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

Objective We assessed the effect of an open vascular simulation course on the surgical skill of junior surgical residents in performing a vascular end-to-side anastomosis and determined the course length required for effectiveness. We hypothesized that a 6-week course would significantly increase th...

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Bibliographic Details
Published in:Journal of vascular surgery 2012-12, Vol.56 (6), p.1771-1781
Main Authors: Robinson, William P., MD, Schanzer, Andres, MD, Cutler, Bruce S., MD, Baril, Donald T., MD, Larkin, Anne C., MD, Eslami, Mohammed H., MD, Arous, Elias J., MD, Messina, Louis M., MD
Format: Article
Language:English
Subjects:
Adult
Anastomosis, Surgical - education
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Clinical Competence
Emergency and intensive care: renal failure. Dialysis management
Female
Humans
Intensive care medicine
Internship and Residency
Male
Medical sciences
Models, Anatomic
Problem-Based Learning
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Time Factors
Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
Vascular Surgical Procedures - education
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Summary:Objective We assessed the effect of an open vascular simulation course on the surgical skill of junior surgical residents in performing a vascular end-to-side anastomosis and determined the course length required for effectiveness. We hypothesized that a 6-week course would significantly increase the surgical skill of junior residents in performing an end-to-side anastomosis, while a 3-week course would not. Methods We randomized 37 junior residents (postgraduate year 1 to 3) to a course consisting of three (short course, n = 18) or six (long course, n = 19) consecutive weekly 1-hour teaching sessions. Content focused on instrument recognition and performance of an end-to-side vascular anastomosis using a simulation model. A standardized 50-point vascular skills assessment (SVSA) measured knowledge and technical proficiency. Senior residents (postgraduate year 4 to 5) were tested at baseline. Junior residents were tested at baseline and at 1 and 16 weeks after course completion, and their scores were compared with baseline and senior resident scores. Residents and faculty completed a standardized anonymous evaluation of the course. Results Baseline scores between short-course and long-course participants were not different. At baseline, junior residents had significantly lower SVSA scores than senior residents (36 ± 7 vs 41.4 ± 2.5; P = .002). One week after course completion, SVSA scores for short-course (43.5 ± 2.9 vs 34.2 ± 7.5; P = .008) and long-course (43.9 ± 5.6 vs 38.3 ± 5.9; P = .006) participants were significantly improved from baseline. SVSA scores decreased slightly at 16 weeks but remained above baseline in short-course (39 ± 6.2 vs 34.2 ± 7.5; P = .03) and long-course (40 ± 4.5 vs 38.3 ± 5.9; P = .08) participants. Long vs short course length didnot affect improvement in SVSA scores at 1 or 16 weeks. In short-course and long-course participants, SVSA scores at 1 and 16 weeks were not significantly different from senior resident scores. Course ratings were high, and 95% of residents indicated the course “made them a better surgeon.” Residents and faculty felt the educational benefit of the course merited the investment of resources. Conclusions 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 t
ISSN:0741-5214
1097-6809
DOI:10.1016/j.jvs.2012.06.105