Barriers to Engagement in Surgical Simulation Education

ABSTRACT

Introduction: The COVID-19 pandemic has negatively impacted clinical experience and case volumes. Surgical simulation is now an even more powerful training tool and, to maximize potential, we must ensure learner engagement. Our aim was to identify barriers to surgical simulation engagement and strategies to mitigate these. Method(s) Scoping search was performed with a trained librarian of PubMed, EMBASE and Web of Science. Title and screening were completed with inclusion criteria articles describing barriers to engagement with surgical simulation. After full text screening, data was extracted from included articles type of study, MERSQI score, type/number of participants, barriers to engagement and strategies to mitigate these. Result(s) Twenty-nine manuscripts were included with 951 faculty and 2,467 residents. The majority (86%) were in high income countries (HIC) and four in LMICs. Most were surveys (22/29), and five involved semi-structured interviews/focus groups. Mean adjusted MERSQI score was 8. Commonest barriers to HIC engagement were learner clinical duties (9/25), lack of learner time (13/25), lack of learner interest/motivation (9/25) and lack of faculty time or interest to participate (12/25). In LMIC, commonest barriers were lack of simulation lab/equipment (4/4), cost (3/4) and inadequate supervision (3/4). Strategies to improve HIC engagement were mandatory/protected resident simulation training (9/25) and, in LMIC, low cost simulators (4/4) and sharing resources (2/4). Conclusion(s) Identification of barriers to simulation engagement is crucial for successful learning. Given the increased importance of simulation education due to the COVID-19 pandemic, surgical educators should strategize to maximize engagement.