Prospective Trial of Low-Fidelity Deliberate Practice of Aortic and Coronary Anastomoses (TECoG 002)
| Autor: | John R. Spratt, Gabriel Loor, Mara B. Antonoff, Tom C. Nguyen, David L. Joyce, Melissa E. Brunsvold |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty education Video Recording Anastomosis computer.software_genre Education Dreyfus model of skill acquisition 03 medical and health sciences 0302 clinical medicine Health science Educational assessment medicine Humans Prospective Studies 030212 general & internal medicine Simulation Training Curriculum Aorta Cross-Over Studies business.industry Anastomosis Surgical Internship and Residency Coronary Vessels United States Low fidelity Education Medical Graduate Prospective trial Cardiothoracic surgery 030220 oncology & carcinogenesis Physical therapy Feasibility Studies Female Surgery Clinical Competence Educational Measurement business Vascular Surgical Procedures computer |
| Zdroj: | Journal of Surgical Education. 76:844-855 |
| ISSN: | 1931-7204 |
| DOI: | 10.1016/j.jsurg.2018.09.007 |
| Popis: | Objective We sought to examine the feasibility of a home practice curriculum of vascular anastomosis in cardiovascular surgery using a low-fidelity simulation platform and to examine its effectiveness in skill acquisition in senior surgical trainees. Design We organized a multicenter prospective randomized study of senior residents and fellows, who were oriented to a low-fidelity cardiac simulator and an 8-week curriculum of independent practice of aortic and coronary anastomosis. “Treatment” trainees received a simulator and the curriculum. Control trainees received only their usual operative experience. The groups then crossed over; all were studied for 16 weeks in total. Video skill assessments were captured at 0, 8, and 16 weeks and were scored by one blinded investigator using the Joint Council on Thoracic Surgery Education Assessment tool. A post-hoc survey was distributed to invited participants following study completion. Setting University of Minnesota Department of Surgery, Mayo Clinic Department of Cardiovascular Surgery, and the University of Texas Health Science Center at Houston. Participants used the simulator in offices, call rooms, and their homes. Participants Program participation in the study was solicited through the Thoracic Education Cooperative Group. Four institutions expressed interest and a total of 29 trainees were invited to the study and randomized. Of these, 12 (38%) completed the curriculum and submitted the requisite 3 sets of videos (6 treatment, 6 control). All were senior residents and fellows in general and cardiothoracic surgery. Results No significant differences were detected in assessment scores before and after the curriculum nor before or after the control period in the overall or postgraduate year-stratified populations. Participant case numbers during the study did not have a significant effect on assessment scores. Randomized participants reported strong interest in deliberate practice of technical skills but identified competing clinical and personal obligations and significant barriers to simulation. Conclusions Considerable variability in performance existed among participants who completed the study, but overall, the curriculum alone was insufficient to improve simulator Joint Council on Thoracic Surgery Education scores compared to those not undergoing the curriculum. Among senior residents and fellows, provision of a practice curriculum and simulator for repeated practice is feasible but clinical and personal responsibilities were barriers to repetitive practice. |
| Databáze: | OpenAIRE |
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