Practice improves performance on a coronary anastomosis simulator, attending surgeon supervision does not

Enter, Daniel; Lou, Xiaoying; Hui, Dawn S.; Andrei, Adin Cristian; Barner, Hendrick B.; Sheen, Luke; Lee, Richard

doi:10.1016/j.jtcvs.2014.09.029

Cited by 20 publications

(21 citation statements)

References 18 publications

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“…Acknowledging the limitations of simulation-based training, the simulator can never mimic the feel of live human tissue and the complexity of human physiology. But it might serve as a crucial adjunct or bridge for the advanced technique, with a safer transition to daily clinical practice [Enter 2015;Mokadam 2017;Feins 2017;Ribeiro 2017;Ramphal 2005]. The simulation does not mimic the feel of living human tissue and the complexity of human physiology.…”

Section: E778mentioning

confidence: 99%

Simulation Training in Minimally Invasive Direct Coronary Artery Bypass Grafting

Song

Zhao

et al. 2020

HSF

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Background: To evaluate the effect of minimally invasive direct coronary artery bypass (MIDCAB) simulator for cardiac residency training. Methods: A total of 26 resident surgeons who had never trained for coronary artery anastomosis participated in this training program. They received coronary artery anastomosis training on off-pump coronary artery bypass grafting (OPCAB) simulator for 15 h. After training, their performance of anastomosis was evaluated on the OPCAB simulator according to 12 items and a 5-point global rating scale. Based on the total score of assessment, those with an individual score of 12-36 formed group A, while group B was composed of the remaining trainees. The two groups then received another 15 h coronary artery anastomosis training on the MIDCAB simulator, and the performance was assessed. Results: Trainees improved their performance of coronary artery anastomosis after training on the OPCAB simulator. Group A was composed of 7 trainees with an individual with a total score of 12–36 points and group B was composed of the remaining 19 trainees. After MIDCAB simulator training, significant differences were noted in the pre- and post-training values in the A group (P < .001), and the assessment value of group A was significantly better than those of group B (P < .05). No significant difference was detected between pre- and post-training values in group B after MIDCAB simulator training (P > .05). Conclusion: We concluded that trainees who performed well in OPCAB simulation training can also perform better in MIDCAB, and our designed MIDCAB simulator was useful for residency training.

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Section: E778mentioning

confidence: 99%

Simulation Training in Minimally Invasive Direct Coronary Artery Bypass Grafting

Song

Zhao

et al. 2020

HSF

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“…Previous studies have demonstrated a relationship between operative efficiency and age, gender, American Society of Anesthesiologists score, and surgical team experience. [11][12][13][14] These findings could not be replicated in our study population, composed entirely of patients undergoing lung resection. However, our results corroborate the findings of a systematic review of general thoracic surgery procedures reporting that age, gender, tobacco use, and comorbidities (including American Society of Anesthesiologists score) had minimal or no significant impact on surgical times.…”

Section: Discussionmentioning

confidence: 64%

Surgical team turnover and operative time: An evaluation of operating room efficiency during pulmonary resection

Azzi

Shah

Seely

et al. 2016

The Journal of Thoracic and Cardiovascular Surgery

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“…An instructional video was provided in three trials 5 , 14 , 17 . In person education sessions were provided in four trials 14 , 15 , 17 , 18 .…”

Section: Resultsmentioning

confidence: 99%

Objective improvement with coronary anastomosis simulation training: meta-analysis

et al. 2022

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Background Coronary artery anastomosis training and assessment are vital for patient safety and for conferring a prognostic benefit. A systematic review and meta-analysis were performed to analyse the impact of simulation on coronary anastomosis proficiency in terms of time taken and skill score. Methods This review was conducted in accordance with PRISMA guidelines, searching PubMed, Embase and Cochrane databases on 10 October 2020, using the terms ‘Coronary anastomosis simulation’ or ‘vascular anastomosis simulation’ and ‘anastomosis simulation’. Studies included had objective measurement of scores of before and after simulation. Meta-analysis was performed using RevMan, version 5.4 (Cochrane Library). Results From a pool of 1687 articles, 12 articles evaluating the use of simulation in teaching coronary anastomosis were identified, with objective scores at baseline and after simulation. The 12 papers included 274 subjects. Data on 223 subjects could be extracted for analysis in performing coronary anastomosis in a simulated environment. Eight trials evaluated improvement in time and 12 trials evaluated performance using an objective evaluation score. In comparison with no formal simulation training, simulation was associated with improved skill in a five-point scale (standardized mean difference 1.68 (95 per cent c.i. 1.23 to 2.13; P < 0.001)) and time (mean difference 205.9 s (95 per cent c.i. 133.62 to 278.18; P < 0.001)) in trials included in the meta-analysis. Furthermore, novice cardiothoracic surgeons benefited more from simulation as regards time improvement compared with senior cardiothoracic surgeons (293 versus 120 s improvement; P = 0.003). Fidelity of simulator did not have a significant effect on rates of improvement. Conclusion Simulation-based training in coronary anastomosis is associated with improved time efficiency and overall performance in comparison with no intervention. Further studies are necessary to determine the optimum timing of trainees progressing from simulation training to live operating.

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Practice improves performance on a coronary anastomosis simulator, attending surgeon supervision does not

Abstract: Practice on low-fidelity simulators enabled trainees to improve on a broad range of skills; however, the additional effect of attending-level supervision is limited. In an era of increasing staff surgeon responsibilities, unsupervised practice may be sufficient for inexperienced trainees.

Cited by 20 publications

References 18 publications

Simulation Training in Minimally Invasive Direct Coronary Artery Bypass Grafting

Simulation Training in Minimally Invasive Direct Coronary Artery Bypass Grafting

Surgical team turnover and operative time: An evaluation of operating room efficiency during pulmonary resection

Objective improvement with coronary anastomosis simulation training: meta-analysis

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