Duke Surgery opened the Surgical Education and Activities Lab (SEAL) in 2005 to train residents, fellows, medical students, and faculty on simulation equipment in a risk-free environment to advance medical education and improve patient safety.

 

Simulation training through the use of the SEAL plays a key role in the General Surgery Residency Program. Residents train on the simulators and are assessed based on their performance to varying tasks and drills.

 

The lab provides residents with round-the-clock access to minimally invasive laparoscopic surgical simulators, virtual reality laparoscopic surgical simulators and endoscopy simulators for practicing flexible bronchoscopy, and upper and lower gastrointestinal (GI) flexible endoscopy procedures. Residents can hone skills and practice minimally invasive procedures without the pressures of the operating room. A variety of non-simulator based training modules are also available.

 

The virtual reality simulators can help trainees get used to visualizing the operative field through the laparoscopic lens. They also help users gain skills in the simultaneous use of a variety of instruments with both hands.

 

The endoscopy trainers provide haptic feedback which makes the scope insertion and manipulation feel like working with a real patient. This feature, coupled with the use of real-time computer graphics and anatomic models developed from actual patient data, creates an environment that closely mimics an actual procedure. Trainees doing an upper GI endoscopy, for example, are able to insert the scope into the “patient” and use the program’s tools to replicate patient swallowing, suction of gastric fluid and the even lens cleaning. Medications are also given to facilitate the “procedure.” A “virtual attending” can provide useful information and feedback to trainees as they perform the procedure.

 

Additional laparoscopic trainers provide a simulated work environment with real instruments and objects to mimic operative skill sets.

 

The multidisciplinary SEAL advisory board is working to expand the program and have plans to include additional simulators and address all of the specialties that can benefit from this added teaching resource. The goal is that all residents practicing minimally invasive laparoscopic surgery will have the skill set to pass a national test on the fundamentals of laparoscopic surgery to credential in this area. Board members also envision medical students and attending surgeons benefiting from the opportunity to practice and perfect techniques on simulators.

 

In January 2008, the SEAL was accredited as a Level I Comprehensive Education Institute (CEI) by the American College of Surgeons. Today the SEAL has expanded its training to include nurses, physician assistants, and anesthesiologists – a feat which has largely been made possible by Duke Surgery’s collaboration with other Duke programs which now comprise the Duke Surgery Comprehensive Education Institute (CEI).