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        Policy UpdatesNewsroomReoptimizationBIOGRAPHIESAF Senior Leaders      Airmen assigned to the 99th Medical Group perform in an orthopedic spine surgery at Nellis Air Force Base, Nevada, Aug. 27, 2018. Having in-house surgeons allows patients to bypass referrals downtown. (U.S. Air Force photo by Airman 1st Class Andrew D. Sarver)Virtual training platform maintains, improves military surgeons’ skills
                        
                        
                        Airmen assigned to the 99th Medical Group perform in an orthopedic spine surgery at Nellis Air Force Base, Nev., Aug. 27, 2018. Having in-house surgeons allows patients to bypass referrals downtown. (U.S. Air Force photo by Airman 1st Class Andrew D. Sarver)
                
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Virtual training platform maintains, improves military surgeons' skillsPublished Jan. 30, 2019
                    
                    By Shireen Bedi
                    
                    
                    Air Force Surgeon General Public Affairs
            **FALLS CHURCH, Va. (AFNS) --**It is vital for medical Airmen to continuously maintain and improve their skills. To access more training opportunities, military surgeons are looking to virtual training platforms.
The Air Force is working with sister services to study a virtual training platform called Crowd-Sourced Assessment of Technical Skills, or C-SATS. C-SATS provides specialized training for surgeons to further improve their specialized skills.
According to Maj. Joshua Tyler, director of robotics at Keesler Air Force Base, Mississippi, C-SATS lets surgeons receive virtual feedback on an objective, third-party platform. This unbiased feedback helps improve their skills.
“Basically, a panel of expert surgeons virtually reviews a case you submit, and (then) provides feedback,” said Tyler. “This helps our surgeons learn the most advanced surgical techniques they would otherwise have less exposure to.”
While C-SATS shows promising results in studies with civilian surgeons, it has not yet been studied with military surgeons.
“The Department of Defense’s trained surgeons are talented and qualified, but it takes experience and time to become proficient,” said Army Col. Robert Lim, chief of Minimally Invasive Surgery at Tripler Army Medical Center, Hawaii. “The C-SATS platform provides additional opportunities to ensure skills are maintained and perfected.”
To assess C-SATS’s use on improving the skills and capabilities of military surgeons, Lim and his team, including Tyler, received a grant from the Telemedicine and Advanced Technology Research Center at the U.S. Army Medical Research and Materiel Command in December of 2017.
“The grant will look at military surgeons recently back from deployment,” said Lim. “We are looking at surgeons at Keesler Air Force Base, Naval Base San Diego, William Beaumont Army Medical Center, and Tripler Army Medical Center.”
One benefit of the C-SATS platform is that busy surgeons can use it on their schedule, instead of waiting for training opportunities.
“This is especially important for specialists who may not have as many opportunities to practice their specific skills on-base,” said Tyler. “This platform provides another way to ensure they can retain their clinical currency.”
Using C-SATS, surgeons submit a recording of a case they have completed, after removing any identifiable patient information. The development team at C-SATS will then edit the video file into key steps of the procedure and send it to expert reviewers familiar with the procedure.
One of those expert reviewers is Tyler.
“Not only do we take great care to ensure patient privacy, but we also ensure the surgeon that performs the operation and the reviewers remain anonymous,” said Tyler. “The expert surgeons will then score the video on key areas such as how well the surgeon used their hands, how well they manipulated the tissue, or assess their pace. The surgeon gets feedback on a very granular level, specifying the exact second where a surgeon could improve their technique.”
As Tyler explains, C-SATS has the potential to be an in important tool that supports full spectrum medical readiness by maintaining currency and improving skills.
“C-SATS has had tremendous success in improving skills and patient outcomes in the private sector, and we want to know how this platform can work for our military surgeons,” said Tyler. “This platform can provide military surgeons an additional opportunity to stay up-to-date on advanced techniques and receive additional support with new innovations like surgical robotics.”Air Force Medical Service 



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