Table 1 Demonstrating the ideas collated and synthesised to form a summary statement describing why live animals are used in trauma surgical simulation
Round 1—individual reflections | ||||||||
Feel of tissues Bleeding Warmth O2 saturations Emotive Real time change of physiology | Perfect for learners getting technical skills Haptic feel is very important You learn from real anatomy rather than models | Haemorrhage control + ‘live’, perfused, bleeding Surgical dissection skills Anatomical difference Skeletal fixation Difficult to combine these elements with other simulation modality | To enhance realism and prepare for real life situations To add stress factor To mimic physiology as close as possible | Feeling of tissues Realistic bleeding and bleeding control Realistic preparation of tissue strata | Practice with different kinds of tissues | No realistic simulators Difficult to convince surgeons about shifting to other simulators Impossibility of replicating procedures/acquiring skills if animals are not used | Best haptic fidelity and physical fidelity Major problem = students do not want to be trained on animals | Active haemorrhage Full-size of model ‘Liquidity’ Dynamic behaviour |
Round 2—pairs/group of three | ||||||||
Similar to human feedback, graded response, more realistic Anatomy vs physiology—more realistic and important | Better simulates physiology Stress factor: more in line with real trauma management Pinnacle of high-fidelity trauma—for both technical and non-technical skills | Tissue realistic Layers Bleeding | Whole thing with bleeding, visual aspect, smell, combined in one simulation | |||||
Round 3—two groups, each with a facilitator | ||||||||
Tissue and physiology fidelity—dissection, tissue handling, bleeding; lends itself to non-technical skills training in real time Stress response/emotional response/satisfaction of training | Replicate visual aspect, tissue properties, smell Emotional part—influenced by bleeding, and the fact the model is alive | |||||||