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

Objectives Enthusiasm for simulation early in cardiothoracic surgery training is growing, yet evidence demonstrating its utility is limited. We examined the effect of supervised and unsupervised training on coronary anastomosis performance in a randomized trial among medical students. Methods Forty-...

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Bibliographic Details
Published in:The Journal of thoracic and cardiovascular surgery 2015, Vol.149 (1), p.12-17.e2
Main Authors: Enter, Daniel H., MD, Lou, Xiaoying, BS, Hui, Dawn S., MD, Andrei, Adin-Cristian, PhD, Barner, Hendrick B., MD, Sheen, Luke, BA, Lee, Richard, MD, MBA
Format: Article
Language:English
Subjects:
Adult
Anastomosis, Surgical
Cardiac Surgical Procedures - education
Cardiothoracic Surgery
Clinical Competence
Coronary Vessels - surgery
Education, Medical, Graduate - methods
Female
Humans
Learning Curve
Male
Models, Anatomic
Models, Cardiovascular
Motor Skills
Prospective Studies
Single-Blind Method
Students, Medical
Task Performance and Analysis
Time Factors
Young Adult
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Summary:Objectives Enthusiasm for simulation early in cardiothoracic surgery training is growing, yet evidence demonstrating its utility is limited. We examined the effect of supervised and unsupervised training on coronary anastomosis performance in a randomized trial among medical students. Methods Forty-five medical students were recruited for this single-blinded, randomized controlled trial using a low-fidelity simulator. After viewing an instructional video, all participants attempted an anastomosis. Subsequently, the participants were randomized to 1 of 3 groups: control (n = 15), unsupervised training (n = 15), or supervised training with a cardiothoracic surgeon or fellow (n = 15). Both the supervised and unsupervised groups practiced for 1 hour per week. After 4 weeks, the participants repeated the anastomosis. All pre- and posttraining performances were videotaped and rated independently by 3 cardiothoracic surgeons blinded to the randomization. All raters scored 13 assessment items on a 1 to 5 (low-high) scale along with an overall pass/fail rating. Results After the training period, all 3 groups showed significant improvements in composite scores (control: +0.52 ± 0.69 [ P  = .014], unsupervised: +1.05 ± 0.48 [ P  
ISSN:0022-5223
1097-685X
DOI:10.1016/j.jtcvs.2014.09.029