Train early and with deliberate practice: simple coronary surgery simulation platform results in fast increase in technical surgical skills in residents and students
| Autor: | T. Schilling, Felix Kirchhoff, Jan Heimeshoff, Axel Haverich, Erik Beckmann, Morsi Arar, Felix Fleissner, Malakh Shrestha, Wilhelm Korte, Tobias Goecke, Constanze Merz, Tim Kaufeld, Andreas Martens |
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| Rok vydání: | 2019 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male medicine.medical_specialty education Coronary surgery 030204 cardiovascular system & hematology Simulation training 03 medical and health sciences 0302 clinical medicine Surgical skills medicine Humans Computer Simulation Overall performance Cardiac Surgical Procedures Coronary Artery Bypass Students Training programme Psychomotor learning business.industry Internship and Residency Thoracic Surgery Surgical training 030228 respiratory system Education Medical Graduate Physical therapy Surgery Female Clinical Competence Cardiology and Cardiovascular Medicine business |
| Zdroj: | Interactive cardiovascular and thoracic surgery. 30(6) |
| ISSN: | 1569-9285 |
| Popis: | OBJECTIVES The amount of intense and focused training with the specific goal to improve performance (i.e. deliberate practice) is a predictor of expert-level performance in multiple domains of psychomotor skill learning. Simulation training improves surgical skills in cardiac surgery. We established a training programme that enables early surgical exposure and assessment. We investigated the training effects in coronary surgery simulations in trainees with different levels of surgical experience. METHODS The early surgical exposure and assessment programme comprises a low- and high-fidelity simulation, self-organized training, instructed workshops and a stepwise challenge increase. Performance was assessed with a multidimensional skill matrix using video recordings. Two groups of trainees [students (N = 7), 1-/2-year residents (N = 6)] completed introductory training (pretraining, level 1) and two 3-week training periods (levels 2 and 3). Fellows (N = 6) served as controls. Residents and students underwent deliberate practice training with specific training targets. Fellows performed regularly scheduled coronary surgery cases. Entry and exit assessments were conducted for levels 2 and 3. RESULTS Fellows did not improve overall performance. Residents and students showed significant improvements in both technical accuracy and completion times. Residents reached an overall performance level comparable to fellows. Students reached similar accuracy of surgical skills with longer completion times [level 3 exit score/time: fellows 27 (24–29)/min; residents 27 (21–30)/min, P = 0.94; students 17 (17–25)/min, P = 0.068]. CONCLUSIONS Deliberate practice training resulted in a fast and substantial increase in surgical skills in residents and students. Unexperienced residents reach performance levels of fellows. Deliberate practice simulation programmes should be a mandatory component of surgical training. |
| Databáze: | OpenAIRE |
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