Spotlight on New ACS AEI International Committee Consultant Ömer Burak Argun, MD

ACS AEI Fellowship

I am very proud of my surgical simulation fellowship status by the ACS AEI. I started my simulation fellowship in January 2009 under the mentorship of Dr. Robert Sweet at the simulation center of the University of Minnesota, formerly SimPORTAL and now M Simulation. My 1-year fellowship was very useful. Currently, I am a surgeon working in the field of uro-oncology, however,  I am more interested in robotic surgery. I have been a faculty member in the urology department of Acıbadem Mehmet Ali Aydınlar University in Istanbul, Turkey, since 2011 and I am working with Dr. Ali Rıza Kural and his team, continuing my career as an associate professor of urology.

I believe that training a surgeon is one of the most sophisticated and difficult processes. I have only just realized how important it is to know that all information cannot be accessed in books and that complex procedures such as surgery are transferred from 1 person to another. The most important information I understood while under the supervision of Dr. Sweet is that I have learned curriculum development is actually the most important stage in knowledge transfer.

While at the University of Minnesota, I had the opportunity to have detailed and in-depth knowledge about the importance of education and writing a curriculum, and how to convey knowledge to a person. This higher specialization then led me to create an algorithm that has guided my whole life and academic standing. During this 1-year education, the most important thing I learned was not the simulators worth hundreds of thousands of dollars, but how developing a curriculum about them was the most important thing.

As a part of the University of Minnesota’s CREST, its research and development department realized the importance of being a team. We developed a virtual endoscopic simulator from zero with four distinguished engineers and my role was the medical consultant for this project.

Application Into Practice

My knowledge in the field of education primarily helped me with the lessons I taught to our medical students. Instead of using old-style PowerPoint lessons, I could see the benefits from these lessons where students watched the lessons in advance and then continued as case discussions, resulted in more active participation by the students.

We held our first ureteroscopy simulation course in the Acibadem maslak hospital in 2013. For this course, we used the flexible ureteroscopy training model and curriculum, which was my simulation fellowship thesis.

We accepted a total of 10 trainees for our first course. It has been a great pleasure for me that a few of those trainees have now performed more than 1,000 ureteroscopy cases in total without any ureteral avulsions or major complications. Later, after I completed 5 more of these courses in different provinces, I offered the course to the Turkish Urological Surgery Association, where I currently serve on the board of directors. So far, a total of 15 ureteroscopy courses have been conducted using the same models.

National E Learning Residency Training Program (ERTP)

Another program that should be highlighted is the national urology residency training program and my physicomotor training responsibility in this field. We call this project “ERTP”—in Turkish, it means e-learning residency training program. The ERTP working group—consisting of urologists—was established by the Society of Urological Surgery to create an e-learning model and curriculum in April 2018. Learning objectives were set up in order to determine and standardize the contents of the presentations. In accordance with the Bloom Taxonomy, 834 learning objectives were created for a total of 90 lectures (18 lectures for each PGY year). A total of 90 videos were shot by specialized instructors and webcasts were prepared. Webcasts were posted at uropedia.com.tr—the web library of the Society of Urological Surgery. Today, this program is reaching almost 80% of the national urology residency programs. Each year, we are updating the lessons according to the new guidelines and feedback of the residents and faculty members.

I am the psychomotor training program coordinator of ERTP. We conduct this training program nationally and currently there are approximately 550 urology residents in Turkey every year and we train approximately 500 of them. During the curriculum development process of this training, we published Endoscopic Instrumentation Vol. 1.

In this book, we have written chapters about endoscopic urological instrumentation by expert lecturers from Turkey, conveying practical information and technical features of the devices. The topics of the first book included cystoscopy, ureteroscopy, and laparoscopic surgery. In Endoscopic Instrumentation Vol. 2, we intend to explain transurethral surgery, percutaneous nephrolithotomy, and robotic surgery.  The second book for the curriculum of the psychomotor part will be printed at the beginning of 2023.

For the second book, we interviewed industry companies and created an online visual library so that we would not experience the problems we experienced in the first book. We have uploaded these images to a G-Drive file and by giving access for the authors to this drive folder, we aimed to overcome copyright problems in finding images and to further facilitate the work of our esteemed authors.

