David D Odell1, Ryan A Macke2, Vakhtang Tchantchaleishvili3, Gabriel Loor4, Jennifer S Nelson5, Damien J LaPar6, John F LaZar3, Benjamin Wei7, Walter F DeNino8, Kathleen Berfield9, William Stein10, Samuel J Youssef11, Tom C Nguyen12. 1. Thoracic Surgery Resident's Association, Executive Committee, Chicago, Illinois; Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. Electronic address: dodell@northwestern.edu. 2. Thoracic Surgery Resident's Association, Executive Committee, Chicago, Illinois; Division of Cardiothoracic Surgery, University of Wisconsin, Madison, Wisconsin. 3. Thoracic Surgery Resident's Association, Executive Committee, Chicago, Illinois; Division of Cardiac Surgery, University of Rochester, Rochester, New York. 4. Thoracic Surgery Resident's Association, Executive Committee, Chicago, Illinois; Division of Cardiothoracic Surgery, University of Minnesota, Minneapolis, Minnesota. 5. Thoracic Surgery Resident's Association, Executive Committee, Chicago, Illinois; Division of Cardiothoracic Surgery, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina. 6. Thoracic Surgery Resident's Association, Executive Committee, Chicago, Illinois; Division of Thoracic and Cardiovascular Surgery, University of Virginia, Charlottesville, Virginia. 7. Thoracic Surgery Resident's Association, Executive Committee, Chicago, Illinois; Division of Cardiovascular and Thoracic Surgery, Duke University, Durham, North Carolina. 8. Thoracic Surgery Resident's Association, Executive Committee, Chicago, Illinois; Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, South Carolina. 9. Thoracic Surgery Resident's Association, Executive Committee, Chicago, Illinois; Division of Cardiothoracic Surgery, University of Washington, Seattle, Washington. 10. Thoracic Surgery Resident's Association, Executive Committee, Chicago, Illinois; Division of Cardiothoracic Surgery, Emory University, Atlanta, Georgia. 11. Thoracic Surgery Resident's Association, Executive Committee, Chicago, Illinois; Division of Cardiac Surgery, Swedish Medical Center, Seattle, Washington. 12. Thoracic Surgery Resident's Association, Executive Committee, Chicago, Illinois; Department of Cardiothoracic and Vascular Surgery, University of Texas at Houston, Houston, Texas.
Abstract
BACKGROUND: Surgical skills are traditionally taught and practiced in the operating room. However, changes in health care policy and outcome-based evaluation have decreased trainee operative autonomy. We examined cardiothoracic residents' perceptions of operative experience and the role of simulation. METHODS: The In-Training Examination (ITE) is taken each year by all residents. Completion of a 30-question preexamination survey is mandatory, ensuring a 100% response rate. Survey data related to operative experience, career preparedness, and surgical simulation were analyzed. Opinion questions were asked on a 5-point Likert scale. Respondents were grouped into three cohorts by training paradigm (2-year versus 3-year traditional programs and 6-year integrated programs). RESULTS: In all, 314 respondents (122 2-year, 96 3-year, and 96 6-year integrated) completed the survey. Of the three groups, residents in 3-year programs had the highest levels of satisfaction. Advanced training was most common among residents in 6-year integrated programs (66%, versus 49% for 2-year and 26% for 3-year programs; p = 0.63). Desire to specialize drove further training (97%), with 2% stating further training was needed owing to inadequacy and 1% owing to a poor job market. In all assessed categories, the majority of residents believed that simulation did not completely replicate the educational value of an operative case. CONCLUSIONS: Cardiothoracic residents largely feel well prepared for the transition to practice under the current educational paradigm. Although many residents seek advanced training, it seems driven by the desire for specialization. Residents view simulation as an adjunct to traditional intraoperative education, but not as a viable replacement. Further study is necessary to better understand how best to integrate simulation with operative experience.
BACKGROUND: Surgical skills are traditionally taught and practiced in the operating room. However, changes in health care policy and outcome-based evaluation have decreased trainee operative autonomy. We examined cardiothoracic residents' perceptions of operative experience and the role of simulation. METHODS: The In-Training Examination (ITE) is taken each year by all residents. Completion of a 30-question preexamination survey is mandatory, ensuring a 100% response rate. Survey data related to operative experience, career preparedness, and surgical simulation were analyzed. Opinion questions were asked on a 5-point Likert scale. Respondents were grouped into three cohorts by training paradigm (2-year versus 3-year traditional programs and 6-year integrated programs). RESULTS: In all, 314 respondents (122 2-year, 96 3-year, and 96 6-year integrated) completed the survey. Of the three groups, residents in 3-year programs had the highest levels of satisfaction. Advanced training was most common among residents in 6-year integrated programs (66%, versus 49% for 2-year and 26% for 3-year programs; p = 0.63). Desire to specialize drove further training (97%), with 2% stating further training was needed owing to inadequacy and 1% owing to a poor job market. In all assessed categories, the majority of residents believed that simulation did not completely replicate the educational value of an operative case. CONCLUSIONS: Cardiothoracic residents largely feel well prepared for the transition to practice under the current educational paradigm. Although many residents seek advanced training, it seems driven by the desire for specialization. Residents view simulation as an adjunct to traditional intraoperative education, but not as a viable replacement. Further study is necessary to better understand how best to integrate simulation with operative experience.
Authors: Adriana G Ramirez; Nebil Nuradin; Fidele Byiringiro; Robinson Ssebuufu; George J Stukenborg; Georges Ntakiyiruta; Thomas M Daniel Journal: Ann Thorac Surg Date: 2018-02-21 Impact factor: 4.330
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: Alexander A Brescia; Clauden Louis; Jessica G Y Luc; Garrett N Coyan; Jason J Han; David Blitzer; Fatima G Wilder; Curtis S Bergquist; Jordan P Bloom; Rishindra M Reddy; Gurjit Sandhu; J Hunter Mehaffey Journal: JTCVS Open Date: 2022-05-13