Simulation-Based Skill Training for Trainees in Cardiac Surgery: A Systematic Review

Abstract

Of 16 studies that met the criteria, only four (25%) randomized controlled trials were identified, and the remaining were observational studies. Seven observational studies (43.7%) were single-group pre-post tests. The mean number of trainees was 20.4 (SD, 14.1). Low-fidelity simulators were used in 13 studies (81.2%). Most of the studies (81.3%) were high quality based on a Medical Education Research Study Quality Instrument score of 12 or more. Evidence of assessment tool validation was absent among all studies. No study outcome measures were directed to skills transfer to the operating room or patient outcomes. Overall learning outcomes' effect sizes were consistently high (2.2; SD, 1.6), with junior residents benefitting most (effect size, 2.8; SD, 2.2) CONCLUSIONS: Simulation-based skill training is associated with improved learning outcomes for cardiac surgery trainees with large effect sizes, but more behavior-level outcomes are required to fully assess its value.

Resident perception of standardization and credentialing for high‐risk bedside procedures in cardiothoracic surgery: Results from an institutional pilot study

“…[4][5][6] To address standardization concerns and increase the frequency of training, simulations are utilized to facilitate trainee practice in a no-risk environment. [17][18][19][20][21][22][23] For bedside procedures, groups have shown the benefit of simulation training before patient procedures. [17][18][19][20] For thoracentesis, Barsuk et al 17 showed in a ran- insertion while the greatest improvement in confidence was for endotracheal intubation.…”

An exploration of the surgical skill training curriculum for cardiac surgery residents

“…Compared with traditional teaching methods, simulated teaching can provide students with opportunities for repeated practice . After a systematic review of the research on simulated teaching of cardiac surgery, Ribeiro et al found that simulation‐based training is associated with improved learning outcomes for cardiac surgery trainees. Therefore, we also use simulated teaching to arrange training for residents in our hospital.…”

“…We believe that basic surgical techniques training should indeed be conducted earlier. Ribeiro et al found that junior residents could benefit more from training than senior residents, based on their systematic review. In our study, although no rigorous analysis was conducted, only one senior resident was among the eight trainees who completed all three modules.…”

See one—practice—do one—practice—teach one—practice: The importance of practicing outside of the operating room in surgical training

“…A recent systematic review identified 16 simulation-based studies in which technical skill acquisition was objectively measured. 32 The majority of skill training focused on coronary artery anastomosis (45%), cannulation (15%), aortorrhaphy (10%), mitral valve (10%), and robotics (10%). The majority of studies used ''low-fidelity'' synthetic or tissue-based models.…”

“…After all, even low-cost, low-fidelity simulators are proven to be highly effective for trainees. 32 Indeed, the majority of surgical programs have made investments to ensure the availability of equipment and time for simulation training.…”