This book has served as a curriculum that we are using in resident training. After the didactic lessons had been developed, we thought about how we could do the basic laparoscopy training of the residents during the pandemic period. During this period, we asked a local company to make low-cost training boxes.

In this second volume, we aim to make the book serve both as a printed document and an online platform, by using a QR code that we plan to implement a YouTube link associated with it. For this reason, we ask our authors to prepare short videos of 30 seconds or 1 minute about the episodes of the surgeries and send these videos to us in a separate folder. Next to each section, we are planning to share a QR code that can be scanned by smartphones so our videos on YouTube can be viewed. Below we share how the book image will look like.

More than 1 industrial company will cover the translation of both books to English and other languages in the near future for expanding the knowledge.

Low-Cost Training Box

Our Urologic Surgery Society originally provided 55 of these training boxes (currently 73 boxes) for this project. We sent these boxes to different provinces. The boxes were compatible with lap tops and the Zoom platform. During the training we conducted via Zoom platform, the trainers and trainees had the chance to receive 1-on-1 training. We were able to see the inside of the training box and and the outside view for the residents position, which is very important for laparoscopy. We formed a training team of approximately 20 trainers (now we have 30 trainers) and then completed the Train the Trainer courses. Afterwards, we completed the basic laparoscopy trainings of the 4th- and 5th-year urology residents within a program on the weekends. While giving these trainings, we benefited from platforms like E-Blus. However, platforms and courses were not the same as E-Blus materials. Additionally, we are working on the development of these materials so that they can be used more accurately and adapted to urology.

So far we have trained more than 130 residents in 2021. What we have learned from this online physcomotor course is that they are more cost-effective with in-person meetings and courses. We are expanding our trainer faculty numbers so we will able to increase the number of residents we reach.

Introduction to CASE

The name of our university's simulation center is Center for Advanced Simulation and Education (CASE). It is located on the campus of Mehmet Ali Aydınlar University. It currently serves as the most comprehensive and largest simulation center in the country. The simulation center’s Director, Dr. Emin Aksoy, currently serves as the chairman of NASCE as well. Network of Accredited Skills Centers in Europe (NASCE) stands for the European Simulation Center Education Accreditation Committee. Our center is accredited by Society of Simulation in Healthcare (SSIH), in both the field of core and simulation training. It has also been accredited by the Aaalac committee, which concerns the animals rights and ethical rules.

In this realistically designed center on an area of 1800 m², CASE offers emergency service, ambulance simulator, operating room, skill laboratories, delivery room, debriefing rooms, home environment simulation room, patient room, nursing simulation laboratory, drug preparation room, polyclinic, 2 virtual reality laboratory, ultrasonography training room, intensive care, virtual patient simulation laboratories, medical school students, and basic training laboratory where various scenario application simulations can be mixed with all healthcare professionals.

CASE makes a difference in both undergraduate and graduate education with its various medical simulation methods and technological infrastructure. Learning space patient simulation center management software and simulators are used. This technological infrastructure is a software system that records all the trainings made at the university with the Learning space software, provides access to the video recordings, and where students and educators can log in from their own authorization level accounts and make exams and evaluations. All simulators and medical devices in CASE can be connected to this system, and the simulation process is recorded.

In order to explain the capacity of the center, I would like to share the following video that introduces the center.

CASE consists of medical simulation laboratories in a closed area of 2200 m², as well as a fully equipped operating room with 9 operating tables for laparoscopic surgery, a robotic surgery training center and a dissection laboratory for cadaver-based surgery training, and laboratories with surgical simulators. With mechanical ventilation, point suctions are made over the operating tables and air locks are formed by pressurizing the room entrances with fresh air. In this way, air and odor exits to the outside of the hall are prevented and users are provided to work in a comfortable environment. With all these innovations and capacity, CASE currently serves as the most comprehensive simulation center serving on a country-wide basis.

As I try to help my country and my colleagues on a national scale, I continue to work and produce with more determination and enthusiasm every day. Once again, I would like to express my gratitude to Dr. Sweet and the ACS AEI for their vision and hard work.

All of the photos were provided courtesy of Acıbadem Mehmet Ali Aydınlar University.