Communal Forum Explores Synergies between Surgeons and Engineers

Surgeons and engineers convened this spring at ACS headquarters in Chicago, Illinois—in a newly expanded 1.5-day format—to explore advancements in simulation technology with the aim of redefining approaches to innovative surgical education.

“We have extended the 2025 Surgeons and Engineers meeting this year because of the demand and due to the large number of abstracts that we received,” said Ajit K. Sachdeva, MD, FACS, FRCSC, Senior Vice President, Education.

A 40% increase in the number of abstracts submitted this year yielded 15 podium presentations and 44 poster presentations—each focused on current trends in surgical simulation-based training. 

“We look forward to this year’s meeting leading to a productive dialogue, resulting in collaborations that will be very meaningful to our larger community,” added Dr. Sachdeva in his opening remarks.

More than 130 surgeons, academic and industry engineers, scientists, and others—including attendees from 10 countries—attended the 2025 Surgeons and Engineers: A Dialogue on Surgical Simulation meeting, now in its sixth year.   

New programming for the multidisciplinary meeting included strategies for building relationships between surgeons and engineers underscored by real-world success stories, the successes and challenges of 3D printing within the framework of surgical education, and a session examining practical applications for cognitive task analysis. A “speed-dating” exercise also was introduced this year in an effort to expedite networking opportunities for attendees.

Simulator Competition and Panel Spark Innovation and Collaboration

Building on the momentum of the inaugural competition last year, the 2025 Do-It-Yourself (DIY) Simulator/Model Competition featured 17 self-built entries illustrating the surgical simulation community’s shared drive for creative solutions to enhance education and training.

A panel of surgeon and engineer judges evaluated each simulator/model, and meeting attendees had the opportunity to vote for their favorite entry.

The first-place awardee was Layla Triplett, MEd, from Duke University Surgical Education and Activities Laboratory in Durham, North Carolina, for the “Inguinal Hernia Simulator.” Jeremiah Egolf, BSBME, of Boston Children’s Hospital in Massachusetts, received the People’s Choice award for “Open Spina Bifida Fetoscopic Repair Simulator.” (Competition participants were not required to be surgeons or engineers, and entries from simulator/model companies were not accepted.)

A Special Panel—"How to Build Better Surgical Simulations: Part 3"—served as an extension of panels presented at the 2023 and 2024 meetings and featured the perspectives of a surgeon educator, academic engineer, and industry engineer.

The panelists included Dmitry Nepomnayshy, MD, MSc, FACS, (surgeon educator) from the University of Massachusetts Chan-Lahey in Burlington; Doga Demirel, PhD, MSc, (academic engineer) from The University of Oklahoma in Norman; and Tansel Halic, PhD, (industry engineer) from Intuitive Surgical in Suwanee, Georgia.

Last year’s surgeon-educator panelist, John T. Paige, MD, FACS, served as moderator of the 2025 Special Panel. He developed several discussion points for the session based on topics that were deliberated in 2024. Dr. Paige also is a professor of clinical surgery and director of wound care at Louisiana State University in New Orleans.

Strategies for overcoming barriers to conducting multi-institutional studies related to simulator development was a key topic addressed by the panelists. An essential component of working across institutions and specialties is to bridge any potential communication gaps.

“It is critical for an engineer to ask clear and concise questions that help surgeons articulate their domain-specific requirements,” said Dr. Demirel. “As engineers, our domain is different than that of the surgeon's domain. When surgeons have conversations about their work, they tend to use words that people outside of their realm might not understand.”

Dr. Nepomnayshy emphasized the importance of gaining professional society support and securing project champions, particularly at the partner institution.

“Allow collaborators to feel a sense of ownership in the process, as if they are co-owners in a small business venture,” explained Dr. Nepomnayshy. “If people have intellectual ownership in the process, they often are more willing to go the extra mile on their own.”

Developing standardizing metrics for simulator design and use was another topic considered by panelists. Metrics should be based on rigorous data and a universal understanding of how to define “good fidelity,” which refers to how closely a simulator mimics real-world procedures, skills, and surgical setting.

