Implementation of a novel portfolio of structured, curriculum-aligned, simulation-based, cardiothoracic surgery training courses: Evolving the delivery of surgical education

Moorjani, Narain; Lewis, Michael; Shah, Rajesh; Barnard, Sion; Graham, Tim; Rathinam, Sridhar

doi:10.1016/j.jtcvs.2017.07.075

Cited by 33 publications

(21 citation statements)

References 17 publications

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“…Trainees also work antisocial hours, that is during night time, weekends, and public holidays. Structured learning is facilitated nationally by means of a comprehensive portfolio of courses 8 and supplemented regionally through didactic and simulationbased teaching programs. The Society for Cardiothoracic Surgery in Great Britain and Ireland (SCTS) also offers a portfolio of traveling fellowships to enable trainees consolidate their clinical expertise before consultant appointment.…”

Section: Methods Training Structure and Terminologymentioning

confidence: 99%

Impact of coronavirus 2019 (COVID-19) on training and well-being in subspecialty surgery: A national survey of cardiothoracic trainees in the United Kingdom

Caruana

Patel

Kendall

et al. 2020

The Journal of Thoracic and Cardiovascular Surgery

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Objectives: The coronavirus 2019 (COVID-19) pandemic has overwhelmed health care systems and disrupted routine care internationally. Health care workers face disruption to their work routines and professional development, as well as an elevated risk of infection and morbidity. We sought to establish the impact of the COVID-19 pandemic on the well-being, practice, and progression of all trainees in cardiothoracic surgery in the United Kingdom. Methods: A 31-item questionnaire was designed, validated, and disseminated via email and an instant-messaging platform. Results: In total, 76 (of 118, 64%) cardiothoracic surgical trainees responded, representing all training grades and programs nationally; 48 (63%) and 24 (32%) were concerned about their physical and mental health, respectively, 25 (33%) had taken time off work due to COVID-19, 65 (86%) had treated patients with COVID-19, 36 of whom (55%) were wearing satisfactory personal protective equipment at the time, 41 (54%) remain concerned about personal protective equipment provision at their institution, 42 (55%) had been redeployed to cover other specialties, and 23 (30%) had encountered ethical dilemmas related to care of patients. There was a significant impact on time spent in outpatient clinics (44% reduction), multidisciplinary team meetings (79% reduction), and operating theaters (78% reduction). In total, 67 (88%) of respondents were concerned about the impact on their training, and 54 (71%) felt that the deviation may require an extension in their planned training time. Conclusions: The duration and impact of the current pandemic is, as yet, uncertain. Timely sharing of experiences, concerns, and expectations will inform health care and education policy and influence practice in the pandemic era and beyond. (J

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Section: Methods Training Structure and Terminologymentioning

confidence: 99%

Impact of coronavirus 2019 (COVID-19) on training and well-being in subspecialty surgery: A national survey of cardiothoracic trainees in the United Kingdom

Caruana

Patel

Kendall

et al. 2020

The Journal of Thoracic and Cardiovascular Surgery

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“…By producing a simulator that can be used in any environment, surgeons are able to rehearse technically challenging procedures in inconsequential environments. Simulators have been shown to be effective in training and have been successfully incorporated into national training programs in adult cardiothoracic surgery [6][7][8]. However, within CHS there is a clear gap in simulation, where one could argue the need is greater due to the high stakes involved and the complexity/limitation of cases [2].…”

Section: Discussionmentioning

confidence: 99%

Development of a dynamic Chest Wall and operating table simulator to enhance congenital heart surgery simulation

et al. 2020

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Background: The Hands-On Surgical Training in Congenital Heart Surgery (HOST-CHS) program using 3D printed heart models has received positive feedback from attendees. However, improvements were necessary in the simulator set up to replicate the ergonomics experienced in the operating room. This paper illustrates the development of a dynamic chest wall and operating table simulator to enhance the simulation experience. Methods: The simulator was designed to address the limitations with the existing set up. This included a suboptimal operating position, unrealistic surgical exposure and limitations in illuminating the operative field and recording procedures. A combination of computer-aided design and various 3D-printing techniques were used to build the components. The simulator's usefulness was evaluated by surgeons who attended the 5th annual HOST course via a questionnaire. Results: The simulator consists of three components; an operating table simulator which allows height adjustment and pitch-and-roll motion; a suture retraction disc, which holds sutures under tension to improve exposure; and a pediatric chest wall cavity to replicate a surgeon's access experience during surgery. Nineteen surgeons completed the questionnaire. All surgeons agreed that the addition of the simulator was acceptable for surgical simulation and that it helped replicate the ergonomics experienced in the operating room. Conclusions: The inclusion of the HOST-CHS simulator adds value to simulation in congenital heart surgery (CHS) as it replicates the view and exposure a surgeon experiences. Improvements like these will help develop highfidelity simulation programs in CHS, which could be utilized to train surgeons globally.

