DS22 Enhancing dermatology surgical skills through simulation training
Authors: Jo-Yve Wong, Shahd Elamin, Neil Doran, John McKenna, Victoria Campbell, Olivia Dolan
Journal: British Journal of Dermatology (2024)

Abstract Attaining proficient surgical skills is an integral part of dermatology training, ensuring the delivery of effective services to facilitate prompt diagnosis and treatment. However, the majority of new trainees lack prior surgical experience, with regional variation in the availability of courses available. Simulation-based training has been utilized across medical disciplines to provide a safe and controlled environment for structured learning. Studies have shown that simulation training builds cooperative team building, as well as enhancing proficiency even in patient-based settings (Okuda Y, Bryson EO, DeMaria S et al. The utility of simulation in medical education: what is the evidence? Mount Sinai J Med 2009; 76: 330–43). Recognizing these benefits, we established a workshop aimed at improving confidence levels in dermatological surgery through a simulation-based approach. A comprehensive questionnaire evaluating baseline prior surgical experience and confidence levels in various techniques was distributed to all dermatology trainees and dermatology nurses involved in surgery. The workshop was conducted at intervals, held across three sessions, and feedback was gained from attendees. Following each session, confidence levels in various surgical techniques were re-evaluated using a similar questionnaire. Organizing the workshop encompassed finding suitable venue arrangements, equipment procurement, and facilitator coordination. Funding for the workshop was provided by an NHS healthcare trust. Additionally, a comprehensive home practice surgery kit was provided to dermatology trainees to support ongoing skill development and consolidate learning between workshop sessions. This included information linking to surgical guidelines, preoperative considerations and educational resources. The initial results indicated that the majority (66%) of trainees had limited to no prior surgical experience, with 100% agreeing that surgical skills training could be improved. Before the workshop, overall confidence levels in surgical skills averaged at 37%. Following the first workshop, which covered skills requests ad hoc, this improved to 43%. Subsequent workshops divided groups into structured learning objectives, and incorporated clinical simulation scenarios. Overall confidence levels increased to 63% and 55%, after the second and third workshops, respectively. The variation in results may be attributed to a higher proportion of junior attendees in the third workshop. Feedback from participants and wider dermatology teams have been positive, with respondents commending the interactivity and practical utility of the sessions delivered. In conclusion, this initiative proved to be a successful project in improving confidence in performing skin surgery, highlighting the positive educational potential of simulation-based training. Challenges in its organization include the logistics of cost, funding, equipment and availability of instructors. We aim to establish a platform for ongoing skill development and to continue conducting workshops biannually, accommodating to the evolving needs of medical and nursing staff.