Simulation devices in cardiothoracic and vascular anesthesia.

The subspecialty of cardiothoracic and vascular anesthesia is becoming increasingly complex. Trainees must learn to manage difficult cases and be skilled in performing a variety of procedures. With work hour limitations and societal pressures working to reduce learning and practice opportunities for trainees, new training modalities must be utilized. Simulation is currently being used to increase training efficiency. It allows trainees to experience uncommon clinical situations and complications, repetitive practice opportunities, and can be done on a flexible schedule-all without risk to the patient. Additionally, feedback after a simulation can provide trainees with an assessment of their training progress. Many of the procedures and cases in cardiothoracic and vascular anesthesia can be simulated. Current devices can simulate bronchoscopy, vessel cannulation, complex case management, and cardiopulmonary bypass. They vary from the simple to the complex and from inexpensive homemade wooden devices to high-end computer-controlled virtual reality simulators. Although not all these simulators have been validated as to their educational efficacy, they offer a new avenue to improve training efficacy and efficiency. More research needs to be done to validate these devices and assess their role in anesthesia training.