Cara Swain (Stockholm / SE; Birmingham / GB), Hugo Cohen (Birmingham / GB), Gert Helgesson (Stockholm / SE), Rory Rickard (Birmingham / GB), Klas Karlgren (Stockholm / SE)
Abstract text (incl. references and figure legends)
Introduction
"Live tissue training" (LTT) uses terminally-anaesthetised animals as human patient simulator models, for medical professionals to learn surgical techniques. Despite increasing availability and variety of alternative simulators, and clear ethical implications, many assert that LTT is the trauma simulation "gold standard". The educational benefit of LTT is unclear, in terms of tangible outcomes for learners or improved health outcomes for patients. The aim was to explore how LTT is used in surgical trauma simulation to determine educational merit.
Material & Methods
A systematic review was performed according to PRISMA guidelines. A combination of narrative synthesis and reflexive thematic analysis were used to identify key attributes of LTT which contribute to educational attainment for learners.
Results
LTT is primarily used to practice psychomotor surgical skills and to apply knowledge of trauma management. The focus is either an individual practitioner"s performance of simple "ATLS" skills in the pre-hospital environment or complex "damage control" skills conducted by surgeons as part of a team. Strong empirical evidence which demonstrates that LTT is more beneficial than alternative simulation modalities was not identified; nevertheless, it is preferred and strongly supported by learners. Thematic analysis indicated that the critical and dynamic nature of haemorrhage, a realistic environment, and an invoked emotional response to training may influence learner perception of self-efficacy relating to clinical knowledge and skill performance.
Conclusion
There is insufficient evidence to support superiority of live animals over other modalities for skills training. However, there appears to be some evidence in the literature that for experienced learners involved in complex surgical (team) training, LTT has potentially unique educational value in terms of learner psychology which may impact subsequent clinical performance.
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