PROFESSIONAL Simulation based education Models for teaching surgical skills in general practice The authors believe that teaching surgical skills to general practice registrars using SBE is a priority because: • while recent reports indicate an increasing number of conditions requiring surgical intervention in general practice, 2 there is simultaneous deskilling of general practitioners in performing minor surgical procedures 3 • an increase in procedural work has the potential to attract more junior doctors to the specialty of general practice 4 by improving job satisfaction, range of work and patient satisfaction. 5 General practitioner supervisors – who play an important role in training general practice registrars to undertake and master practice- based surgical procedures 6 – need to ensure that registrars are technically and clinically competent and safe. In order to maintain procedural skills, and to increase enthusiasm for such procedures, simulated models are useful as they allow the opportunity for ‘deliberate practise’ 7 in a stress free environment. It has been observed that medical skills laboratories do lead to improvement in procedural skills compared with standard or no training when assessed by simulator performance and immediately post-training. 8,9 There are a range of simulation models available for teaching surgical skills and their advantages and disadvantages have been well described. 10 When choosing a teaching model, the ‘functional similarity’ of the model to its real-life counterpart is crucial. 11 In recent years, many simulation models have become available commercially, but most of these are expensive, difficult to access, or are poor replicas of the conditions seen in human patients. Sushruta – the father of plastic surgery – has been stated to use simple simulation models such as fruits and animal hides to teach common surgical procedures. 12 In this article we describe three simulation models for teaching surgical skills in general practice following the examples described by Sushruta to teach: 12 Simulation based education (SBE) has been widely incorporated into the curricula of most Australian medical schools and in the Australian Junior Doctors curriculum (http://curriculum. cpmec.org.au). In addition, SBE is used in general practice vocational training and is integrated into the curricula of The Royal Australian College of General Practitioners (RACGP) (www.racgp. org.au/curriculum) and the Australian College of Rural and Remote Medicine (ACRRM) (www. acrrm.org.au/curriculum). Simulation based education is also used in the training of many other health professions, including nursing, physiotherapy, pharmacy and speech therapy. Health Workforce Australia has recognised the current and potential use of SBE in medical training and is now providing financial support for a coordinated national approach. 1 Sankar Sinha Nicholas Cooling Background Simulation based education is an accepted method of teaching procedural skills in both undergraduate and postgraduate medical education. There is an increasing need for developing authentic simulation models for use in general practice training. Objective This article describes the preparation of three simulation models to teach general practice registrars basic surgical skills, including excision of a sebaceous cyst and debridement and escharectomy of chronic wounds. Discussion The role of deliberate practise in improving performance of procedural skills with simulation based education is well established. The simulation models described are inexpensive, authentic and can be easily prepared. They have been used in general practice education programs with positive feedback from participants and could potentially be used as in-practice teaching tools by general practitioner supervisors. Importantly, no simulation can exactly replicate the actual clinical situation, especially when complications arise. It is important that registrars are provided with adequate supervision when initially applying these surgical skills to patients. Keywords simulation, models; procedural skill; general practice, teaching Reprinted from AusTRAlIAn FAmIly PhysIcIAn Vol. 41, no. 12, DecembeR 2012 985