Image: The inexpensive and adaptable GlobalSurgBox (Photo courtesy of University of Colorado)
A tool designed to help surgical trainees practice skills such as knotting, suturing, vascular and bowel anastomoses and other techniques has helped break down barriers to simulation resources. Results of a recent study show that of the 30 general surgery residents surveyed, access to the tool named GlobalSurgBox significantly improved their ability to practice essential surgical skills.
In quantifying the usefulness and usefulness of GlobalSurgBox for surgical residents, researchers from the Department of Surgery at the University of Colorado School of Medicine (Aurora, CO, USA) found that among respondents , only 3.3% reported regularly using institutional simulation resources such as simulation centers. on the campus. The most frequently reported barriers were lack of convenient access and lack of time. After using GlobalSurgBox, 90% of residents surveyed said lack of convenience or time was no longer a barrier to practice.
The GlobalSurgBox was originally envisioned at the CU School of Medicine as a more portable and affordable simulation method. Using a wooden board as a platform for all surgical exercises and commonly available supplies, researchers included fishing line and shoelaces to practice knotting, rubber bands for sutures, and linear balloons for vascular anastomoses. . They organized all supplies into a 12-inch toolbox for portability, creating the GlobalSurgBox. In May 2021, the group assembled the first 50 GlobalSurgBoxes. The idea was that for every box created for a UC medical school student or resident, participants would create a second box for medical partners in low- and middle-income countries.
Through several iterations, the GlobalSurgBox has now evolved into a training tool that can be assembled with inexpensive, readily available components adapted to various countries or medical settings. As more CU School of Medicine students and residents have been involved in creating and adapting GlobalSurgBox, some have created a website and instructional videos with professional training. The students developed a comprehensive guide on how to assemble a box, links to purchase each of the materials, documents to guide the assembly of a GlobalSurgBox, and even templates on how to write grants so that this can be extended to other institutions. This will help students and surgical trainees in countries other than the United States to assemble boxes with locally available materials.
Students and residents have also been creative in adapting the box and continuing to create cheaper and better iterations. The students initially used samples of synthetic skin commonly used by tattoo artists to practice suturing, but later found that yoga mats were just as useful and at a fraction of the cost. In Kenya, where yoga mats aren’t as common as in the United States, medical students and residents modified the GlobalSurgBox to use flip flops instead. Others cultivated relationships across campus so they could salvage unused surgical instruments such as needle pushers and forceps that would otherwise be discarded.
“The beauty of this box is that it’s really adaptable to any environment, and the user is responsible for creating a simulator that meets their specific needs,” said Yihan Lin, MD, MPH, fellow in surgery. cardiothoracic at the University of Colorado School. from the department of surgical medicine, which initially imagined the GlobalSurgBox. “It has been used by medical students, residents, fellows and teachers in many programs and countries around the world. It is an easy to set up and easy to use resource.
University of Colorado School of Medicine Department of Surgery