Key result
Low-cost cardiac surgery simulation is linked to ~34% better procedural knowledge and improved practical ability.
Why the study?
Cardiothoracic surgery simulation training opportunities outside the Royal Australasian College of Surgery or industry workshops are rare due to high costs and limited faculty, time, assessment tools, or curricula.
Does a low-cost cardiac simulation programme improve self-assessed knowledge and practical ability in surgical trainees and staff?
Observational (n=45)
No
Does a low-cost cardiac simulation programme improve self-assessed knowledge and practical ability in surgical trainees and staff?
Mean Difference: 34 (95% CI 28–42)
A low-cost cardiac surgery simulation program is feasible and significantly improves self-assessed anatomical knowledge and procedural skills among trainees and staff.
May support low-cost simulation in cardiac surgery training; leaves open whether gains improve operative outcomes or patient safety.
BACKGROUND: Simulation training is a useful adjunct to surgical training and education (SET) in Cardiothoracic Surgery yet training opportunities outside the Royal Australasian College of Surgery or industry-sponsored workshops are rare due to high cost and limited training faculty, time, assessment tools or structured curricula. We describe our experience in establishing a low-cost cardiac simulation programme. METHODS: We created low-cost models using hospital facilities, hardware stores, abattoirs and donations from industry. Three workshops were conducted on coronary anastomoses, aortic and mitral valve replacement. RESULTS: Whole porcine hearts were sourced from local farms. Industry donations of obsolete stock were used for suture and valve material-stations constructed using ironing-board, 2-L buckets and kebab-skewers. Suture ring holders were fashioned from recycled cardboard or donated. All participants were asked to complete pre and post simulation self-assessment forms. Across three workshops, 45 participants (57.8% female) with a median age 27 (interquartile range 24-31) attended. Training level consisted of nurses (8, 17.8%), medical students (17, 37.8%), residents/house officers (6, 13.3%) and registrars (14, 31.1%). There were improvements in knowledge of anatomy (mean difference 18%; 95% confidence interval 12%-24%), imaging (16%; 10%-22%) and procedural components (34%; 28%-42%); and practical ability to describe steps (30%; 24%-38%), partially (32%; 26%-38%) or fully complete (32%; 28%-38%) the procedure. CONCLUSIONS: Simulation-based training in cardiac surgery is feasible in a hospital setting with low overhead costs. It can benefit participants at all training levels and has the potential to be implemented in training hospitals as an adjunct to the SET programme.
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Sharma et al. (2021) conducted an observational in Cardiothoracic Surgery training (n=45). Low-cost cardiac surgery simulation programme vs. Pre-simulation (baseline) was evaluated on Knowledge of procedural components (MD 34%, 95% CI 28-42). A low-cost cardiac surgery simulation programme improved participants' knowledge of procedural components (mean difference 34%; 95% CI 28-42%) and practical ability to fully complete the procedure.
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