see one do one teach one this
expressions been the foundation of
surgical training for over a century but
unfortunately it’s no longer working our
system of training is an apprenticeship
method you spend your five to nine years
post medical schools following other
experienced surgeons around observing
them learning to do what they do this
worked for a time especially when the
number of procedures we needed to learn
was very small residents had a lot of
hands-on time with patients and they had
a significant amount of autonomy today
the world has changed
residents have an enormous number of
procedures they need to learn and those
procedures are now more complicated
thanks to new technologies like robotics
3d printing and navigation to give you
an example one study questioned the
leaders of surgery across the country
and asked them what are the critical
procedures that residents need to learn
they identified 171 surgeries that
residents should know how to do by the
time they leave residency and go into
independent practice but when they
actually looked at the surgeries that
those residents did by the time that
they graduated they found that many of
the procedures they had done once twice
or 0 times
additionally the time residents have to
operate is becoming less work hour
restrictions have limited residents to
only 80 hours of work a week all right
they’re so lazy but amazingly they’ve
lost a year of training time that they
previously had workflow changes like
electronic medical record systems have
residents in front of a computer for
almost 50 percent of their time instead
of in front of a patient finally culture
is changing people are more aware of
what residents do and don’t want them
touching them so residents have less
autonomy and less hands-on time
sometimes there’s a situation where you
see something you’ve never seen before
so it’s not even see one do one it’s
just do one like this time where we
received a call from the zoo and there
was a gorilla that was injured and
needed surgery now you may be wondering
why was the zoo calling a team of very
human surgeons who take care of people
to operate on the gorilla and that’s a
story for another time but we jumped to
answer the call now the zoo couldn’t
tell us what was wrong with the gorillas
because they had to tranquilize it take
it to x-ray and then immediately to the
operating room so we were walking into
the operating room in the zoo with no
clue what to expect amazingly the
gorillas did great it was a really
wonderful experience but I had to think
there had to be a better way to practice
just in time for those cases when a
gorilla comes in through the door so how
are we doing today
a study from brian george answered that
question they looked at residents
ability to practice independently
overall five years of their training the
results may shock you at the end of
their training thirty point seven
percent of residents were still unable
to operate independently I’ve seen the
surgical training gap firsthand during
my own surgical residency believe it or
not I often was asked to google the
surgery we were doing to find the
instruction manual
the blistering pace of new technology
and procedures aren’t just affecting
residents anymore they’re affecting
surgeons out in practice it is not
uncommon to see a site like this in the
operating room where surgeons are
operating on a patient with instructions
folded out on them as they work at the
conclusion of his paper Brian Jordan
that the residency system that we know
it today no longer works to make matters
worse sorry to be so negative
who gets better is that we have an aging
population and they’re gonna need more
and more surgery we have a surgeon
shortage coming and we’re gonna be short
50,000 surgeons in just a few decades so
what do we do what if I told you there
was a technology that allows you to
practice a procedure anytime and
anywhere in a safe repeatable way well
there is that technology is virtual
reality or VR let’s take a look
[Music]
now remember VR did not start as a toy
it started as a serious scientific tool
for NASA today no aircraft pilot can
operate a commercial jet without first
learning their skills in a simulator and
passing a battery of tests in aviation
when it’s life or death simulators are
not tomorrow’s luxury they are today’s
necessity so why should it be any
different in the medical world in a
future with VR simulation we can bridge
the training gap so our graduating
residents are ready to practice
independently in a future with VR
simulation we could train more surgeons
faster so we can tackle the oncoming
surgeon shortage in a future with VR
simulation surgeons would only do
procedures that it was safe for them to
do so they wouldn’t be googling the
operation during the procedure we’ve
already made big steps in this brave new
reality in a pilot study we took a group
of students and train them in VR we then
took them and tested them on the real
surgical procedure and we were surprised
with the results the VR trained group
nearly doubled the surgical performance
scores of non VR trained individuals VR
surgical training is scalable affordable
and most importantly it works with this
technology the next generation of
surgeons will be ready for whatever
comes through the door
[Applause]
