# Surgical Simulator for Improving Skill Proficiency and Resilience

> **NIH NIH R01** · KITWARE, INC. · 2022 · $476,303

## Abstract

Abstract
 Minimally invasive techniques that are constantly evolving have increased the skill
requirements for successful and safe surgical procedures. There has been an extensive effort in
the last two decades to develop medical simulators for training surgeons. However, much of the
work has focused on medical students and surgical residents who are currently in formal
training programs. There is a recognized need to ensure practicing surgeons maintain their level
of skills through continuous evaluation while simultaneously learning newer procedures or
equipment that get adopted into the OR. The objective of this proposal is to develop, evaluate
and validate simulation technologies to train, retrain and advance the performance and
resiliency of practicing surgeons. We plan to develop open source software templates for rapid
creation of high-fidelity simulations that include rare and adverse surgical events to enable
practicing surgeons maintain and enhance their surgical skill.
 In this project, we propose extending Interactive Medical Simulation Toolkit (iMSTK)-an
open source medical simulation platform, that has been used to prototype virtual trainers for
laparoscopic surgery, orthognathic surgery and other clinical applications. We will develop
software templates for rare and adverse event simulation, including hemorrhage (due to vessel
puncture and unintentional cutting), thermal injury, anatomical variation, and physiological
modeling. In most cases, physiological models are developed separately without coordination
with interactive surgical simulation limiting their capability. In this project, we will integrate
Kitware’s open source Pulse Physiological Engine with iMSTK to build a closed-loop physiology
model that handles local physiological changes and global, systemic physiological responses.
 This project is a collaboration between Kitware Inc. and the University at Buffalo School
of Medicine and Biomedical Sciences (UB) with an End-User Advisory Group (EAG) from
Children National Medical Center (CNMC) and Baylor University Medical Center (BUMC). The
institutes have a long record of collaboration in simulation technology development projects. We
will demonstrate the new software templates by building a virtual surgical simulator for
cholecystectomy with bile-duct injury and other complications that can occur in this type of
surgery. The End-User Advisory Group will meet with the technical team on regular basis to
provide feedback on the technical development. We will conduct face, content, and construct
validity test and learning assessment to validate the simulator.

## Key facts

- **NIH application ID:** 10468965
- **Project number:** 5R01EB031808-02
- **Recipient organization:** KITWARE, INC.
- **Principal Investigator:** Rachel Clipp
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $476,303
- **Award type:** 5
- **Project period:** 2021-09-01 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10468965

## Citation

> US National Institutes of Health, RePORTER application 10468965, Surgical Simulator for Improving Skill Proficiency and Resilience (5R01EB031808-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10468965. Licensed CC0.

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