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During past decades, technical and technological advances in surgical and interventional procedures have resulted in the consolidation of minimally invasive procedures and interventions that minimise trauma to patients while maximising treatment/diagnostic efficiency. However, the road to mastery of these procedures is a long and challenging one, where trainees must undergo years of postgraduate residency and specialization.

To achieve proficiency, candidates need to acquire a series of technical and nontechnical (cognitive, decision making) skills. The process begins during medical degree, in which theoretical knowledge is imparted traditionally by on site lessons. However, real training begins during residency, when candidates are placed under guided tutorship to develop technical and decision-making skills. This process, known as the Halstedian paradigm (“see one, do one, teach one”) is nowadays considered (1) time and resource consuming both for residents and mentors, who must integrate learning in clinical practice; and (2) subjective, since assessment of competence is highly dependent on the mentor. Furthermore, there is an ever-higher social awareness demanding patient-safe training ensuring the certification of qualified professionals.

As a consequence, training paradigms are shifting towards new structured programmes striving to (1) provide means for learning and training in patient-free environments, (2) adapt to resident’s schedule and (3) provide an objective assessment of the different skills. In this change, technology enhanced learning (TEL) plays a major role, both for technical (virtual reality simulation, instrument tracking for motion analysis, etc.) and nontechnical (e-learning, augmented videos, etc.) skills learning. Training centres and hospitals are integrating TEL into their learning programmes; however, there are no general guidelines on their incorporation and use, being highly dependent on the centres’ economical possibilities and the funders’ choices rather than on their pedagogical value.

This diversity in fact reflects a larger issue: the lack of a common European pedagogical framework for learning and accrediting surgical and interventional skills. As a consequence, it is up to each country to set curricular and competency standards, which on the long run can be a hindrance to professional’s mobility across the EU.

The European Knowledge Alliance for Innovative Education of Surgical and Interventional Skills (EASIER) proposes an innovative approach for surgical and interventional teaching and learning based on TEL. EASIER will exploit the use of ICT and other TEL-related assets (virtual reality, augmented video, augmented box trainers, etc.) to provide residents and mentors with a solution to program training activities, have access to ubiquitous learning and monitor progress on the different skills. The solution will be grounded on a validated learning framework, based on the pedagogical model developed in LLP project MISTELA, which was successfully applied to minimally invasive surgery (MIS) cognitive skills’ learning. This will set the basis for a EU strategy on a common TEL-based programme offering structured learning and assessment, which will help standard graduate and postgraduate training across the continent, thus favouring mobility of professionals as well as the exchange and co-creation of knowledge.


All partners in the Alliance share a common goal: to develop a common European standard for surgical and interventional learning supported on the efficient use of TEL. As a consortium, partners are fully aware of the needs of surgical and interventional education and the impact that a project such as this may have in the field. TEL-based surgical learning has been growing in the last twenty years, often at a higher rate than that of learning programmes trying to keep up with it. No pedagogical consensus exists on their use, and validation studies present more often than not diverging results. EASIER will provide European training institutions with a pedagogically-supported, TEL-based learning management system (LMS). In order to build it, the Alliance comprises a mix of private and public institutions coming from the fields of higher education surgical learning, ICT R&D and pedagogical consultancy.

As main stakeholders of the project’s results, EASIER goals fully align with the strategy of participating surgical training HEI devoted to surgical and interventional education. These institutions (CCMIJU - Spain, DSRT-SU - Hungary, MEDIS - Romania) participate in their respective countries in training new professionals under the highest quality standards. As such they must always keep up front of the state of the art in surgical and interventional techniques, pedagogical approaches and technologies for learning. Moreover, they must strive towards ensuring that residents become fully capable professionals, able to safely practice in any hospital in the world.

Technological and pedagogical partners include technological HEI (UPM - Spain, TUDELFT - The Netherlands, UCY - Cyprus) and companies (CYRIC, SIMENDO, MediShield - The Netherlands, EVR- Spain). Both HEI and the Dutch SMEs share a common interest in the research, development and commercialization of new TEL solutions for surgical and interventional education. In EASIER, they do not only find the means for new strategic partnerships in the field, but an opportunity to bring their technologies together and develop a complete TEL solution for surgeons and interventionists from all over Europe. The consortium’s strength is also a great opportunity for growing and publicising their brands. Finally, SEIT, Everis and CYRIC, as experts in pedagogical and e-learning services, will also benefit from the know-how generated in the project by exploiting the pedagogical model and the LMS.

The Alliance fully aligns with EU policies for higher education. Mainly addressing postgraduate levels (master/doctorate), EASIER is committed to the same goals stated by the Bologna Process regarding strengthening quality assurance and facilitating study, learning and recognition of qualifications. The MISTELA pedagogical model, on which this project will be based, established a roadmap for setting and assessing learning outcomes supported by the use of TEL, as well as recommendations on the use of ICT resources and the definition of didactic contents according to learning outcomes. In EASIER, ICT and related technologies are proposed to provide flexible, ubiquitous learning of technical, cognitive and decision-making skills. The proposal of a common pedagogical model describing guidelines to acquire all these skills will help to standardize learning pathways and accreditation across EU, facilitating the exchange of knowledge and professionals’ mobility.