Incorporating Simulation Into Oral and Maxillofacial Surgery Residency Education and Training: Christiana Care's Method

Surgical residency education has undergone a paradigm shift, with more emphasis being placed on the value of simulation as a core educational tool. As a result, the Halstedian education model of ‘‘see one, do one, teach one’’ is no longer the preferred method of initial procedural and cognitive training. Patient care involves a more experienced and confident interaction with the resident, likely resulting in enhanced patient care and safety. This requires a change for residents and faculty alike. Although there is considerable literature describing the use of simulation in general surgery and anesthesia residency education, there is scant information specifically on its use in oral and maxillofacial surgery (OMS) residency training. Programs need to balance the reality of clinical duties with the importance of patient safety and proficiency-based trainingthatsimulation canprovide. Simulation provides the ability to tailor specific educationalgoalstofittheneedsofaprogram’sstrengthsand resources and ensures that residents gain experience in high-risk, low-volume procedures and to make the learning conducive to all levels of learners within the residency. 1 The process of implementing simulation education involves a change in philosophy with regard to current residency education. This new philosophy requires that the learner, not the patient, be the educational focus and itensuresthat errorsare used asteaching points. 2 Further, it fosters competency based on validatedmeasurements. 2 TheOMSresidencyprogram at Christiana Care is developing and implementing simulation with the institution’s Virtual Education and Simulation Training Center into the core curriculum of residency training. Six core areas of residency training were identified: surgical skills, physical diagnosis, ethics and professionalism, Advanced Cardiovascular Life Support (ACLS), anesthesia, and patient management. Simulation models are being developed that cover these core areas. Currently, scant information is available in the literature on implementing simulation into OMS residency education; thus, we present an initial novel approach toward residency education. In the implementation of this pilot program, sessions were developed and scheduled over the course of the academic year: 1) management of difficult airways, 2) local skin flaps (Fig 1), 3) laparoscopic fundamentals for arthroscopy of the temporomandibular joint, 4) objective structured assessment of technical skills for formative assessment of laceration closure, 3 5) delib