Virtual training platform maintains, improves military surgeons’ skills

To access more training opportunities, military surgeons are looking to virtual training platforms.

The U.S. Air Force is working with sister services to study a virtual training platform called Crowd-Sourced Assessment of Technical Skills, or C-SATS. It provides specialized training for surgeons to further improve their specialized skills.

Airmen assigned to the 99th Medical Group perform in an orthopedic spine surgery at Nellis Air Force Base, Nevada, Aug. 27, 2018. Having in-house surgeons allows patients to bypass referrals downtown. (U.S. Air Force photo by Airman 1st Class Andrew D. Sarver)
Credit: U.S. Air Force

According to Maj. Joshua Tyler, director of robotics atKeesler Air Force Base, Mississippi, C-SATS lets surgeons receive virtualfeedback on an objective, third party platform. This unbiased feedback helpsimprove their skills. “Basically, a panel of expert surgeons virtually reviewsa case you submit, and [then] provides feedback,” said Tyler. “This helps oursurgeons learn the most advanced surgical techniques they would otherwise haveless exposure to.”

While C-SATS shows promising results in studies withcivilian surgeons, it has not yet been studied with military surgeons.

“The Department of Defense’s trained surgeons are talentedand qualified, but it takes experience and time to become proficient,” saidU.S. Army Col. Robert Lim, chief of Minimally Invasive Surgery at Tripler ArmyMedical Center, Hawaii. “The C-SATS platform provides additional opportunitiesto ensure skills are maintained and perfected.”

To assess C-SATS’s use on improving the skills andcapabilities of military surgeons, Lim and his team, including Tyler, receiveda grant from the Telemedicine and Advanced Technology Research Center at theU.S. Army Medical Research and Materiel Command in December of 2017.

“The grant will look at military surgeons recently back fromdeployment,” said Lim. “We are looking at surgeons at Keesler Air Force Base,Naval Base San Diego, William Beaumont Army Medical Center and Tripler ArmyMedical Center.”

One benefit of the C-SATS platform is that busy surgeons canuse it on their schedule, instead of waiting for training opportunities.

“This is especially important for specialists who may nothave as many opportunities to practice their specific skills on-base,” saidTyler. “This platform provides another way to ensure they can retain theirclinical currency.”

Using C-SATS, surgeons submit a recording of a case theyhave completed, after removing any identifiable patient information. Thedevelopment team at C-SATS will then edit the video file into key steps of theprocedure and send it to expert reviewers familiar with the procedure.

“Not only do we take great care to ensure patient privacy,but we also ensure the surgeon that performs the operation and the reviewersremain anonymous,” said Tyler. “The expert surgeons will then score the videoon key areas such as how well the surgeon used their hands, how well theymanipulated the tissue, or assess their pace. The surgeon gets feedback on avery granular level, specifying the exact second where a surgeon could improvetheir technique.”

As Tyler explains, C-SATS has the potential to be an inimportant tool that supports full-spectrum medical readiness by maintainingcurrency and improving skills.

“C-SATS has had tremendous success in improving skills and patientoutcomes in the private sector, and we want to know how this platform can workfor our military surgeons,” said Tyler. “This platform can provide militarysurgeons an additional opportunity to stay up-to-date on advanced techniquesand receive additional support with new innovations like surgical robotics.”