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.
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.
aDivision of Cardiovascular Surgery, Mayo Clinic and Foundation, Rochester, Minn
bDepartment of Cardiovascular Perfusion, Mayo Clinic and Foundation, Rochester, Minn
cDepartment of Anesthesiology, Mayo Clinic and Foundation, Rochester, Minn
dMayo Multidisciplinary Simulation Center, 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.
Disclosures: T. Sundt reports grant support from Sorin.
ABSTRACT