Journal of Surgical Simulation 2020; 7: 57 - 62

Published: 24 November 2020



Safety of online surgical training resources

Michael Edwards
Corresponding author: Michael Edwards, Friarage Hospital, Northallerton, North Yorkshire, DL6 1JG, UK. Email:


Online surgical training resources should provide the trainee with unlimited, fault-free information. A preliminary investigation explored the standards of quantity, quality and safety of information provided in a sample of online training resources, describing wide-bore chest drain insertion. They were examined for information for a single essential step: the length of the skin incision. Twenty-five online resources were identified. Five failed to mention skin incision length at all. Four others gave unhelpful information. Four gave incorrect information. Eleven gave unsubstantiated numerical information that would probably lead to too short or, in one resource, to too long an incision. The online training resources included poor quality surgical information, with deficiencies and disagreements in the information given on skin incision length. Urgent correction of low quality and unsafe surgical information is recommended. In comparison, the MHDOS (Masterscript High Detail Operating System) website provides a highly detailed training resource correctly recommending a skin incision length that was half the circumference of the surgeon’s forefinger and includes “what ifs” and evidence. Raising the standard of information available online could be achieved by linking the information from the high to the low detail resources. This could lead to better surgical safety standards worldwide.


surgical education; websites; quality control; simulation; safety standards; LocSSIP