The Journal of Thoracic and Cardiovascular Surgery
Volume 143, Issue 2 , Pages 264-272.e9, February 2012

Evaluation of simulation training in cardiothoracic surgery: The Senior Tour perspective

  • James I. Fann, MD

      Affiliations

    • Stanford University and VA Palo Alto Health Care System, Palo Alto, Calif
    • Corresponding Author InformationAddress for reprints: James I. Fann, MD, Department of Cardiothoracic Surgery, Stanford University, 300 Pasteur Drive, Stanford, CA 94305.
  • ,
  • Richard H. Feins, MD

      Affiliations

    • University of North Carolina, Chapel Hill, NC
  • ,
  • George L. Hicks Jr., MD

      Affiliations

    • University of Rochester, Rochester, NY
  • ,
  • Jonathan C. Nesbitt, MD

      Affiliations

    • Vanderbilt University, Nashville, Tenn
  • ,
  • John W. Hammon, MD

      Affiliations

    • Wake Forest School of Medicine, Winston-Salem, NC
  • ,
  • Fred A. Crawford Jr., MD

      Affiliations

    • Medical University of South Carolina, Charleston, SC
  • ,
  • Senior Tour in Cardiothoracic Surgery

Received 27 April 2011; received in revised form 27 July 2011; accepted 4 October 2011. published online 11 November 2011.

Objective

The study objective was to introduce senior surgeons, referred to as members of the “Senior Tour,” to simulation-based learning and evaluate ongoing simulation efforts in cardiothoracic surgery.

Methods

Thirteen senior cardiothoracic surgeons participated in a 2½-day Senior Tour Meeting. Of 12 simulators, each participant focused on 6 cardiac (small vessel anastomosis, aortic cannulation, cardiopulmonary bypass, aortic valve replacement, mitral valve repair, and aortic root replacement) or 6 thoracic surgical simulators (hilar dissection, esophageal anastomosis, rigid bronchoscopy, video-assisted thoracoscopic surgery lobectomy, tracheal resection, and sleeve resection). The participants provided critical feedback regarding the realism and utility of the simulators, which served as the basis for a composite assessment of the simulators.

Results

All participants acknowledged that simulation may not provide a wholly immersive experience. For small vessel anastomosis, the portable chest model is less realistic compared with the porcine model, but is valuable in teaching anastomosis mechanics. The aortic cannulation model allows multiple cannulations and can serve as a thoracic aortic surgery model. The cardiopulmonary bypass simulator provides crisis management experience. The porcine aortic valve replacement, mitral valve annuloplasty, and aortic root models are realistic and permit standardized training. The hilar dissection model is subject to variability of porcine anatomy and fragility of the vascular structures. The realistic esophageal anastomosis simulator presents various approaches to esophageal anastomosis. The exercise associated with the rigid bronchoscopy model is brief, and adding additional procedures should be considered. The tracheal resection, sleeve resection, and video-assisted thoracoscopic surgery lobectomy models are highly realistic and simulate advanced maneuvers.

Conclusions

By providing the necessary tools, such as task trainers and assessment instruments, the Senior Tour may be one means to enhance simulation-based learning in cardiothoracic surgery. The Senior Tour members can provide regular programmatic evaluation and critical analyses to ensure that proposed simulators are of educational value.

CTSNet classifications: 2

Abbreviations and Acronyms: VATS, video-assisted thoracoscopic surgery

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 This study was supported by the Thoracic Surgery Directors Association and the Joint Council for Thoracic Surgery Education, the Thoracic Surgery Foundation for Research and Education Simulation Grant (J.I.F. and R.H.F.), and the Western Thoracic Surgical Association Doty Award (J.I.F.). Corporate sponsors of this session included the Chamberlain Group, Sorin Group, Cryolife, Inc, St Jude Medical, Teleflex Medical, and Lifelike BioTissue.

 Disclosures: Authors have nothing to disclose with regard to commercial support.

 Members of the Senior Tour in Cardiothoracic Surgery: James A. Alexander, MD, Fred A. Crawford, Jr, MD, Thomas M. Daniel, MD, L. Penfield Faber, MD, John W. Hammon, MD, Kamal A. Mansour, MD, William F. Northrup III, MD, D. Glenn Pennington, MD, Bruce A. Reitz, MD, W. Steves Ring, MD, Norman J. Snow, MD, Donald C. Watson, MD, and Walter G. Wolfe, MD.

PII: S0022-5223(11)01098-1

doi:10.1016/j.jtcvs.2011.10.013

The Journal of Thoracic and Cardiovascular Surgery
Volume 143, Issue 2 , Pages 264-272.e9, February 2012