1. Teaching heart valve surgery techniques using simulators: a systematic review
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EL-Andari, Ryaan, Bozso, Sabin J., Kang, Jimmy J.H., Fialka, Nicholas M., Adams, Corey, and Nagendran, Jeevan
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Synthetic training devices -- Usage ,Surgical research ,Medical personnel -- Training ,Surgery, Experimental ,Surgeons -- Training ,Heart valve replacement -- Training ,Health ,Health care industry - Abstract
The apprentice model has traditionally been the primary method of teaching cardiac surgery trainees. Limitations of this model include insufficient time to learn all neces sary skills, minimal exposure to rare cases and to complex repair techniques, small number of patients in small centres, high cost and absence of objective measures of feedback. In recent years, simulation-based training (SBT) has been used in order to address the gaps left by the apprentice model. We performed a systematic review of PubMed and Embase for articles investigating the use of SBT in teaching surgical valve techniques published in 2022 or earlier in order to summarize the current literature regarding the use of SBT for trainees learning surgical valve repair and replacement techniques. We compiled data on the impact of SBT on time to completion of tasks, proportion of trainees who committed technical errors, skills scores and theoretical knowledge. Studies in which outcomes were evaluated showed significant improvement in these measures after participation in SBT. Simulationbased training has been shown to improve the surgical skills of trainees in a relatively short period. As hands-on experience in the feld of cardiac surgery is invaluable and often difficult to reproduce effectively, it is likely that a combination of hands-on training and SBT will be adopted moving forward to provide optimal exposure for surgical trainees. Le modele de l'apprenti est la principale methode traditionnelle de formation des stagiaires en chirurgie cardiaque. Ce modele comporte toutefois des limites : manque de temps pour apprendre toutes les competences necessaires, exposition minime aux cas rares et aux techniques de reparation complexes, faible nombre de patients dans les petits centres, cout eleve et absence de mesures de retroaction objectives. Depuis plusieurs annees, la formation par simulation est employee pour combler ces lacunes. Nous avons realise une revue systematique d'articles trouves dans PubMed et Embase portant sur le recours a la formation par simulation dans l'enseignement des techniques de chirurgie valvulaire, publies en 2022 ou avant, afin de resumer la litterature sur le sujet. Nous avons compile des donnees mesurant l'incidence de la formation par simulation sur le temps de realisation des taches, la proportion de stagiaires ayant commis des erreurs techniques, les scores de competence et les connaissances theoriques chez les stagiaires. Ces mesures, pour les etudes les ayant evaluees, se sont signi ficativement ameliorees apres la participation a la formation par simulation. Il a ete demontre que cette modalite ameliore les competences chirurgicales des stagiaires en une periode assez courte. L'experience pratique dans le domaine de la chirurgie cardiaque est inestimable et souvent complexe a reproduire efficacement; a l'avenir, la formation des stagiaires en chirurgie associera probablement la pratique et la simulation pour une exposition optimale. Valvular heart disease is a relatively common condition affecting an estimated 2.5% of the population in developed nations. (1-4) The mitral valve (MV) and aortic valve (AV) are the 2 most commonly diseased valves. (2,4) Severe valvular heart disease is not amenable to pharmacotherapy, and, thus, the only definitive treatment is surgical repair or replacement of the diseased valve. Heart valve repair and replacement are complex procedures requiring years of training to achieve proficiency. Surgical trainees have traditionally learned these technical skills in the operating room through the apprentice model, which entails a surgical resident's being taught by a single mentor at a time. (5,6), Although hands-on experience is irreplaceable and has a record of proven success, several limitations have been identified with the apprentice model. (7,8) These limitations include insufficient time to learn all [...]
- Published
- 2023
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