Establishing a Simulation Training Platform for Cardiac Surgery Residents: Improving Surgical Training and Technical Skill Assessment

Objectives: Multiple factors (e.g., working time directives; economic pressure) reduce the surgical exposition of residents. At the same time quality assurance programs demand risk reduction and high technical skills in patient care. In addition, surgical training does not require specific skill assessments. We sought to develop a simulation platform to improve technical skills of residents and to assess progress of training.

Methods: Based on the objective assessment of technical skills (OSATS) we defined five levels of simulation training: Level 1: manual skills (with nonsurgical tools), Level 2: 2D horizontal model of needle handling, Level 3: 2D horizontal model of vascular anastomosis, Level 4: 3D model of end to side vascular anastomosis, Level 5:3 D model of side-to-side vascular anastomosis. Evaluation is performed using a global rating scale assessing “product,” “tissue,” “motion” and “handling” as well as “Time” and “number of bites” after videotaping of training tasks.

Results: Six cardiac surgeons, who were board certified within the last 6 months and six residents within the first two years of residency were included in the study. Each participant undergoes initial assessment followed by a four week simulation training course with initial training workshops and subsequent self-training for each level. Each level is finalized by videotaping the specific task and assessment by two independent experienced surgeons. Final certification is given after a live performance test. We hypothesize that technical skills can be significantly improved in both groups despite higher experience in certified surgeons.

Conclusions: Residents are keen to enter simulation training for technical skill improvement and assessment. In addition, using the simulation modules, student's might be easier drawn toward a surgical career. The study is ongoing.