Surgical Faculty's Perspectives on the Unknown Utility of Alcohol-Preservation in Surgical Resident Education

Under ideal circumstances, surgical skills training should emulate live surgical conditions as closely as possible. While new anatomically accurate models and virtual/augmented reality simulators make surgical anatomical knowledge acquisition more accessible, research shows that these resources are limited in their ability to fully reflect the live human anatomy, and thus the animal and human body donor models remain the gold standards for surgical simulation (Stefanidis et al., 2013, Venne et al., 2020). Previously, there have been studies comparing the porcine and human body donor models. However, very little is known about alcohol-preserved human body donors in the context of surgical training and education (Balta et al., 2015). The objective of our study was to examine the alcohol-preservation technique and to further elucidate its utility in general surgery resident education. Utilizing semi-structured interviews, we analyzed qualitative data obtained from the accounts of surgical faculty who experienced both the porcine and alcohol-preserved models at The Ohio State University. Results indicated that the porcine and alcohol-preserved human body donor models were preferred for different aspects of surgical training. While the porcine model was preferred for its ability to teach tissue-handling and to simulate live blood flow, the alcohol-preserved model was unanimously preferred for its anatomical relevance. Surgical faculty specifically noted that while there is anatomical overlap between the two models with the anatomy of the rectum, "the small bowel and colon are dramatically different, which does not give the full breadth of colon resection needed for the human model." The alcohol-preserved model was also preferred for its ability to teach advanced surgical procedures in low-stake environments, with a surgical faculty guiding them in a stepwise fashion, and the model was regarded as superior in all aspects as compared to formalin-fixed human body donors. From the results, it was concluded that the alcohol-preserved human body donor model showed unique utility in the context of surgical resident education, simulating live operating conditions more accurately as compared to the formalin-fixed model, and being more anatomically accurate than the porcine model. The findings of this study reflect a significant step in improving surgical resident training and education. Surgical technical proficiency is intimately linked with a surgeon's amount of experience, and by elevating surgical resident preparation, patient surgical outcomes can likely be improved. Future directions of our research involve the continued refinement of the alcohol- and soft-preservation techniques in order to more accurately simulate live operating conditions, to further improve surgeon training and preparation, translating to better future patient surgical outcomes. © FASEB.