THE ROLE OF SIMULATION
IN SHAPING THE FUTURE OF AI AND ROBOTIC
SURGERY: BRIDGING TRAINING, SAFETY AND
INNOVATION.
Malaysian Students’ Surgical Society 5th Symposium:
Building Tomorrow's Surgeon with Artificial Intelligence
AP Dr Mohd Hisham Isa
Lecturer & Emergency Physician
Fellow in Clinical Simulation
mohimois@[Link]
CURRENT LANDSCAPE OF AI & ROBOTIC
SURGERY
• Da Vinci Surgical Systems: Malaysian hospitals are increasingly
adopting advanced robotic systems. For instance, Sunway Medical
Centre has invested in the latest da Vinci Xi surgical system to
enhance surgical capabilities and patient outcomes
([Link]
• Mako Robotic-arm assisted surgery system for joint replacement
surgeries has been adopted by SJMC (Subang Jaya Medical Centre)
• Many institutions are conducting studies to identify key drivers and
future trends in the adoption of robotic surgery in Malaysia (UTHM
Publisher)
CHALLENGES
Complexities Competency Safety
in training validation concerns
WHAT IS SIMULATION
• Simulation is a technique trying to imitate some real
things, state of affairs, or processes (Phrampus et al., 2011).
• Simulate= imitate
• The imitation often for the purposes of training,
education, experimentation, or analysis."
WHAT IS HEALTHCARE SIMULATION?
“a technique that creates a situation or environment to
allow persons to experience a representation of a real
event for practice, learning,
High initial costs for AI tools
evaluation, testing, or
Start with affordable, scalable tools
to gain
an understanding of systems
Implementor
Data privacy and security concerns datahuman actions.”
protection measures
Need for employee training and adaptation Offer training sessions on AI usage
WHY SIMULATION ?
• Experiential Learning
• Controlled Environment
• Immediate Feedback
• Deliberate Practice
• Capture Clinical Variation
• Individualized
AI can analyze vast
Learning
Helps anticipate market
amounts of data trends, customer needs,
• Range of Difficulty Levels
quickly. and potential risks.
• Simulator Validity
EXPERIENTIAL LEARNING
• Learning through direct experience
• Learners actively engage in tasks, reflect on their
actions, and apply those insights to improve
performance
E.g: Robotic Surgery: Mimics intraoperative
challenges, such as bleeding or equipment failure,
enhancing problem-solving skills.
CONTROLLED ENVIRONMENT
• Provides a risk-free platform to make mistakes and
learn from them.
• Adjust environmental factors like lighting,
emergency situation, or equipment malfunctions.
E.g: Practicing robotic surgery during simulated power
failure, equipment failure, etc.
Immediate FEEDBACK
• Simulators provide immediate feedback and
providing users with instant insight into their
performance.
E.g., robotic surgery: learners receive real-time data
on their performance, such as precision, timing, or
technique-can track the accuracy of incisions, depth
of cuts, or time taken for a procedure.
DELIBERATE PRACTICE
• Enables repetitive practice until mastery is achieved
E.g: Residents/trainees use robotic simulators to
repeatedly practice suturing and knot-tying on simulated
tissue until they achieve precision, speed, and
consistency.
CAPTURE CLINICAL
VARIATION
• Simulates diverse clinical scenarios, including
rare or complex cases -HALO
E.g: Practice handling difficult anatomy,
unexpected bleeding, or rare tumor resections.
INDIVIDUALIZED LEARNING
• Learn at Own Pace: Trainees can progress at
their own speed and be flexible at their own
time.
E.g: A surgical trainee practicing robotic arm
docking or suturing can repeat these tasks as often
as needed at their own pace and speed.
RANGE OF DIFFICULTY LEVELS
Simulations can be tailored from novice to advanced
complexity by: Result:
1. Gradually increase the complexity
[Link] skill progression
[Link] the clinical situations
SIMULATOR VALIDITY
• Ensuring Reliability and Consistency in
Simulation Training
E.g: A single simulator can be used by multiple
trainees and will produce consistent findings
and results, ensuring the validity of the
simulation
ENHANCING SAFETY
THROUGH SIMULATION
• Risk-free environment
• No impact on patient care
E.g: In a surgical simulation, trainees can
perform procedures repeatedly without the
consequences of making errors on actual
patients.
ENHANCING SAFETY
THROUGH SIMULATION
Protection Against Physical Risks
E.g: No exposure to infectious diseases,
radiation, or procedural hazards.
PSYCHOLOGICAL SAFETY
• Non-Punitive Environment:
Encourage learners to engage without fear of
judgment or negative consequences for mistakes
• Confidentiality:
Respect learners' privacy and ensure that
performance assessments are discussed in a safe,
confidential manner to avoid unnecessary stress
DRIVING INNOVATION WITH SIMULATION
Integration of Data and Analytics
• Simulations generate data to refine AI models, improving decision-
making and predictive capabilities.
• Promotes evidence-based innovations by evaluating outcomes in
simulated scenarios.
TESTING ETHICAL AND REGULATORY
STANDARDS
• Simulated environments enable the exploration of ethical implications
and compliance with regulatory requirements.
• Reduces risks associated with deploying untested AI and robotic
systems in clinical settings.
FINAL THOUGHTS Simulation as a Transformative Tool
It offers a controlled, risk-free environment
for training
Bridging Training and Innovation
bridges the gap between traditional surgical
training and cutting-edge advancements in AI
and robotics
Enhancing Safety and Reliability
by reducing physical and psychological
risks, and validating skills in a non-punitive,
confidential environment.
Driving AI and Robotic Surgery
Forward
By integrating data analytics from simulations,
HCP can refine AI models, ensure ethical
compliance and explore innovative techniques.
THANK YOU
FOR YOUR ATTENTION
Contact
mohimois@[Link]
[Link]
