Daniel H Enter1, Richard Lee2, James I Fann3, George L Hicks4, Edward D Verrier5, Rebecca Mark6, Xiaoying Lou7, Nahush A Mokadam5. 1. Division of Cardiac Surgery, Bluhm Cardiovascular Institute of Northwestern University, Chicago, Illinois. Electronic address: denter@md.northwestern.edu. 2. Center for Comprehensive Cardiovascular Care, Saint Louis University, St. Louis, Missouri. 3. Department of Cardiothoracic Surgery, Stanford University, Stanford, California. 4. Division of Cardiac Surgery, University of Rochester Medical Center, Rochester, New York. 5. Division of Cardiothoracic Surgery, University of Washington, Seattle, Washington. 6. Joint Council on Thoracic Surgery Education, Chicago, Illinois. 7. Division of Cardiac Surgery, Bluhm Cardiovascular Institute of Northwestern University, Chicago, Illinois.
Abstract
BACKGROUND: Adoption of simulation skills training in cardiothoracic (CT) surgery remains a challenge. This study sought to determine whether a "Top Gun" competition would encourage simulator use and improve technical skills among first-year CT residents. METHODS: A coronary anastomosis simulation module with instructional video was sent to 96 first-year CT residents in traditional programs who were then invited to participate in a Top Gun competition. Residents uploaded a video recording of their baseline anastomosis using the simulator. After 6 weeks of practice under faculty supervision, each trainee uploaded a final video. All submissions were rated in blinded fashion by three CT surgeons. Twelve components were scored on a 5-point Likert scale (1 = poor; 5 = excellent); also, an overall pass-fail grade was given. Five trainees with the highest final scores were invited to compete at a live Top Gun competition. RESULTS: Seventeen trainees submitted a baseline anastomosis video for evaluation; 15 submitted a final video. Overall average scores improved from 3.24 ± 0.61 to 4.01 ± 0.33 (p < 0.001). Performance of the bottom 50% increased (1.11 ± 0.57) relative to the top 50% (0.43 ± 0.31), resulting in no detectable score difference after training (p = 0.14). Overall average time (minutes:seconds) decreased from 11:10 (range, 5:56 to 18:58) to 9:04 (range, 5:52 to 16:23; p < 0.01). Residents achieving a pass from all three raters increased from 13% (2 of 15) to 73% (11 of 15; p < 0.002). Thirteen of 15 residents completed a survey. Residents performed an average of 23 anastomoses (range, 10 to 40). The majority (10 of 13) agreed or strongly agreed that practicing on simulators will improve a trainee's technical skill acquisition. CONCLUSIONS: Focused training results in improved technical skills in vessel anastomosis, especially for residents with lower baseline skills. Simulation, as with any educational endeavor, requires the motivation of the trainee, commitment of the faculty educator, and a defined training curriculum.
BACKGROUND: Adoption of simulation skills training in cardiothoracic (CT) surgery remains a challenge. This study sought to determine whether a "Top Gun" competition would encourage simulator use and improve technical skills among first-year CT residents. METHODS: A coronary anastomosis simulation module with instructional video was sent to 96 first-year CT residents in traditional programs who were then invited to participate in a Top Gun competition. Residents uploaded a video recording of their baseline anastomosis using the simulator. After 6 weeks of practice under faculty supervision, each trainee uploaded a final video. All submissions were rated in blinded fashion by three CT surgeons. Twelve components were scored on a 5-point Likert scale (1 = poor; 5 = excellent); also, an overall pass-fail grade was given. Five trainees with the highest final scores were invited to compete at a live Top Gun competition. RESULTS: Seventeen trainees submitted a baseline anastomosis video for evaluation; 15 submitted a final video. Overall average scores improved from 3.24 ± 0.61 to 4.01 ± 0.33 (p < 0.001). Performance of the bottom 50% increased (1.11 ± 0.57) relative to the top 50% (0.43 ± 0.31), resulting in no detectable score difference after training (p = 0.14). Overall average time (minutes:seconds) decreased from 11:10 (range, 5:56 to 18:58) to 9:04 (range, 5:52 to 16:23; p < 0.01). Residents achieving a pass from all three raters increased from 13% (2 of 15) to 73% (11 of 15; p < 0.002). Thirteen of 15 residents completed a survey. Residents performed an average of 23 anastomoses (range, 10 to 40). The majority (10 of 13) agreed or strongly agreed that practicing on simulators will improve a trainee's technical skill acquisition. CONCLUSIONS: Focused training results in improved technical skills in vessel anastomosis, especially for residents with lower baseline skills. Simulation, as with any educational endeavor, requires the motivation of the trainee, commitment of the faculty educator, and a defined training curriculum.
Authors: Stephanie Fuller; Ara Vaporciyan; Joseph A Dearani; John M Stulak; Jennifer C Romano Journal: Ann Thorac Surg Date: 2020-06-01 Impact factor: 4.330
Authors: Marliza O'Dwyer; Cristina A Fleming; Shane Ahern; Sean Barrett; Nicola B Raftery; Tara Ní Dhonnchú; Kishore Doddakula Journal: BJS Open Date: 2022-01-06