Simulation Experience Enhances Medical Students' Interest in Cardiothoracic Surgery

Tesche, Leora J.; Feins, Richard H.; Dedmon, Matthew M.; Newton, Kimberly N.; Egan, Thomas M.; Haithcock, Benjamin E.; Veeramachaneni, Nirmal K.; Bowdish, Michael E.

doi:10.1016/j.athoracsur.2010.06.117

Cited by 49 publications

(40 citation statements)

References 17 publications

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“…Simulation models provide an opportunity to aid resident skill acquisition, in addition to increasing the interest of medical students and general surgery residents in CT surgery [7,8]. Several studies have documented resident skills improvement on coronary anastomosis and mitral valve simulators at a single institution [9,10].…”

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confidence: 98%

“Top Gun” Competition: Motivation and Practice Narrows the Technical Skill Gap Among New Cardiothoracic Surgery Residents

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Lee

Fann

et al. 2015

The Annals of Thoracic Surgery

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confidence: 98%

“Top Gun” Competition: Motivation and Practice Narrows the Technical Skill Gap Among New Cardiothoracic Surgery Residents

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Lee

Fann

et al. 2015

The Annals of Thoracic Surgery

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“…Additionally, such experiences can be influential in shaping attitudes towards an OR career for medical and nursing students alike [2,23,[28][29][30][31]. The implementation, in the preclinical years, of a hands-on educational programme with a focus on operative specialties may therefore play an important role in the timely exposure of medical and nursing students to these disciplines and, in so doing, assist with their career decision-making process.…”

Section: Introductionmentioning

confidence: 94%

CSTAR Interprofessional Surgery and Anaesthesia School: an Immersive Simulation-Based Programme for Preclinical Medical and Nursing Students at Western University

Cristea¹,

Moreland²,

Xu³

et al. 2014

Med.Sci.Educ.

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The practical aspects of operative and perioperative specialties are often underrepresented in preclinical medical and nursing school curricula. Students must narrow down career choices early during the course of their education, which can be difficult in the absence of adequate exposure. A 5-day training programme was developed at our institution to allow students in both medicine and nursing to learn crucial operating room (OR) principles and skills in a structured, interprofessional setting. The week culminates in an interdisciplinary team-based management of a patient using various forms of simulation. Seventy (70) students participated in the 2012 offering of the programme. A course evaluation survey revealed an overwhelmingly positive response, with many students highlighting the significant practical benefits of the experience. An analysis of pre-and post-course responses revealed that students perceived an improvement in their technical ability (P<0.001, effect size >0.5), comfort level within the OR environment (P<0.001, effect size >0.5) and a greater sense of preparedness for surgical clerkship/clinical encounters (P<0.001, effect size >0.5). Nursing and medical students also noted an enhanced understanding of each other's roles in the OR and reported an increased interest in pursuing a career with a strong technical/hands-on focus (P=0.014, effect size=0.34). Students with an interest in OR specialties may benefit from an early interactive exposure to these fields. Mentor-guided simulated experiences can allow for students to better define their potential career interests in operative and perioperative specialties in a timely fashion.

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“…2,[15][16][17] "Face validity," or how closely the assessment resembles the "real" task, of simulation models remains a limitation for simulation cardiac surgery. The high-pressure environment of a cardiac surgery operating room, which requires coordination of technical expertise, communication among various health care professionals and situational awareness of the patients' changing hemodynamic status, is difficult to recreate in a simulation setting.…”

Section: Discussionmentioning

confidence: 99%

“…1 The Canadian education model follows an apprenticeship style of learning, whereby trainees perform clinical and operative tasks under the supervision of a certified physician or surgeon and, for the duration of the training period, gain increasing clinical autonomy. 2 Residents progress from performing junior postgraduate-level tasks, such as opening and closing surgical incision sites, harvesting bypass conduits and assisting surgeries, to completing entire cardiac procedures from skin-to-skin under the direct supervision of the cardiac consultant during their senior postgraduate years. 3 Outcomes using this model of learning have traditionally demonstrated no negative impact on patient care for cardiac procedures, including coronary artery bypass graft (CABG) both on and off cardiopulmonary bypass, mitral valve repair/replacement, aortic valve replacement (AVR) and various congenital surgeries.…”

