• Weekly, Tuesday mornings for 150 minutes
• Protected time from clinical duties
• Education fellows and faculty lead sessions
• PGY based curriculum

Skills acquisition and refinement are an important area of surgical education that is formalized in a separate curriculum but alongside the core course of Stanford Surgery's educational program. The Goodman Surgical Simulation Center and the Anatomy Bio-Skills Laboratory are the physical plant that houses the skills and simulation program and are accredited by the American College of Surgeons as a Level I Educational Institute. This goes to follow then that the schedule throughout the year is based on the ACS/APDS (Association of Program Directors in Surgery) Surgery Skills Curriculum for Residents.

All phases and most modules of this program are incorporated and assigned to the appropriate PGY level with faculty oversight. A summary of the topics covered are listed.

Phase I: Basic/Core Skills and Tasks

• Advanced Laparoscopic Skills
• Advanced Tissue Handling: Flaps, Skin Grafts
• Airway Management
• Asepsis and Instrument Identification
• Basic Laparoscopic Skills
• Central Line Insertion and Arterial Lines
• Chest Tube Placement and Management
• Colonoscopy
• Hand Sewn Gastrointestinal Anastomosis
• Inguinal Anatomy
• Knot Tying
• Laparotomy Opening and Closure
• Stapled Gastrointestinal Anastomosis
• Suturing
• Tissue Handling, Dissection, and Wound Closure
• Ultrasound
• Upper Endoscopy
• Vascular Anastomosis

Phase 2: Advanced Procedures

• Laparoscopic Appendectomy
• Laparoscopic Inguinal Hernia Repair
• Laparoscopic Right Colon Resection
• Laparoscopic Sigmoid Resection
• Laparoscopic Nissen Fundoplication
• Laparoscopic Ventral/Incisional Hernia Repair
• Laparoscopic/Open Bile Duct Exploration
• Laparoscopic/Open Cholecystectomy
• Laparoscopic/Open Splenectomy
  Laparoscopic Ventral Hernia Repair
• Open Inguinal/Femoral Hernia Repair
• Open Right Colon Resection
• Parathyroidectomy/Thyroidectomy
• Sentinel Node Biopsy and Axillary Lymph Node Dissection

Phase 3: Team-based Skills

• Laparoscopic Crisis
• Laparoscopic Troubleshooting
• Patient Handoff - SAIF-IR
• Preoperative Briefing/Time-Out
• Trauma Team Training

Each module consists of a very short didactic overview, proctored hands-on skills and simulation time, and assessment. The Goodman Surgical Simulation Center is available to all surgery residents by key card entry at any time. Modules are available, with prior coordination of the Goodman Surgical Simulation Program Manager, for individual practice and review. This venue is also available for residents to utilize in patient hand-offs and self study. Most of the modules utilize models and virtual reality or box trainers in accomplishing the goals of teaching the steps of the skill or procedures. Some of the Phase 2 modules utilize cadavers in the Bio-Skills Lab to teach open and laparoscopic skills and procedures. Appropriate specialty trained faculty are the instructors of these modules.

The Fundamentals of Laparoscopic Surgery (FLS) Program is also under the auspices of the Skills and Simulation portion of the surgical education program. Each PGY-4 General Surgery Resident will take the FLS exam at the completion of their Minimally Invasive Surgery (MIS) rotation. 

Individual services also make use of the skills and simulation center in their rotation schedules. 
Communication and leadership, as it relates to patient safety, are as important as medical knowledge or technical skills in surgery. Therefore, a formal program touching on how these important skills relate to patient care is part of the skills curriculum for interns, junior, and senior residents.

You can find a current Surgical Skills schedule on our Scalpel website   (http://scalpel.stanford.edu/) and by clicking on the “Stanford Calendar”.