expressions been the foundation of
surgical training for over a century but
unfortunately it’s no longer working our
system of training is an apprenticeship
method you spend your five to nine years
post medical schools following other
experienced surgeons around observing
them learning to do what they do this
worked for a time especially when the
number of procedures we needed to learn
was very small residents had a lot of
hands-on time with patients and they had
a significant amount of autonomy today
the world has changed
residents have an enormous number of
procedures they need to learn and those
procedures are now more complicated
thanks to new technologies like robotics
3d printing and navigation to give you
an example one study questioned the
leaders of surgery across the country
and asked them what are the critical
procedures that residents need to learn
they identified 171 surgeries that
residents should know how to do by the
time they leave residency and go into
independent practice but when they
actually looked at the surgeries that
those residents did by the time that
they graduated they found that many of
the procedures they had done once twice
or 0 times
additionally the time residents have to
operate is becoming less work hour
restrictions have limited residents to
only 80 hours of work a week all right
they’re so lazy but amazingly they’ve
lost a year of training time that they
previously had workflow changes like
electronic medical record systems have
residents in front of a computer for
almost 50 percent of their time instead
of in front of a patient finally culture
is changing people are more aware of
what residents do and don’t want them
touching them so residents have less
autonomy and less hands-on time
sometimes there’s a situation where you
see something you’ve never seen before
so it’s not even see one do one it’s
just do one like this time where we
received a call from the zoo and there
was a gorilla that was injured and
needed surgery now you may be wondering
why was the zoo calling a team of very
human surgeons who take care of people
to operate on the gorilla and that’s a
story for another time but we jumped to
answer the call now the zoo couldn’t
tell us what was wrong with the gorillas
because they had to tranquilize it take
it to x-ray and then immediately to the
operating room so we were walking into
the operating room in the zoo with no
clue what to expect amazingly the
gorillas did great it was a really
wonderful experience but I had to think
there had to be a better way to practice
just in time for those cases when a
gorilla comes in through the door so how
are we doing today
a study from brian george answered that
question they looked at residents
ability to practice independently
overall five years of their training the
results may shock you at the end of
their training thirty point seven
percent of residents were still unable
to operate independently I’ve seen the
surgical training gap firsthand during
my own surgical residency believe it or
not I often was asked to google the
surgery we were doing to find the
instruction manual
the blistering pace of new technology
and procedures aren’t just affecting
residents anymore they’re affecting
surgeons out in practice it is not
uncommon to see a site like this in the
operating room where surgeons are
operating on a patient with instructions
folded out on them as they work at the
conclusion of his paper Brian Jordan
that the residency system that we know
it today no longer works to make matters
worse sorry to be so negative
who gets better is that we have an aging
population and they’re gonna need more
and more surgery we have a surgeon
shortage coming and we’re gonna be short
50,000 surgeons in just a few decades so
what do we do what if I told you there
was a technology that allows you to
practice a procedure anytime and
anywhere in a safe repeatable way well
there is that technology is virtual
reality or VR let’s take a look
[Music]
now remember VR did not start as a toy
it started as a serious scientific tool
for NASA today no aircraft pilot can
operate a commercial jet without first
learning their skills in a simulator and
passing a battery of tests in aviation
when it’s life or death simulators are
not tomorrow’s luxury they are today’s
necessity so why should it be any
different in the medical world in a
future with VR simulation we can bridge
the training gap so our graduating
residents are ready to practice
independently in a future with VR
simulation we could train more surgeons
faster so we can tackle the oncoming
surgeon shortage in a future with VR
simulation surgeons would only do
procedures that it was safe for them to
do so they wouldn’t be googling the
operation during the procedure we’ve
already made big steps in this brave new
reality in a pilot study we took a group
of students and train them in VR we then
took them and tested them on the real
surgical procedure and we were surprised
with the results the VR trained group
nearly doubled the surgical performance
scores of non VR trained individuals VR
surgical training is scalable affordable
and most importantly it works with this
technology the next generation of
surgeons will be ready for whatever
comes through the door
[Applause]
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