The successful application of simulation-based training in thoracic surgery residency

Burkhart, Harold M.; Riley, Jeffrey B.; Hendrickson, Sarah E.; Glenn, George F.; Lynch, James J.; Arnold, Jackie J.; Dearani, Joseph A.; Schaff, Hartzell V.; Sundt, Thoralf M.

doi:10.1016/j.jtcvs.2009.10.029

« Previous Next »The Journal of Thoracic and Cardiovascular Surgery
Volume 139, Issue 3 , Pages 707-712, March 2010

The successful application of simulation-based training in thoracic surgery residency

Read at the Thirty-fifth Annual Meeting of The Western Thoracic Surgical Association, Banff, Alberta, Canada, June 24–27, 2009.

Harold M. Burkhart, MD
- Division of Cardiovascular Surgery, Mayo Clinic and Foundation, Rochester, Minn
- Address for reprints: Harold M. Burkhart, MD, Division of Cardiovascular Surgery, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905.
Jeffrey B. Riley, CCP
- Department of Cardiovascular Perfusion, Mayo Clinic and Foundation, Rochester, Minn
Sarah E. Hendrickson, MA
- Division of Cardiovascular Surgery, Mayo Clinic and Foundation, Rochester, Minn
George F. Glenn, CCP
- Department of Cardiovascular Perfusion, Mayo Clinic and Foundation, Rochester, Minn
James J. Lynch, MD
- Department of Anesthesiology, Mayo Clinic and Foundation, Rochester, Minn
Jackie J. Arnold, RN
- Mayo Multidisciplinary Simulation Center, Mayo Clinic and Foundation, Rochester, Minn
Joseph A. Dearani, MD
- Division of Cardiovascular Surgery, Mayo Clinic and Foundation, Rochester, Minn
Hartzell V. Schaff, MD
- Division of Cardiovascular Surgery, Mayo Clinic and Foundation, Rochester, Minn
Thoralf M. Sundt III, MD
- Division of Cardiovascular Surgery, Mayo Clinic and Foundation, Rochester, Minn

Received 26 June 2009; received in revised form 6 October 2009; accepted 17 October 2009. published online 28 December 2009.

Objective

We developed and tested a clinical simulation program in the principles and conduct of cardiopulmonary bypass with the aim of improving confidence and proficiency in this critical aspect of cardiac surgical care.

Methods

Fifteen residents from 6 resident-training programs who reported no prior cardiopulmonary bypass observation or simulation-based perfusion experience participated in a cardiopulmonary bypass course involving both didactic lectures and hands-on simulation. A computer-controlled hydraulic model of the human circulation was used in a specifically designed multidisciplinary simulation center environment to give the participants hands-on training with both basic operations and specific perfusion crisis scenarios. Pretraining and posttraining assessments concerning confidence, knowledge, and applications with regard to cardiopulmonary bypass were administered and compared.

Results

Likert scale scores on confidence-related items increased significantly (P < .001), from 59% ± 16% to 92% ± 8%. Pretraining versus posttraining scores (72% ± 14%) on similar cognitive items were not significantly different (P=.3636). Scores on similar open-ended application items before and after training improved from 62% ± 25% to 85±10% (P < .0001). All subjects agreed that simulation-based cardiopulmonary bypass training was superior to classroom- and clinic-based education and that the scenarios enhanced their learning experience.

Conclusions

Simulation-based cardiopulmonary bypass training appears to be an effective technique to build the confidence of thoracic surgery residents regarding knowledge and applications. Scenario-based practice in a specifically designed simulated environment is a valuable adjunct to traditional educational methods and has the potential to improve the training of thoracic residents.

CTSNet classification: 2, 25

Abbreviations and Acronyms: CPB, cardiopulmonary bypass, TSDA, Thoracic Surgery Directors Association