— College of Medicine — Department of Surgery — Residencies and fellowships — General Surgery Residency — Program Curriculum — Simulation Labs

Simulation Labs

The General Surgery Residency Program at UNMC has an extensive surgical skills training program in place. This comprehensive skills training program allows our residents to have the opportunity to become proficient in the technical skills and procedures required of surgical residents in a safe and low stress environment at the Davis Global Center.

The Davis Global Center is a highly advanced clinical simulation facility purposefully designed to foster the practice of patient care in highly-functioning and effective interprofessional teams. The 192,000 sq.ft. center is made up of five distinct levels that work together to create a safe and innovative learning environment.

We have a comprehensive simulation program that includes labs with fresh cadaveric tissue that include both open and laparoscopic cases. We have simulators for minimally invasive training (Fundamentals of Laparoscopic Surgery (FLS) trainers and a Fundamentals of Endoscopic Surgery (FES) trainer), robotics (DaVinci SimNow), and ultrasound. We also offer multiple courses from the American College of Surgeons (ACS). Through this comprehensive skills training curriculum, we aim to train residents to be technically proficient in all aspects and approaches to surgery.

Fresh Cadaveric Tissue Lab

Task Trainers

Minimally Invasive Surgery Training

Our first through fourth year residents participate in cadaveric simulation labs. Each lab has two faculty, one residency class per lab, and a small faculty to resident ratio. During the lab, the residents focus on core surgical procedures from the Surgical Council of Resident Education (SCORE), and are performed on fresh cadaveric tissue. The cases include both open and laparoscopic cases. Over the course of the year, each class attends three to five cadaver labs per year. This allows our residents to focus their technical procedural skills in a low stress environment, prior to participating in these cases on clinical rotations.

In addition, all of our residents complete the ACS hands-on courses that are held in the cadaver lab: Advanced Surgical Skills for Exposures in Trauma (ASSET) and Basic Endovascular Skills for Trauma (BEST).

Starting the first year, our program exercises use task trainers to improve efficiency in their procedural skills including chest tube insertion, intubation, central and arterial line placement. We also have an ultrasound simulation curriculum where we have simulated patients to allow our trainees to hone their skills. Residents are taught basic physics, knobology, and instruction of basic image acquisition for Transthoracic Echo and the FAST and e-FAST exam. This builds residents’ confidence using an ultrasound machine and trains them to make acutely hemodynamic assessments in the ICU. During this time, our faculty help to give tips and tricks to build confidence and prepare our residents to succeed.

There is an increasing emphasis on minimally invasive surgery, including both laparoscopic and robotic surgery. The third level of iEXCEL houses both laparoscopic trainers, as well as the SimNow. During these labs, we work on the efficiency of residents in their movements and ensuring proficiency in suturing.

We have a robotic curriculum which all our residents have at least two dedicated labs per year when they have individual learning time with our faculty to receive constructive feedback. When our residents have completed our program, they are able to be robotically certified.

Fundamentals of Laparoscopic Surgery

Fundamentals of Endoscopic Surgery

The FLS program is an educational module and assessment tool jointly supported by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) and ACS. It's designed to teach the fundamental knowledge, judgment and technical skills required in basic laparoscopic surgery. This test is required to sit for the American Board of Surgery (ABS) Qualifying Examination. Our residents complete this by end of their first year. UNMC is a testing site for the FLS examination.

The FES program is a comprehensive educational and assessment tool designed to teach and evaluate the fundamental knowledge, clinical judgment and technical skills required in the performance of basic gastrointestinal (GI) endoscopic surgery (endoscopy). We have a GI mentor to allow our residents to hone their skills. Our residents complete this during their third and fourth year, all with the goal of improving the quality of patient care. UNMC is a designated FES testing center.