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Simulated cardiac surgery improves expertise, may lower cost
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Simulation-based cardiac surgery training could potentially decrease the number of adverse outcomes and improve responses, effectively lowering costs and leading to better outcomes for patients, according to findings published in The Annals of Thoracic Surgery.
The “out of body” training experience allows students to learn and relearn skills efficiently and safely, as well as correct mistakes as often as necessary. As a result, residents are able to develop their skills and gain confidence while improving clinical outcomes, according to researchers.
“Simulation training should create better surgeons who are trained much more efficiently,” Richard H. Feins, MD, of the department of surgery at the University of North Carolina at Chapel Hill, said in a press release. “This type of learning allows surgery residents to develop their knowledge, skills and confidence, before going into the operating room, thus protecting patients from unnecessary risks.”
The Cardiac Surgery Simulation Consortium developed a 39-session curriculum, consisting of 27 residents, based on simulation training modules for common cardiac surgery procedures, including cardiopulmonary bypass, CABG and aortic valve replacement, as well as three adverse events, including unexpected and undesirable experiences, such as sudden deterioration in heart function.
Residents were given a range of simulations from plastic models to real tissue, such as pig hearts, to realistically represent actual patients receiving surgery. In each of these simulations, the Cardiac Surgery Simulation Consortium incorporated repetition, practice, coaching and review into each training module. According to an abstract, evaluations were based on five-point Likert-scale tools indexed by module, session, task items and repetitions, and statistical analysis relied on generalized linear model estimation and corresponding CIs.
Of the 27 residents who participated in the simulation, all showed improvement, with practice repetitions resulting in exemplary final scores per module (mean ± two standard errors): cardiopulmonary bypass, 4.8 ± 0.12; CABG, 4.41 ± 0.19; aortic valve replacement, 4.51 ± 0.2; massive air embolism, 0.68 ± 0.14; acute intraoperative aortic dissection, 4.52 ± 0.17; and sudden deterioration in cardiac function, 4.76 ± 0.16.
Additionally, the results show that 85% of residents who had completed simulation training and 100% of the faculty reported feeling more confident in the skill set and performance of the resident in the operating room.
“Simulation-based training in adverse events could well prove lifesaving,” Feins said in the release. “This training has the ability to decrease the number of adverse outcomes that occur and to minimize the ramifications of those events. This could result in better outcomes for patients, as well as lower costs and improved efficiency.” – by Dave Quaile
Disclosure: Feins and two other researchers report a financial relationship with KindHeart Inc. Another researcher reports financial relationships with HeartWare and St. Jude Medical.
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