Simulation-Based Training in Cardiac Surgery

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Presentation transcript:

Simulation-Based Training in Cardiac Surgery Richard H. Feins, MD, Harold M. Burkhart, MD, John V. Conte, MD, Daniel N. Coore, PhD, James I. Fann, MD, George L. Hicks, MD, Jonathan C. Nesbitt, MD, Paul S. Ramphal, MD, Sharon E. Schiro, PhD, K. Robert Shen, MD, Amaanti Sridhar, BS, Paul W. Stewart, PhD, Jennifer D. Walker, MD, Nahush A. Mokadam, MD The Annals of Thoracic Surgery Volume 103, Issue 1, Pages 312-321 (January 2017) DOI: 10.1016/j.athoracsur.2016.06.062 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Component task simulator allowing for deliberate practice and multiple repetitions of ascending aortic cannulation, removal of air from the aortic line, and decannulation. (B) Completed repair of ascending aortic dissection occurring during coronary artery bypass in the acute intraoperative aortic dissection module using the Ramphal cardiac surgery simulator. The Annals of Thoracic Surgery 2017 103, 312-321DOI: (10.1016/j.athoracsur.2016.06.062) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 For aortic cannulation assessment form (ACAF) scores, the upper panel shows the statistical estimate of the mean for each repetition the residents performed during various sessions of the cardiopulmonary bypass (CPB) module. The bottom panel summarizes performance per repetition based on the aortic cannulation Likert item evaluated in four different modules. (AVR = aortic valve replacement; CABG = coronary artery bypass graft; CPBAT = cardiopulmonary bypass assessment tool; SDCF = sudden deterioration in cardiac function.) The Annals of Thoracic Surgery 2017 103, 312-321DOI: (10.1016/j.athoracsur.2016.06.062) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 For each assessment tool in the aortic valve replacement (AVR) module, the statistical estimate of the mean is shown for each evaluation of the residents. Data show improvement in component task performance with repetitions sustained in the performance of the complete aortic valve replacement procedure. (ACAT = aortic closure assessment tool; AVRAT = aortic valve replacement assessment tool; DAAT = deairing assessment tool; PAT = prosection assessment tool; VCAF = venous cannulation assessment form.) The Annals of Thoracic Surgery 2017 103, 312-321DOI: (10.1016/j.athoracsur.2016.06.062) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Mean response for each of the scheduled evaluations in the acute intraoperative aortic dissection (AIAD) module. Statistical estimate of the mean is shown for each evaluation. The data show improvement in component task performance with repetitions sustained in the performance of the complete aortic valve replacement procedure. (ARAT = aortic repair assessment tool; EAP AIAD = emergency action plan for acute intraoperative aortic dissection; FCAT = femoral cannulation assessment tool.) The Annals of Thoracic Surgery 2017 103, 312-321DOI: (10.1016/j.athoracsur.2016.06.062) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions