Standardization is superior to traditional methods of teaching open vascular simulation

Bath, Jonathan; Lawrence, Peter F.; Chandra, Ankur; O’Connell, Jessica; Uijtdehaage, Sebastian; Jiménez, Juan Carlos; Davis, Gavin; Hiatt, Jonathan R.

doi:10.1016/j.jvs.2010.07.064

Cited by 37 publications

(19 citation statements)

References 36 publications

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“…[7][8][9][10][11] Although the effectiveness of simulation training has not been as widely investigated in open vascular surgery as it has in other surgical disciplines, evidence for its benefit is emerging. 5,[12][13][14] The Association of Program Directors in Surgery in conjunction with the American College of Surgeons has outlined a surgical skills curriculum for general surgery residents. 15,16 The Residency Review Committee in Surgery has mandated the use of surgical skills laboratory training for surgical residents.…”

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confidence: 99%

A randomized comparison of a 3-week and 6-week vascular surgery simulation course on junior surgical residents' performance of an end-to-side anastomosis

Robinson

Schanzer

Cutler

et al. 2012

Journal of Vascular Surgery

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An open vascular simulation course consisting of three weekly 1-hour sessions increased the surgical skill of junior residents in performing a vascular end-to-side anastomosis to that of senior residents on a standardized assessment. A 6-week course provided no additional benefit. This study supports the use of an open vascular simulation course to teach vascular surgical skills to junior residents. A course consisting of three 1-hour sessions is an effective and efficient component of a simulation program for junior surgical residents in a busy surgical center.

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confidence: 99%

A randomized comparison of a 3-week and 6-week vascular surgery simulation course on junior surgical residents' performance of an end-to-side anastomosis

Robinson

Schanzer

Cutler

et al. 2012

Journal of Vascular Surgery

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“…Regarding the training method, 1 study revealed that standardization (where 1 instructor taught the same procedure repeatedly) was more effective than traditional training (where different surgeons supervise simulation training). 23 Another study demonstrated that AAA-specific simulation training was effective for improving surgical skills. 8 However, these studies were limited by the relationship between simulation training and the outcomes of practical OS, which comprises complex procedures, not being clarified.…”

Section: Discussionmentioning

confidence: 99%

Learning Curve Analysis to Determine Operative Requirements for Young Vascular Surgeons Learning Open Abdominal Aortic Aneurysm Repair

Shirasu

Furuya

Nagai

et al. 2019

Circ J

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Background:Since endovascular aneurysm repair has become predominant, the issue of training young vascular surgeons in open abdominal aortic aneurysm (AAA) surgery has received significant attention. Through learning curve analysis, we aimed to determine the number of cases needed for young surgeons to achieve satisfactory open surgical skills. Methods and Results:A total of 562 consecutive patients who underwent open repair either by an attending surgeon (group A) or 6 young vascular surgeons (group Y) were included and assessed with regards to the preparation, clamp, and total operation times. Although some of the patients' characteristics were different, the surgical procedures were comparable between the 2 groups. There was a clear trend towards a decrease in each 10 successive cases in group Y. The operation times in group A were constant at 72±30 (preparation), 48±10 (clamp), and 231±59 min (total), which were achieved by young vascular surgeons in 10, 30, and 10 cases, respectively. In the cumulative sum analysis, 25-27 cases were necessary for young vascular surgeons to enhance their surgical skills. The complication rate in group Y was no higher than that in group A. Conclusions: Young vascular surgeons can safely learn open AAA repair without increasing operation time or complications.Approximately 30 cases would be necessary to gain satisfactory surgical skills.

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“…The surgical residents who were randomized to the standardized approach developed better technical skills, motion efficiency, and accuracy. Furthermore, in a post-study evaluation, more than 70% of surgical residents reported a preference for a standardized training approach [10]. In addition, use of the penoscrotal approach has been shown to decrease risk of dorsal nerve injury, improve the surgeon's ability to anchor the pump in the scrotum, and improve corporeal exposure [11].…”

Section: Discussionmentioning

confidence: 99%

Expert Training with Standardized Operative Technique Helps Establish a Successful Penile Prosthetics Program for Urologic Resident Education

King

Klausner

Johnson

et al. 2011

The Journal of Sexual Medicine

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Introduction The challenge of resident education in urologic surgery programs is to overcome disparity imparted by diverse patient populations, limited training times, and inequalities in the availability of expert surgical educators. Specifically, in the area of prosthetic urology, only a small proportion of programs have full-time faculty available to train residents in this discipline. Aim To examine whether a new model using yearly training sessions from a recognized expert can establish a successful penile prosthetics program and result in better outcomes, higher case volumes, and willingness to perform more complex surgeries. Methods A recognized expert conducted one to two operative training sessions yearly to teach standardized technique for penile prosthetics to residents. Each session consisted of three to four operative cases performed under the direct supervision of the expert. Retrospective data were collected from all penile prosthetic operations before (February, 2000 to June, 2004: N = 44) and after (July, 2004 to October, 2007: N = 79) implementation of these sessions. Main Outcome Measures Outcomes reviewed included patient age, race, medical comorbidities, operative time, estimated blood loss, type of prosthesis, operative approach, drain usage, length of stay, and complications including revision/explantation rates. Statistical analysis was performed using Student's t-tests, Fisher's tests, and survival curves using the Kaplan-Meier technique (P value ≤ 0.05 to define statistical significance). Results Patient characteristics were not significantly different pre- vs. post-training. Operative time and estimated blood loss significantly decreased. Inflatable implants increased from 19/44 (43.2%, pre-training) to 69/79 (87.3%, post-training) (P < 0.01). Operations per year increased from 9.96 (pre-training) to 24 (post-training) (P < 0.01). Revision/explantation occurred in 11/44 patients (25%, pre-training) vs. 7/79 (8.9%, post-training) (P < 0.05). Conclusions These data demonstrate that yearly sessions with a recognized expert can improve surgical outcomes, type, and volume of implants and can reduce explantation/revision rates. This represents an excellent model for improved training of urologic residents in penile prosthetics surgery.

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Standardization is superior to traditional methods of teaching open vascular simulation

Cited by 37 publications

References 36 publications

A randomized comparison of a 3-week and 6-week vascular surgery simulation course on junior surgical residents' performance of an end-to-side anastomosis

A randomized comparison of a 3-week and 6-week vascular surgery simulation course on junior surgical residents' performance of an end-to-side anastomosis

Learning Curve Analysis to Determine Operative Requirements for Young Vascular Surgeons Learning Open Abdominal Aortic Aneurysm Repair

Expert Training with Standardized Operative Technique Helps Establish a Successful Penile Prosthetics Program for Urologic Resident Education

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