TY - JOUR
T1 - Simulation in coronary artery anastomosis early in cardiothoracic surgical residency training
T2 - The Boot Camp experience
AU - Fann, James I.
AU - Calhoon, John H.
AU - Carpenter, Andrea J.
AU - Merrill, Walter H.
AU - Brown, John W.
AU - Poston, Robert S.
AU - Kalani, Maziyar
AU - Murray, Gordon F.
AU - Hicks, George L.
AU - Feins, Richard H.
N1 - Funding Information:
Disclosures: Supported by the Thoracic Surgery Directors Association and Western Thoracic Surgical Association Doty Award . Corporate sponsors for this session included Sorin Group , Cryolife, Inc , Scanlan International , Deknatel , and Ethicon .
PY - 2010/5
Y1 - 2010/5
N2 - Objective: We evaluated focused training in coronary artery anastomosis with a porcine heart model and portable task station. Methods: At "Boot Camp," 33 first-year cardiothoracic surgical residents participated in 4-hour coronary anastomosis sessions (6-7 attending surgeons per group of 8-9 residents). At beginning, midpoint, and session end, anastomosis components were assessed on a 3-point rating scale (1 good, 2 average, 3 below average). Performances were video recorded and reviewed by 3 surgeons in a blinded fashion. Participants completed questionnaires at session end, with follow-up surveys at 6 months. Results: Ten to 18 end-to-side anastomoses with porcine model and task station were performed. Initial assessments ranged from 2.11 ± 0.58 (forceps use) to 2.44 ± 0.48 (needle angles). Midpoint scores ranged from 1.76 ± 0.63 (forceps use) to 1.91 ± 0.49 (needle angles). Session end scores ranged from 1.29 ± 0.45 (needle holder use) to 1.58 ± 0.50 (needle transfer and suture management and tension; P < .001). Video recordings confirmed improved performance (interrater reliability >0.5). All respondents agreed that task station and porcine model were good methods of training. At 6 months, respondents noted that the anastomosis session provided a basis for training; however, only slightly more than half continued to practice outside the operating room. Conclusions: Four-hour focused training with porcine model and task station resulted in improved ability to perform anastomoses. Boot Camp may be useful in preparing residents for coronary anastomosis in the clinical setting, but emphasis on simulation development and deliberate practice is necessary.
AB - Objective: We evaluated focused training in coronary artery anastomosis with a porcine heart model and portable task station. Methods: At "Boot Camp," 33 first-year cardiothoracic surgical residents participated in 4-hour coronary anastomosis sessions (6-7 attending surgeons per group of 8-9 residents). At beginning, midpoint, and session end, anastomosis components were assessed on a 3-point rating scale (1 good, 2 average, 3 below average). Performances were video recorded and reviewed by 3 surgeons in a blinded fashion. Participants completed questionnaires at session end, with follow-up surveys at 6 months. Results: Ten to 18 end-to-side anastomoses with porcine model and task station were performed. Initial assessments ranged from 2.11 ± 0.58 (forceps use) to 2.44 ± 0.48 (needle angles). Midpoint scores ranged from 1.76 ± 0.63 (forceps use) to 1.91 ± 0.49 (needle angles). Session end scores ranged from 1.29 ± 0.45 (needle holder use) to 1.58 ± 0.50 (needle transfer and suture management and tension; P < .001). Video recordings confirmed improved performance (interrater reliability >0.5). All respondents agreed that task station and porcine model were good methods of training. At 6 months, respondents noted that the anastomosis session provided a basis for training; however, only slightly more than half continued to practice outside the operating room. Conclusions: Four-hour focused training with porcine model and task station resulted in improved ability to perform anastomoses. Boot Camp may be useful in preparing residents for coronary anastomosis in the clinical setting, but emphasis on simulation development and deliberate practice is necessary.
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U2 - 10.1016/j.jtcvs.2009.08.045
DO - 10.1016/j.jtcvs.2009.08.045
M3 - Article
C2 - 19846125
AN - SCOPUS:77950918020
SN - 0022-5223
VL - 139
SP - 1275
EP - 1281
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
IS - 5
ER -