How do vascular surgery trainees optimise simulation-based learning? A qualitative study

Background: Technical skills acquisition in modern surgical training is augmented by simulator-based education outside the operating room. Aims: This research sought to explore and understand optimal learning conditions for vascular surgery trainees during simulation from their perspective. Methods: Ten doctors at various stages of surgical training were recruited to participate from various training events. Semi-structured interviews were conducted individually on a date beyond initial recruitment. Topics included perceptions around how participants learn best from simulation and what they value, prioritise and require from simulation-based training. Initial data analysis was conducted shortly after initial interviews took place, and further interviews were conducted until data saturation was reached. Data were extracted using inductive thematic analysis. Results: Participants believed simulation was important within surgical training, and that progression towards competence in core technical skills was particularly important. They appreciated direct consultant trainer supervision, contemporaneous bi-directional verbal feedback, and summative written feedback. Visual fidelity and complex/rare procedures were low on their priorities, with a strong desire to optimise fundamental skills acquisition. Participants also felt strongly about the benefits of advanced receipt of a detailed outline of session content and relevant reading material to maximise the educational benefit of training sessions. Conclusions: Core operative skills and commonly encountered major operative cases should be prioritised in vascular technical skills training. In designing simulators, the main focus should centre on specific skill acquisition as a procedural component rather than aiming to replicate an entire procedure. A flipped classroom model of pre-reading, low student-to-trainer ratios, and detailed feedback from consultant trainers should be encouraged.