Simulation in coronary artery anastomosis early in cardiothoracic surgical residency training

The Boot Camp experience

James I. Fann, John H. Calhoon, Andrea J. Carpenter, Walter H. Merrill, John Brown, Robert S. Poston, Maziyar Kalani, Gordon F. Murray, George L. Hicks, Richard H. Feins

Research output: Contribution to journalArticle

82 Citations (Scopus)

Abstract

Objective: We evaluated focused training in coronary artery anastomosis with a porcine heart model and portable task station. Methods: At "Boot Camp," 33 first-year cardiothoracic surgical residents participated in 4-hour coronary anastomosis sessions (6-7 attending surgeons per group of 8-9 residents). At beginning, midpoint, and session end, anastomosis components were assessed on a 3-point rating scale (1 good, 2 average, 3 below average). Performances were video recorded and reviewed by 3 surgeons in a blinded fashion. Participants completed questionnaires at session end, with follow-up surveys at 6 months. Results: Ten to 18 end-to-side anastomoses with porcine model and task station were performed. Initial assessments ranged from 2.11 ± 0.58 (forceps use) to 2.44 ± 0.48 (needle angles). Midpoint scores ranged from 1.76 ± 0.63 (forceps use) to 1.91 ± 0.49 (needle angles). Session end scores ranged from 1.29 ± 0.45 (needle holder use) to 1.58 ± 0.50 (needle transfer and suture management and tension; P < .001). Video recordings confirmed improved performance (interrater reliability >0.5). All respondents agreed that task station and porcine model were good methods of training. At 6 months, respondents noted that the anastomosis session provided a basis for training; however, only slightly more than half continued to practice outside the operating room. Conclusions: Four-hour focused training with porcine model and task station resulted in improved ability to perform anastomoses. Boot Camp may be useful in preparing residents for coronary anastomosis in the clinical setting, but emphasis on simulation development and deliberate practice is necessary.

Original languageEnglish
Pages (from-to)1275-1281
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume139
Issue number5
DOIs
StatePublished - May 2010

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Internship and Residency
Needles
Coronary Vessels
Swine
Surgical Instruments
Operating Rooms
Sutures
Surveys and Questionnaires
Surgeons

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Simulation in coronary artery anastomosis early in cardiothoracic surgical residency training : The Boot Camp experience. / Fann, James I.; Calhoon, John H.; Carpenter, Andrea J.; Merrill, Walter H.; Brown, John; Poston, Robert S.; Kalani, Maziyar; Murray, Gordon F.; Hicks, George L.; Feins, Richard H.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 139, No. 5, 05.2010, p. 1275-1281.

Research output: Contribution to journalArticle

Fann, JI, Calhoon, JH, Carpenter, AJ, Merrill, WH, Brown, J, Poston, RS, Kalani, M, Murray, GF, Hicks, GL & Feins, RH 2010, 'Simulation in coronary artery anastomosis early in cardiothoracic surgical residency training: The Boot Camp experience', Journal of Thoracic and Cardiovascular Surgery, vol. 139, no. 5, pp. 1275-1281. https://doi.org/10.1016/j.jtcvs.2009.08.045
Fann, James I. ; Calhoon, John H. ; Carpenter, Andrea J. ; Merrill, Walter H. ; Brown, John ; Poston, Robert S. ; Kalani, Maziyar ; Murray, Gordon F. ; Hicks, George L. ; Feins, Richard H. / Simulation in coronary artery anastomosis early in cardiothoracic surgical residency training : The Boot Camp experience. In: Journal of Thoracic and Cardiovascular Surgery. 2010 ; Vol. 139, No. 5. pp. 1275-1281.
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