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confidence: 99%

Safety and efficiency assessment of training Canadian cardiac surgery residents to perform aortic valve surgery

et al. 2013

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Background:Research has demonstrated equivalent patient safety outcomes for various cardiac procedures when the primary surgeon was a supervised trainee. However, cardiac surgery cases have become more complex, and the Canadian cardiac surgery education model has undergone some changes. We sought to compare patient safety and efficiency of aortic valve replacement (AVR) between Canadian patients treated by senior cardiac trainees and those treated by certified cardiac surgeons. Methods:We completed a single-centre, case-matched, prospectively collected and retrospectively analyzed study of AVR. Patients were matched between trainees and consultants for age, sex, New York Heart Association and Canadian Cardiovascular Society status, urgency of operation and diabetes status. Results:We analyzed 1102 procedures: 624 isolated AVRs and 478 AVRs with coronary artery bypass graft (CABG). For isolated AVR, there was no significant difference in 30-d mortality (p = 0.13) or in major adverse events (p = 0.38) between the groups. In the AVR+CABG group, there was no significant difference in 30-day mortality (p = 0.10) or in the rates of major adverse events (p = 0.37) between the groups. Secondary outcomes (hospital and intensive care unit lengths of stay, valve size and type) did not differ significantly between the groups for isolated AVR or AVR+CABG. Conclusion:Despite a higher-risk patient population and changes in the cardiac surgery training model, it appears that outcomes are not negatively affected when a senior trainee acts as the primary surgeon in cases of AVR.Contexte : La recherche a fait état de résultats équivalents au plan de la sécurité des patients lors de diverses interventions cardiaques lorsque le chirurgien principal était un résident supervisé. Toutefois, la chirurgie cardiaque se complexifie et le modèle de formation canadien en chirurgie cardiaque a subi quelques transformations. Nous avons voulu comparer la sécurité de patients canadiens et l'efficience du remplacement de la valvule aortique (RVA) selon que les patients étaient traités par des rési-dents séniors en chirurgie cardiaque ou par des chirurgiens certifiés.Méthodes : Nous avons procédé à une collecte prospective de cas assortis, dans 1 seul centre, puis à une analyse rétrospective des cas de RVA. Les patients ont été répartis entre résidents et experts et assortis selon l'âge, le sexe, la classification de la NYHA (New York Heart Association) et de la Société canadienne de cardiologie, le caractère urgent de l'intervention et le statut à l'égard du diabète.Résultats : Nous avons analysé 1102 interventions : 624 RVA isolés et 478 RVA avec pontage aorto-coronarien (PAC). Dans les cas de RVA isolés, on n'a noté aucune différence significative pour ce qui est de la mortalité à 30 jours (p = 0,13) ou des effets indésirables majeurs (p = 0,38) entre les groupes. Pour ce qui est du groupe RVA+PAC, on n'a noté aucune différence significative quant à la mortalité à 30 jours (p = 0,10) ou quant aux taux d'effets indésirables majeurs (p = 0,37) en...

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Simulation Experience Enhances Medical Students' Interest in Cardiothoracic Surgery

Cited by 49 publications

References 17 publications

“Top Gun” Competition: Motivation and Practice Narrows the Technical Skill Gap Among New Cardiothoracic Surgery Residents

“Top Gun” Competition: Motivation and Practice Narrows the Technical Skill Gap Among New Cardiothoracic Surgery Residents

CSTAR Interprofessional Surgery and Anaesthesia School: an Immersive Simulation-Based Programme for Preclinical Medical and Nursing Students at Western University

Safety and efficiency assessment of training Canadian cardiac surgery residents to perform aortic valve surgery

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