“I think that the lack of agreement on what defines good fidelity is part of the difficulty associated with developing standardization,” said Dr. Nepomnayshy. “From my perspective, nothing compares to using actual surgical instruments. So, if you're going to facilitate skills transfer from a simulator to the clinical environment, you should develop simulators that use real surgical instruments in some domain. Surgeons should be consulted at the beginning of the process, or more likely a consortium like the professionals gathered here today.”

The session’s final topic examined practices for reaching a consensus on learning objectives and protocols for simulator research and development. One suggested approach was to link metrics to learning objectives (instead of the reverse), with a specific focus on patient outcomes and goals for surgeon or trainee performance.

“Learning objectives should be a kind of living document,” said Dr. Halic. “They need to be updated and changed regularly, and that requires a long-term commitment from multiple stakeholders rather than one silo of effort. Based on my experience, we should keep the outcomes at the core, then it'll be much easier to have a consensus of learning.”

3D Printing and the Promise of Enhanced Simulation Training

Presenting the pro perspective supporting the use and cost-effectiveness of 3D modeling in surgical education was David (DJ) Traina, Interim Director of Technology for the University of Washington Medical Center’s Clinical Additive Manufacturing Program.

“3D printing gives us an ability to provide patients or trainees with a more intuitive understanding of the state of anatomy or disease,” said Traina in “Debate: Is 3D Printing Still Valuable in Surgical Simulation?,” noting that these models can enhance informed consent conversations with patients.

“Of course, preoperative planning is where 3D printing shines in healthcare,” he added, suggesting that patient-specific modeling can be used as a way for surgeons to practice ahead of time. “Surgeons can print out multiple approaches, multiple models of someone's anatomy and practice a case over and over in different ways and compare and analyze those approaches.”

In terms of cost-effectiveness, Traina cited a study published in August 2024 by the American College of Radiology and the Radiological Society of North America, in which researchers examined a registry launched in 2020 that collected data on 3D printing performed in 20 US healthcare facilities. The study revealed that 3D printing in radiology saved an estimated 41 minutes or $2,500 per case.

In addition to improvements in preoperative planning and the potential for cost savings, 3D-modeling digital designs are shareable, and many groups or labs often post their educational models and simulator designs online.

“It is almost the same thing as teleporting your simulator from one place to another, assuming you have a printer on both ends,” said Traina, pointing out that segmentation and computer-aided design software is not only less expensive today but more intuitive to use.

“My favorite example of this is when NASA emailed a wrench from Earth to the International Space Station’s 3D printer,” said Traina. “We can do the same thing with our simulators. We're an interdisciplinary group from all across the world, and we have the ability to share our simulators via email or Dropbox, which is super exciting.”

Charles J. Aprahamian, MD, FAAP, FACS, surgeon-in-chief at Children’s Hospital of Illinois in Peoria and managing medical director of pediatrics OSF Saint Francis Medical Center, provided the con side of the debate. “This is a cautionary tale for all of us here. Are we pursuing technology simply for technology’s sake? Does a $2,000 savings matter if the patient has a wound complication that costs $40,000–$60,000 on readmission? Ultimately, we need to do better at our job of surgery and taking care of people.”

Dr. Aprahamian underscored the similarities—and redundancies—between 3D modeling and cross-sectional imaging, including computed tomography and magnetic resonance imaging, as both technologies use 2D data to represent 3D structures. He also pointed out limitations in the cost and availability of materials for complex 3D models, especially materials that may not replicate the actual properties of human tissue. 

“It’s a matter of using the right tool for the right job—both technologies are outstanding. If applied correctly, you’ll get the best outcomes at the best costs and the overall best value for the patients,” he said.

Interdisciplinary Partnerships Stimulate Digital Health Innovation

The keynote address, “Forging Partnerships, Transforming Care: Engineers and Surgeons in the Digital Health Revolution,” was presented by Bijan Najafi, PhD, MSc, professor of surgery at the University of California, Los Angeles (UCLA). Dr. Najafi also serves as the research director of the UCLA Center for Advanced Surgical and Interventional Technology, and he is co-director of the National Science Foundation/Industry-University Cooperative Research Centers Program Center to Stream Healthcare in Place.

