by expert assessors over multiple criteria: i) An Objective Structured Assessment of Technical Skill (OSATS) score, ii) Time, iii) Trainee Self-Confidence, iv) Ultimate Tensile Strength.
Results:
Touch Surgery produced significantly faster learning times (1363s vs. 1060s; p=0.011) and overall performance times (2860s vs. 2361s; p=0.004), with trainees having more confidence in their performance ability (50.89% vs. 65.21%; p=0.001). Both control and Touch Surgery produce similar results for Ultimate Tensile Strength (0.311MPa vs. 0.310MPa; p=0.965) and OSATS score (26.90 vs. 28.34; p=0.361).
Conclusion:
Touch Surgery has proven itself to be as capable of teaching a flexor tendon repair as traditional methods. The literature has yet to demonstrate that this improves patient safety or outcomes.