Sierra FCR, Suárez BMF, Hernández MI, Juárez HA, Castillo RC, Sánchez PJ

Language: Spanish
References: 16
Page: 30-39
PDF size: 558.27 Kb.

ABSTRACT

Introduction: Surgical medical residency plans face the dilemma of traditional teaching methods, which promote the acquisition of skills and competencies through “in vivo” practices. To date, the learning process for surgical practice of cardiac surgery has not been fully consolidated. The development of new teaching strategies is necessary for the evolution of training plans. One viable option is to generate simulation programs on biological models that can be added to traditional teaching plans.
Objective: To evaluate the impact on the development of surgical skills of a structured learning program of cardiac surgery techniques in porcine biological models in a group of cardiothoracic surgery residents.
Methods: A surgical simulation program was implemented in swine biological models consisting of 20 theoreticalpractical sessions, simulating the interaction between surgeon and first assistant in the operating room, guided by a tutor and two instructors. An evaluation and analysis of the impact of the program on the development of skills and knowledge acquired at the beginning and end of the program was analyzed.
Results: 20 practical sessions were performed during the academic cycle, with 10 participating resident physicians, observing a favorable evolution in the motor skills of the assistants evaluated at the end of the program, with a mean initial score of 18.8 (SD ±4.686), which evolved to 27.3 (SD ±2.003) out of a total of 30 points at the end of the program.
Discussion: Based on the evaluation of the program, an improvement in the surgical skills obtained by the resident physicians was observed.
Conclusions: Simulation learning implies a safe practice process for residents and patients, which has a positive impact on the development of motor skills.

REFERENCES

1. Inam H, Asif N, Sohail AA, Fatimi SH. Wet labs: A useful toolin training surgical residents in a third world country. AnnMed Surg (Lond). 2020;57:137-9. http://dx.doi.org/10.1016/j.amsu.2020.07.014

2. Porras-Hernández JD. Enseńanza y aprendizaje de la cirugía.Investig educ médica. 2016;5(20):261-7. http://dx.doi.org/10.1016/j.riem.2016.05.008

3. Rao S. Ethics on the learning curve. J Indian Assoc PediatrSurg [Internet]. 2022;27(2):191-5. http://dx.doi.org/10.4103/jiaps.JIAPS_364_20

4. Bernstein M, Knifed E. Ethical challenges of in-the-field training:a surgical perspective. Learn Inq [Internet]. 2007;1(3):169-74. http://dx.doi.org/10.1007/s11519-007-0010-4

5. Escobar MA, McCullough LB. Responsibly managing ethicalchallenges of residency training: A guide for surgeryresidents, educators, and residency program leaders. J AmColl Surg. 2006;202(3):531-5. http://dx.doi.org/10.1016/j.jamcollsurg.2005.11.006

6. Krishnamoorthy, Wr C, Shah, Bartely, Kendall, Lewis, etal. An intensive training of cardiothoracic surgical skillsand simulation course increases procedural knowledge -feedback from fifteen courses. Blood Hear Circ. 2019;3(1).http://dx.doi.org/10.15761/bhc.1000149

7. Rabenstein AP, Khomutova A, Shroyer ALW, Scriven R,McLarty A, Tannous H, et al. Cardiac surgical simulationprogram during general surgery residency increases residentphysician exposure to cardiac surgery and technical expertise.JTCVS Open. 2022;9:179-84. http://dx.doi.org/10.1016/j.xjon.2022.01.002

8. Castillo Romero C, Ricciardi G. Nikaidoh procedure: The WetLab trainee’s perspective. World J Pediatr Congenit Heart Surg.2021;12(1):124-7. http://dx.doi.org/10.1177/2150135120957644

9. Valdis M, Chu MWA, Schlachta C, Kiaii B. Evaluation ofrobotic cardiac surgery simulation training: A randomizedcontrolled trial. J Thorac Cardiovasc Surg. 2016;151(6):1498-1505.e2. http://dx.doi.org/10.1016/j.jtcvs.2016.02.016

10. Smelt J, Valencia O, Nowell J, Roberts N, Jahangiri M. Agreementbetween examiners in wet lab assessment of cardiothoracictrainees.Bull R Coll Surg Engl.2017;99(5):190-4.http://dx.doi.org/10.1308/rcsbull.2017.190

11. Fann JI, Sullivan ME, Skeff KM, Stratos GA, Walker JD, GrossiEA, et al. Teaching behaviors in the cardiac surgery simulationenvironment. J Thorac Cardiovasc Surg. 2013;145(1):45-53.http://dx.doi.org/10.1016/j.jtcvs.2012.07.111

12. Brandăo CM de A, Dallan LRP, Dinato FJ, Monteiro R, FiorelliAI, Jatene FB. Evaluation method of training simulationon biological models for cardiovascular surgery residents.J Card Surg. 2021;36(7):2247-52.http://dx.doi.org/10.1111/jocs.15524.

13. Reuthebuch O, Lang A, Groscurth P, Lachat M, Turina M,Zünd G. Advanced training model for beating heart coronaryartery surgery: the Zurich heart-trainer. Eur J CardiothoracSurg. 2002;22(2):244-8. http://dx.doi.org/10.1016/s1010-7940(02)00269-5.

14. Norman G, Dore K, Grierson L. The minimal relationshipbetween simulation fidelity and transfer of learning: Simulationfidelity. Med Educ. 2012;46(7):636-47. http://dx.doi.org/10.1111/j.1365-2923.2012.04243.x

15. Baker CJ, Sinha R, Sullivan ME. Development of a cardiacsurgery simulation curriculum: from needs assessment resultsto practical implementation. J Thorac Cardiovasc Surg.2012;144(1):7-16.http://dx.doi.org/10.1016/j.jtcvs.2012.03.026

16. Gillinov, M., Mick, S., Mihaljevic, T., & Suri, R. M. (2016).Watch one, do one, teach one. JTCVS, 151(6), 1506-1507.https://doi.org/10.1016/j.jtcvs.2016.02.033