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J Thorac Cardiovasc Surg 2010;139:707-712
© 2010 The American Association for Thoracic Surgery

Evolving Technology/Basic Science

The successful application of simulation-based training in thoracic surgery residency

^a Division of Cardiovascular Surgery, Mayo Clinic and Foundation, Rochester, Minn
^b Department of Cardiovascular Perfusion, Mayo Clinic and Foundation, Rochester, Minn
^c Department of Anesthesiology, Mayo Clinic and Foundation, Rochester, Minn
^d Mayo Multidisciplinary Simulation Center, Mayo Clinic and Foundation, Rochester, Minn

Read at the Thirty-fifth Annual Meeting of The Western Thoracic Surgical Association, Banff, Alberta, Canada, June 24–27, 2009.

Received for publication June 26, 2009; revisions received October 6, 2009; accepted for publication October 17, 2009.

^_* Address for reprints: Harold M. Burkhart, MD, Division of Cardiovascular Surgery, Mayo Clinic College of Medicine, 200 First St SW, Rochester, MN 55905. (Email: burkhart.harold{at}mayo.edu).

Objective: We developed and tested a clinical simulation program in the principles and conduct of cardiopulmonary bypass with the aim of improving confidence and proficiency in this critical aspect of cardiac surgical care.

Methods: Fifteen residents from 6 resident-training programs who reported no prior cardiopulmonary bypass observation or simulation-based perfusion experience participated in a cardiopulmonary bypass course involving both didactic lectures and hands-on simulation. A computer-controlled hydraulic model of the human circulation was used in a specifically designed multidisciplinary simulation center environment to give the participants hands-on training with both basic operations and specific perfusion crisis scenarios. Pretraining and posttraining assessments concerning confidence, knowledge, and applications with regard to cardiopulmonary bypass were administered and compared.

Results: Likert scale scores on confidence-related items increased significantly (P < .001), from 59% ± 16% to 92% ± 8%. Pretraining versus posttraining scores (72% ± 14%) on similar cognitive items were not significantly different (P = .3636). Scores on similar open-ended application items before and after training improved from 62% ± 25% to 85 ± 10% (P < .0001). All subjects agreed that simulation-based cardiopulmonary bypass training was superior to classroom- and clinic-based education and that the scenarios enhanced their learning experience.

Conclusions: Simulation-based cardiopulmonary bypass training appears to be an effective technique to build the confidence of thoracic surgery residents regarding knowledge and applications. Scenario-based practice in a specifically designed simulated environment is a valuable adjunct to traditional educational methods and has the potential to improve the training of thoracic residents.