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J Surg Educ. 2017 Jun 6. pii: S1931-7204(16)30269-0. doi: 10.1016/j.jsurg.2017.05.018. [Epub ahead of print]

Systematic Review of Patient-Specific Surgical Simulation: Toward Advancing Medical Education☆.

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Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada. Electronic address:
Department of General Surgery, University of Calgary, Calgary, Alberta, Canada.
Department of Computer Sciences, University of Calgary, Calgary, Alberta, Canada.
Faculty of Education, University of Calgary, Calgary, Alberta, Canada.
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
Department of Surgery, University of Arizona, Tucson, Arizona.



Simulation-based education has been shown to be an effective tool to teach foundational technical skills in various surgical specialties. However, most of the current simulations are limited to generic scenarios and do not allow continuation of the learning curve beyond basic technical skills to prepare for more advanced expertise, such as patient-specific surgical planning. The objective of this study was to evaluate the current medical literature with respect to the utilization and educational value of patient-specific simulations for surgical training.


We performed a systematic review of the literature using Pubmed, Embase, and Scopus focusing on themes of simulation, patient-specific, surgical procedure, and education. The study included randomized controlled trials, cohort studies, and case-control studies published between 2005 and 2016. Two independent reviewers (W.H.R. and N.D) conducted the study appraisal, data abstraction, and quality assessment of the studies.


The search identified 13 studies that met the inclusion criteria; 7 studies employed computer simulations and 6 studies used 3-dimensional (3D) synthetic models. A number of surgical specialties evaluated patient-specific simulation, including neurosurgery, vascular surgery, orthopedic surgery, and interventional radiology. However, most studies were small in size and primarily aimed at feasibility assessments and early validation.


Early evidence has shown feasibility and utility of patient-specific simulation for surgical education. With further development of this technology, simulation-based education may be able to support training of higher-level competencies outside the clinical settingto aid learners in their development of surgical skills.


Medical knowledge; Practice based learning and improvement; medical education; patient-specific simulation; surgical simulation; systematic review

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