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The Successful Application Of Simulation-based Training In Thoracic Surgery Residency
Harold M Burkhart, Jeffrey Riley, Sarah Hendrickson, George Glenn, James Lynch, Jackie Arnold, Hartzell Schaff, Thoralf Sundt
Mayo Clinic, Rochester, MN
BACKGROUND:
Medical simulation is rapidly emerging as an educational tool much as it has been in other industries for many years. We therefore developed and tested a clinical simulation program in the principles and conduct of cardiopulmonary bypass (CPB) with the aim of improving confidence and proficiency in this critical aspect of cardiac surgical care.
METHODS:
Eight residents from five United States resident training programs who reported no prior CPB observation or simulation-based perfusion experience participated in a two-day CPB course involving both didactic lectures and hands-on CPB simulation. A Stockert S-5 pump (Sorin Group USA, CO, USA) connected to an Orpheus (Ulco Technologies, Marrickville, NSW, Australia), a computer controlled hydraulic model of human circulation, was utilized in a specifically-designed multidisciplinary simulation center environment to give the participants hands-on training with basic operations as well as specific perfusion crisis scenarios. Pre and post-training assessments concerning confidence, knowledge and applications with regard to CPB were administered and pre and post-training scores compared by matched-pair t-test with p < 0.05 set as statistically significant.
RESULTS:
Likert scale scores on six confidence-related items increased significantly (p < 0.001). Pre versus post scores on ten similar multiple-choice cognitive items were not significantly different (p = 0.785). Scores on five similar open-ended application items before and after training improved from 60 ± 28.7% to 79 ± 7.6% (p = 0.130). All subjects agreed that simulation-based CPB training was superior to classroom and clinic-based education, that the scenarios met their needs to enhance their learning experience, and that they recommend the course to their peers.
CONCLUSIONS:
Simulation-based CPB 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 valuable adjunct to traditional education methods and has the potential to improve the training of thoracic residents.
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