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Clementines help surgeons-in-training to practice

What's part substantial and sturdy, part spongy and delicate? A clementine. Also, tissues of the pelvis.

Shots reports today that Pamela Andreatta, EdD, a medical educator at the University of Michigan Medical School, realized the useful likeness of these two structures when considering how to prepare residents to conduct surgery. By practicing cutting and stitching techniques on the fruits, doctors in training could get a better feel for surgery than by only observing a surgeon, and they could do so more cheaply than using high-tech surgical simulators. Laparoscopic surgery in particular, Andreatta said, could be better understood using this simple model.

From the entry:

The idea came to Andreatta after a colleague in gynecologic oncology asked whether she could come up with a simulation to teach the delicate task of removing lymph nodes, something done to minimize the spread of cancer.


Andreatta set up an exercise using an opaque box with holes in the top through which you can insert a camera, scissors and grasper. She invited residents, medical students and faculty to dissect clementines.

They had to take off the peel in as few pieces as possible, remove the pith, separate the segments, then put everything back together and suture the peel closed. They had two hours to complete the task.

Among the 41 exercise participants, minimally invasive surgeons - many of whom remarked on the similarities between the simulation and actual surgery - scored best, with residents and nonsurgical faculty following and medical students further behind. Andreatta said the results "confirm that the clementine is a suitable model for training," and she now encourages training on the fruits as well as foam shapes purchased from a craft store. She added:

You can find clementines or setsumas or tangerine variations all over the world... You can go out and pick them off a tree, and it costs very little or nothing... and yet it's very advanced training.

Previously: Image of the Week: Antique trephination set and A look at an iPad in the operating room
Photo by Muffet

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