Every deanery should identify a regional simulation hub working in partnership with the regional simulation lead.
In geographically large deaneries consideration should be given to developing 2 or 3 appropriately placed simulation hubs. Approximately 1 simulation hub for every 50-100 trainees is recommended.
A model simulation hub should;
- Be positioned appropriately geographically so it is easily accessible to trainees
- Have an adequate amount of gynaecological simulation training equipment to deliver a structured laparoscopic simulation programme covering basic, intermediate and advanced core competencies.
- Have adequate space to deliver simulation teaching and knowledge based lectures
- Utilise the training opportunities region-wide and develop a large faculty to support training within the hub.
The exact amount of simulation equipment required will be dependent on the number of trainees training within the deanery, however a single simulation hub should aim to have at least;
- 10 laparoscopic simulation boxes and screens/laptops
- 10 laparoscopic Johan graspers
- 10 laparoscopic Maryland graspers
- 10 laparoscopic scissors
- 10 laparoscopic needle holders
- 10 suture pads
Consumable which will need to replenished on a regular basis include;
- Model consumables – balloons, tape, cotton wool
These consumables can often be already found in local education centres or out of date material can be sourced from theatre if appropriate. Industry support may be also helpful with regards to materials and consumables.
In order to deliver a structured and formal laparoscopic simulation programme the regional lead should work with local surgical leads and college tutors to create a diverse faculty deanery wide and also utilise virtual training options. Senior trainees should be encouraged to join faculty and develop leadership skills further.
A “hub and spoke” model approach may be helpful for some deaneries, particularly those over a large geographical region and when faculty is limited. Virtual platforms could allow the theoretical element of the course to be run in one large centre and shared simultaneously to the smaller hubs throughout the region and beyond.
Consideration should be given to providing all trainees with their own simulation box and equipment at the onset of training to allow ongoing home learning and practice. This may be accomplished at a regional level by top slicing the ST1 and 2 study leave budget for example. Alternatively, a laparoscopic box loan scheme may be considered, where boxes are given to regional hospitals for trainees to use in house but trainees can also take the box away for a set period of time eg 3 days.