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“…14 In addition, an extensive simulation-based curriculum for CT trainees showed improved confidence and also increased examination pass rates over the 3-year period. 17 Although most simulation research focused on individual skill acquisition, a team simulation approach with CT residents acting as surgeons, anesthesiologists, perfusionists, surgical assistants, and operating room technicians was shown to successfully model real-world scenarios in cardiac surgery and augment resident training. 18 Simulations like these that repeatedly show an increase in confidence and aptitude could ultimately improve patient safety when residents transition into CT training.…”

Section: Simulationmentioning

confidence: 99%

Educational research and training innovation in cardiothoracic surgery: A year in review

Hunt

Zhou

Lui

et al. 2019

The Journal of Thoracic and Cardiovascular Surgery

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, it has been an exciting year for the field. However, this volume of research renders it difficult to keep abreast with the latest innovations in education. This year alone in CT surgery, there were 35 education-focused abstracts, 24 sessions oriented toward emerging technology, and more than 180 sessions devoted to surgical skills and simulations. Many studies explored the role of technology-based tools in augmenting CT surgery training. These were applied to the field broadly, within subspecialties, and at all levels of medical training from medical student to senior attending. Research also grappled with how to best enhance recruitment of students into CT surgery. It is these advances in education that will prove vital to the future of CT surgery education. Reflecting on the extensive scholarly work published and presented at the major CT surgical conferences, the aim of this paper is to explore the education highlights of the 2017 to 2018 academic year and provide commentary on where the field may be headed. EDUCATIONAL RESEARCH ACROSS THE FIELD OF CT SURGERY Structure of the Field Many researchers over the course of the year investigate how the field of CT surgery is changing and how trainees in particular are responding. The presence of physician extenders within CT surgery has increased in recent years. A national survey assessing opinions of physician extender involvement showed that overall impression is favorable but that their role can occasionally impede resident education, especially in regard to patient management on the ward. 1 In regard to training structure, residents appear to prefer traditional programs to the integrated 6-year (I-6) program. The most common reasons given for not applying to the I-6 program were lack of commitment to CT surgery as a medical student and uncertainty of adequacy of I-6 training-from the belief that general surgery training is more well-rounded. 2 For general thoracic surgery, the 4/3 and traditional programs were the preferred and more common route compared with the I-6 residents, who nearly all were set on a cardiac career (adult or congenital). 2,3 I-6 programs also increase concern about decreased general surgery operative volume, which emphasizes the need for cooperation and communication between integrated and categorical program directors to ensure adequate training for all residents. 4 Understanding the advantages and challenges of the various educational paradigms, programs continue to modify and improve their curriculum to better address the perceived needs of the specialty and those of the trainees. Support for Residents' Transition to Training and to Practice Research this year focused on understanding how to better support CT surgery residents. Throughout the conferences this year, many sessions were oriented toward

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Implementation of a novel portfolio of structured, curriculum-aligned, simulation-based, cardiothoracic surgery training courses: Evolving the delivery of surgical education

Abstract: This study has described the implementation of the only extensive program of structured simulation-based courses that has been developed to complement clinical training in cardiothoracic surgery.

Cited by 33 publications

References 17 publications

Impact of coronavirus 2019 (COVID-19) on training and well-being in subspecialty surgery: A national survey of cardiothoracic trainees in the United Kingdom

Impact of coronavirus 2019 (COVID-19) on training and well-being in subspecialty surgery: A national survey of cardiothoracic trainees in the United Kingdom

Development of a dynamic Chest Wall and operating table simulator to enhance congenital heart surgery simulation

Educational research and training innovation in cardiothoracic surgery: A year in review

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