Dr. Najafi outlined the evolution of digital technology in surgical care, including the introduction of whole-body CT scanners in the 1970s, the adoption of minimally invasive surgical techniques in the 1980s–1990s, the emergence of telemedicine in the late 1990s, and the rise of generative artificial intelligence (AI) starting in 2020.

“We are entering a surgical care era that is not just reactive—it is anticipatory and deeply individualized,” said Dr.  Najafi. “This digital revolution is not just about technology; it is about reimagining how surgeons and engineers collaborate to enhance surgical precision and transform the patient experience.”

He suggested that surgeon proficiency is composed of two domains—technical skills (including hand dexterity and instrument use) and nontechnical skills (engaging in healthy postural ergonomics and managing stress levels). The current gaps in assessing both skills domains include insufficient measures that lack objective and quantifiable data and specifically for technical skills—a paucity of real-time feedback to identify dexterity weaknesses.

To bridge these gaps, surgeons and engineers have collaborated on technology-driven skills assessment via wearable sensors that examine hand motion and track postural ergonomics and stress levels.

Dr. Najafi cited a 2023 study that he coauthored examining sensor technology and its ability to measure dexterity for cardiac surgical proficiency. In the study, researchers found that sensor-based hand motion analysis can distinguish technical dexterity differences between experts and novices and suggested that “objective quantification of hand dexterity may be a valuable adjunct to training and education in cardiac surgery training programs.”

The future of dexterity assessment is AI, according to Dr. Najafi, with some studies suggesting that AI-generated results correlate with sensor-based assessment regarding, for example, surgical knot-tying tasks. Human review of dexterity videos is time-consuming and labor intensive, and AI assessment could be incorporated into the review to expedite the process while maintaining accuracy, thus enhancing the learning experience for the trainee.

“The synergy between digital health innovations and interdisciplinary partnerships is fostering a shift from static, retrospective assessments to dynamic, real-time feedback loops,” Dr. Najafi said. “This evolution will not only improve training outcomes but will also elevate patient safety and operational efficiency in the surgical suite.”

Applying CTA to Surgical Simulation Research

Panelists outlined the fundamentals of the Cognitive Task Analysis (CTA) process as it relates to surgical simulator development in the Sunday morning session. The speakers—all from the University of Washington in Seattle—included Victoria Roach, PhD, David Hananel, BSEE, BACS, and Robert Sweet, MD, FACS.

“CTA is a methodology used to understand how experts perform highly complex tasks,” explained Hananel. “It is the extension of traditional task analysis techniques that yields information about thought processes and the goal structures that underlie observable task performance.”

Hananel’s involvement with the CTA process began with a question posed by his director of engineering—what do surgeons mean by higher fidelity? “That simple question drove me to search for ways to document requirements in the language of educators as a middle ground and translate it into the language of engineers.”

Dr. Roach provided a real-world example highlighting the CTA process in developing an interactive curriculum to teach trainees how to repair full-thickness injury to the ureter in both clinical and simulated settings. Due to the relatively low number of traumatic ureteral repairs per year, the need for skill maintenance was a demonstrated need. 

“We started with our cognitive task analysis by engaging three expert reconstructive urologists at the University of Washington,” explained Dr. Roach. “These extended interviews deconstructed ureter repair procedures step by step, and for each step, we identified learning objectives, key metrics for completion, requirements for the physical simulator, training tips, surgical technique tips, and instrumentation tips.”

According to Dr. Roach, the CTA process resulted in her team’s development of a high-fidelity training system, with preliminary data supporting its validity for educational purposes.

Providing the subject matter expert perspective, Dr. Sweet suggested thinking of CTAs as a narrative because that is how the information is collected—as a series of discussions or interviews.

“Go into the CTA process with the mindset that you’re presenting to watch a video of yourself doing surgery,” he said. “Take the time to pause every 30 seconds or so and act as if the person you are meeting with, the engineer, has absolutely no background in the operation that you are performing. Remember to walk this individual through everything you are thinking—every thought process.”

The call for abstracts and content for the 2026 ACS Surgeons and Engineers meeting opens this month. The meeting will take place March 10-11, 2026, in Chicago. Check the ACS website regularly for updates.

Tony Peregrin is the Managing Editor of Special Projects in the ACS Division of Integrated Communications in Chicago, IL.