With the advent of open, laparoscopic, robotic, and now the potential for autonomous surgical techniques, both residents and seasoned surgeons face a significant educational challenge. Mastery in modern surgery now demands proficiency across all these approaches to achieve true expertise.
Ethan Mollick touches on this dilemma in his recent book Co-Intelligence (living and working with AI):
Under tremendous time pressure, residents had to choose between learning traditional surgery skills or figuring out how to use these new robots on their own time.
While many doctors ended up undertrained, those who wanted to learn how to use robotic surgery equipment turned away from official channels.
They did their own “shadow learning” by watching YouTube channels or training more on live patients than they probably should have.
This same sort of training crisis is going to spread as AI automates more and more basic tasks.
Even as experts become the only people who can effectively check the work of ever more capable AIs, we are in danger of stopping the pipeline of experts.
What should surgeons prioritize learning and mastering in this digital and AI era? Basic surgical skills, laparoscopy, robotic surgery, or AI and machine learning?
Surgeons need to help drive innovation in surgery, instead of passively waiting for AI to become useful.
To ensure all patients are included, surgeons should seek to expand their involvement in clinical data registries because a lack of data can limit the predictions made by AI algorithms.
Surgeons should seek opportunities to collaborate with data scientists and ML engineers to capture new forms of clinical data and create meaningful interpretations of it.
Surgeons have the clinical insight to answer the right questions with the right data.
Big data has the potential to create GPS-like intraoperative guidance.
A GPS for surgery, trained on millions of surgery videos, providing decision support for surgeons around the world.
It is important for surgeons to demand transparency and interpretability of AI.
AI should be held accountable for its predictions and recommendations.
In order to properly convey the results of complex analyses such as risk predictions, and treatment algorithms to patients within the appropriate clinical context, an understanding of AI will be essential.
Surgeons should contribute to the application of AI in surgery.
Updated: 1 day ago
Medical schools around the world are poised to enter a new field of transformation as digital technologies are gradually being integrated into the education of the next generation of surgeons.
Surgical education uses active and passive learning methods:
Passive methods include anatomy books, guides, manuals, and videos.
Passive learning methods are useful, but their weakness lies in the surgeon’s need to translate 2D images and text into real dimensions.
Active learning includes the practice of procedures on corpses or real patients with a main surgeon present.
Active learning methods also have limitations: corpses are not accessible in several countries, and attending surgery without practicing is not enough for residents to acquire the desired technical skills.
3 Emerging technologies in surgical education
1. Artificial Intelligence
Surgery being a discipline where repetition is the key to mastery, the integration of artificial intelligence has enormous potential to train future surgeons.
AI can provide real-time information on:
The next surgical step.
Suggested instruments to use.
Indicators of time spent at each stage.
Safe and dangerous areas for dissection.
Performance measurement helps identify areas for improvement.
The accuracy of AI algorithms is based on the quantity and quality of data collected, so if surgeons are unwilling to submit recorded videos of difficult or problematic cases, this will impact AI predictions.
2. Augmented Reality
Augmented reality (AR) is the superimposition of information or digital images in the real world.
Most surgical AR applications address the issue of CT and MR images in 2D, turning them into 3D images.
AR allows the surgeon to visualize the images of each patient in 3D, superimposed in real-time on the patient’s body.
Superimposing digital images in the real world helps the surgeon choose the right incision site, to avoid vessels and nerves, and to place the material well.
The surgeon can use augmented reality (AR) to:
Prepare the procedure.
Document the procedure.
Share all this data with residents.
Broadcast in real time what he sees through the smart glasses with all residents or assistants.
3. Virtual Reality
Virtual reality (VR) aims to simulate reality using high-performance computers combined with sensory technologies, complemented by gloves or hand-held controllers.
VR training models allow surgeons to:
Simulate any surgery, with or without supervision.
Provide an opportunity to provide feedback and performance statistics.
The resident or surgeon may repeat the same procedure or method until the desired level of performance is achieved.
Virtual anatomy is a powerful tool that involves digitizing traditional body dissection sessions in medical school, allowing easy handling and presentation of any disease or condition.
The future of surgical education
A study by Goldman Sachs on the impact of virtual reality and augmented reality found that nearly 08 million doctors worldwide can use these technologies in their practice.
The three combined technologies (Virtual Reality, Augmented Reality, and Artificial Intelligence) are an important tool for developing surgical training and addressing the important barriers of non-invasive surgery:
Increase limited field of view
Shorten long learning curves
Reduce operating time
Reduce the cost of the operation
A transition is needed in educational modules and training methods to move away from traditional learning and towards technology-based methods, thus increasing the skills of residents, which will increase their confidence and ambition.