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Resident perceptions of simulation lab utility: A qualitative study across internship and three levels of general surgery residency at skills lab
*Corresponding author: Samir Ranjan Nayak, Department of General Surgery, Ganni Subba Lakshmi Medical College and General Hospital, Rajahmundry, India. drsamirnayak@gmail.com
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Received: ,
Accepted: ,
How to cite this article: Rentachintala T, Mokkarala P, Adusumilli DC, Nayak SR. Resident perceptions of simulation lab utility: A qualitative study across internship and three levels of general surgery residency at skills lab. RMC Glob J. 2025;1:76–79. doi: 10.25259/RMCGJ_21_2025
Abstract
Objectives
Simulation-based surgical training is increasingly adopted to enhance residents’ skills and confidence. However, its perceived utility among trainees in Indian medical settings remains under-explored. The objective of the study is to explore and compare perceptions of postgraduate interns and general surgery residents (PGY-1 to PGY-3) regarding simulation-based training.
Material and Methods
A qualitative study using semi-structured interviews was conducted with 12 participants (3 interns, 9 residents) at GSL Medical College. Data was analyzed theoretically using Braun and Clarke’s framework.
Results
Trainees appreciated the simulation for enhancing technical skills and building confidence. Perceived advantages included safer practice, shorter learning curves, and increased readiness for the OR. Key challenges included limited access, faculty time, and insufficient simulation complexity for senior residents. Suggested improvements included structured simulation curricula, advanced scenario development, and protected practice time.
Conclusion
Simulation training is well-received and valued across all training levels. Incorporating regular, tiered, and faculty-guided sessions may enhance its impact, particularly in resource-limited settings.
Keywords
Clinical Scenarios
Hands on Practice
Residency
Simulation
Skill development
INTRODUCTION
Simulation-based training has transformed surgical education by providing a safe, controlled environment to learn operative techniques, especially in the context of minimally invasive surgery, work-hour restrictions, and rising patient safety standards.1 It offers deliberate, repetitive practice of skills before trainees perform them on patients.2,3 Evidence shows that simulation significantly improves surgical performance, reduces errors, and accelerates learning curves.4,5
Seymour et al. found that residents trained via virtual reality performed laparoscopic cholecystectomy faster and with fewer errors than those without simulation training.6 Meta-analyses confirm that simulation improves intraoperative skills and patient outcomes.7 Accreditation bodies like the ACGME have mandated simulation access in surgical training [Figure 1].8 Besides technical training, simulations improve confidence, teamwork, communication, and critical thinking.9,10
- Demand for complex simulation with progressive participant training level. PGY: Postgraduate year.
Despite global advances, the implementation of simulation in India is still maturing. The National Medical Commission has mandated skills labs; however, their integration and utilization vary.11,12 Studies on Indian residents’ views toward simulation are limited. Some suggest that juniors exhibit high enthusiasm, while seniors display skepticism.13 Boyd et al. found that juniors value simulation more, while seniors seek higher-fidelity tools.14
This study explores the perceptions of general surgery residents and interns at GSL Medical College & General Hospital, Rajahmundry, regarding simulation-based training, identifying barriers and opportunities for improving its implementation.
MATERIAL AND METHODS
Study design
A descriptive qualitative design using semi-structured interviews was conducted at GSL Medical College’s simulation lab.
PARTICIPANTS
Twelve participants (three interns and three each from PGY [postgraduate year]-1 to PGY-3) were selected via purposive sampling. Inclusion criteria: any general surgery trainee who had used the simulation lab.
Data collection
Interviews were conducted in English (April 2025), audio-recorded, and transcribed verbatim. Thematic analysis followed Braun and Clarke’s six-step framework.15
Ethical considerations
Institutional Ethics Committee approval (GSL/IEC/2025/03) was obtained. Participants provided written informed consent.
RESULTS
Theme 1: Skill development and confidence building
Interns and juniors reported improved suturing, knot-tying, and laparoscopic skills after simulator practice. A PGY-1 stated, “Simulation helped me master instrument handling before real surgeries.”
Senior residents acknowledged refinement of specific skills. A PGY-3 noted, “Even now, I revisit laparoscopic suturing in the lab before complex cases.”
Theme 2: Patient safety and readiness
Trainees emphasized the importance of safer transitions to clinical work [Figure 2]. Interns valued practicing before touching real patients. A PGY-2 said, “Practicing chest tube insertion in the lab helped avoid hesitation in the ICU.”
- Perceived impact of key themes across training levels. PGY: Postgraduate year. The numbers in the figure represent the frequency of participant responses (interns, PGY-1 to PGY-3) highlighting perceived impact of each key theme discussed in the interviews.
Theme 3: barriers to utilization
Time constraints, lack of protected sessions, occasional material shortages, and limited faculty availability were major barriers [Figure 3]. A PGY-2 added, “We want to use the lab more, but duty hours restrict us.”
- Mentions of key themes by participant level.
Theme 4: Suggestions for improvement
Trainees suggested structured, tiered simulation curricula by PGY level, advanced scenarios for senior residents, peer mentoring, regular faculty-led sessions, and improved scheduling [Figure 4].
- Frequency of participants’ suggestions for improvement.
DISCUSSION
This study confirms that Indian surgical trainees, particularly juniors, value simulation-based training [Figure 5]. Perceived benefits align with prior studies.3,4 Simulation is seen as an essential adjunct to clinical learning, offering skill mastery without compromising patient safety.5–7
- Distribution of study participants by training level. PGY: Postgraduate year.
Challenges such as workload, access, and supervision are consistent with those in other developing settings.12,13 Structured integration into the curriculum, tiered scenarios, and protected time are necessary to enhance engagement.14,15
Faculty involvement, peer teaching, and scenario diversity can overcome existing limitations. Even basic simulation tools can be effective if supported with thoughtful implementation.16,17
CONCLUSION
All levels of surgical training appreciate simulation training. Interns and juniors benefit most from practicing basic skills, while seniors desire complex, realistic scenarios. Institutional support through scheduled sessions, curriculum integration, and improved resources can ensure simulation becomes a core pillar of surgical education.
Ethical approval
The study was approved by the Institutional Ethics Committee at Ganni Subba Lakshmi Medical College and General Hospital, Rajahmundry, number GSL/IEC/2025/03, dated 3rd January 2025.
Declaration of patients consent
The authors certify that they have obtained all appropriate participant consent.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
Use of artificial intelligence (AI)-assisted technology for manuscript preparation
The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.
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