Enrico Danzer2, Natalia Martinez2, Josef Luba2, Melissa L. Kirkwood3, Benjamin M. Jackson1, Edward Y. Woo1, Ronald M. Fairman1, Grace J. Wang1
1Vascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA; 2Hospital of the University of Pennsylvania, Philadelphia, PA; 3UT Southwestern Medical Center, Dallas, TX.
OBJECTIVES: High-Fidelity (HF) surgical simulation has been shown to improve technical performance. We sought to define the role of repetition in retention of endovascular skills in general surgery interns (GSI) performing advanced endovascular interventions on a virtual reality simulator.
METHODS: Thirteen GSI participated in a didactic session focused on the diagnosis and management of carotid stenosis. Each GSI then performed right carotid angioplasty and stenting under the guidance of a trained instructor (baseline). Each GSI then underwent 2 practice sessions followed by a repeat assessment 3 days following the initial didactic session (post-training). Retention skills were evaluated at a median of 8 weeks (range: 2-20) after course completion. Objective procedural metrics were provided by the simulator. Subjective performance was graded by an expert observer using a structured global assessment scale. The performance of a graduating vascular surgical fellow was used for comparison. Students’ t-tests were used for statistical analysis and a p-value <0.05 was considered statistically significant.
RESULTS: Post-training and retention scores were improved in GSI compared to baseline values (p<0.05). Post-training and retention scores in GSI were not statistically different from fellow performances. Subjective global assessment of skills was likewise significantly improved at post-training and retention time points compared to baseline in GSI (p<0.02). Interestingly, when using the subjective assessment scale, fellow performances scored higher than GSI at all three time points measured (p<0.01).
CONCLUSIONS: HF simulation offers a means to improve technical skills with a high retention rate comparable to that of an experienced trainee in this study of novices performing advanced endovascular interventions.
AUTHOR DISCLOSURES: E. Danzer, Nothing to disclose; R. M. Fairman, Nothing to disclose; B. M. Jackson, Nothing to disclose; M. L. Kirkwood, Nothing to disclose; J. Luba, Nothing to disclose; N. Martinez, Nothing to disclose; G. J. Wang, Nothing to disclose; E. Y. Woo, Nothing to disclose.
Posted April 2012