American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

International ACS-AEI Spotlight: MTSC

Medical Simulation Training Centre (MTSC) at the Medical University of Plovdiv, Bulgaria

We are very proud to present the Medical Simulation Training Centre (MTSC) as the first center to introduce this column with our official accreditation last summer as an American College of Surgeons (ACS) Comprehensive Educational Institute. MSTC is the biggest and most complex training center for medical specialists in Bulgaria. Its mission is to provide the best possible education for students and physicians from different specialties, including internal diseases, pulmonology, cardiology, gastroenterology, rheumatology, anesthesiology, toxicology, surgery, ophthalmology, ENT, orthopaedics, obstetrics and gynecology, pediatrics, and more. Currently, six full-time assistant professors and four professors serve in the MTSC.

MSTC is equipped with a full array of task trainers, manikins, and virtual reality (VR) simulators.

The laparoscopy trainers represent one of the pillars of our sim center. We offer weekly courses for interns and residents. Student workshops are organized quarterly for both Bulgarian and international students, providing numerous educational opportunities in the areas of thoracic and abdominal surgery, urology, and gynecology. The wide variety of instruments and configurations provide an opportunity for training in different approaches and decision making.

MTSC Laprascopy trainer

MTSC students using simulators

Arthroscopy is gaining enormous interest among orthopaedic surgeons and rheumatologists in Bulgaria. The feedback from the manipulators while performing the procedures creates an impression maximally close to real-life conditions.

MTSC Arthroscopy SimulatorMTSC Arthroscopy simulation training

Our newest acquisitions are VR simulators for vitreoretinal and cataract surgery and endoscopic sinus and temporal bone surgery. They are intended to fill the gaps in ophthalmology and ENT training. Both simulators allow for realistic handling and are ideally suited to gaining a thorough understanding of the surgical approaches. We’ve offered curricula in these fields for just a couple of months, and each course combines the training of basic skills with the training of surgical procedures in a consecutively structured course design, leading our students step by step to expert performance.

MTSC simulation machineVR simulators for vitreoretinal and cataract surgery and endoscopic sinus and temporal bone surgery

With the endovascular procedures simulator, the MSTC strives for highly integrated training, and its use has the potential to become a multidisciplinary turning point that can bring together cardiologists, neurosurgeons, and radiologists.

MTSC Endovascular procedures simulator

Regarding endoscopy, we collaborate closely with the national societies of gastroenterologists and pulmonologists.

 MTSC endoscopy training for gastroenterologists and pulmonologistsMTSC Endoscopy simulator

The U/S simulator was a substantial new addition to the sim center that allowed us the opportunity to compose the so-called hybrid trainings (starting the patient case on one simulator and continuing with another simulator for a different procedure). For the sake of didactic education, the U/S simulator combines perfectly with our SimMom manikins, as well as with the endoscopy and endovascular skills simulators. The U/S simulator provides residents, fellows, and practicing physicians an opportunity to acquire and improve their sonography-related skills on a variety of virtual patients, especially at point-of-care setting.

MTSC U/S simulatorMTSC student using U/S simulator

At the MSTC, the curricula are constructed to include dedicated hours for training. We use our own benchmarks to score the participants and constantly increase the number of procedures covered. The box trainers in surgery and all other task trainers are the backbone for teaching procedural competence to students.

MTSC child manikinMTSC simulator

MTSC manikin arms and chestMTSC manikin heads

The pediatric bay is one of the busiest premises of the sim center. The set of standardized patient scenarios is rapidly growing, and the pediatricians are even using the manikins for their semester exams with students.

MTSC students training with pediatric manikinPediatric bay at MTSC

With obstetrics and gynecology, three manikins representing the different stages of the delivery process can be configured in various sets depending on the educational needs of the students in training. For large-scale demos, we use the same configuration with the three SimMoms.

MTSC SimMoms for ob-gyn demosMTSC student training with SimMom

In addition to training students, the MSTC is extensively engaged in developing a growing set of patient scenarios. They are used for the competitions on clinical decision making held at the Annual Conference on Simulation Training in Medicine. The students are very enthusiastic and start preparing at the beginning of the academic year. Since 2015, the sim center has hosted several events, including the Bulgarian–Italian orthopaedic conference with live projection into the lecture halls.

By serving the needs of the higher medical education in our country, we established a small but dedicated community of specialists dealing with simulation training. That’s how the idea for a national conference was born. Each year, we organize a Conference on Simulation Training in Medicine with a great deal of international participation. In 2019, it took place November 8–10, and Professor Carlos Pellegrini (University of Washington) was our keynote speaker.

MSTC is involved in various ongoing research projects, and we are looking for more international collaborations. Our future plans include delivering some international renowned courses like FLS and ATLS so that our center becomes a center of excellence in Southeastern Europe.