The SUrgical Skills Training and Assessment INstrument (SUSTAIN) is currently being developed under an Office of Naval Research (ONR) small business grant to support training and retention of specialized surgical skills throughout military deployment cycles.  Deployed military surgeons perform a wide variety of combat casualty and trauma surgery procedures; however, specialized procedures such as laparoscopy are not performed during typical deployments, and thus, these skills are susceptible to decay.

The Fundamentals of Laparoscopic Surgery (FLS), which includes a manual skills video box trainer, is the current gold standard for laparoscopic skills training and assessment.  However, the FLS training curriculum does not include integration of the cognitive, psychomotor, and perceptual skills involved in surgical tasks, and training for specific procedures is not included.  Additionally, the FLS assessment metrics are limited and the training platform is too large to support mobile refresher training in deployed settings.  The military has identified a need for a more comprehensive understanding of the nature of laparoscopic surgical skill acquisition and decay; objective metrics with which to assess these skills over time; and simulation-based training that supports rapid acquisition, longitudinal retention, and targeted retraining for skill sustainment.

The SUSTAIN simulation-based skills training and assessment technology is being developed to train, assess, and provide refresher training of integrated psychomotor, perceptual, and cognitive laparoscopic skills, and includes novel performance metrics based on motion tracking of the surgeon’s hands and surgical instruments.  Furthermore, SUSTAIN is being developed as a modular system with deployable training modules that are compatible with mobile devices for refresher training. The ultimate goal of this effort is to develop a mobile training and assessment platform capable of supporting a wide variety of military medical applications.