Jason T. Lee, Amy Peruzzaro, Thomas Krummel, Ronald L. Dalman
Division of Vascular Surgery, Stanford University Medical Center, Stanford, CA.
OBJECTIVES: Surgical simulation has emerged as an important adjunct to residency training in the era of duty-hour work restrictions. We conducted a prospective randomized trial to determine whether an endovascular simulation-based curriculum improves the technical performance of surgical residents.
METHODS: Third-year residents rotating on vascular surgery were randomized to SIMULATION consisting of weekly faculty-mentored simulation-based sessions and compared to CONTROL without simulation. Endovascular skills were assessed pre- and post-rotation on a high-fidelity simulator utilizing a previously validated endovascular global assessment scale (score 1-5), and a live OR patient evaluation at the end of the rotation.
RESULTS: From 2008-2011, 25 consecutive surgical residents (13 SIMULATION, 12 CONTROL) rotating on a university vs. service were enrolled. PRE-test assessment was not different between groups documenting similar baseline skills (1.6 vs. 1.4), and operative exposure during their 8-week rotation was similar for open and endovascular cases. Amount of time reading, didactic teaching, and conference attendance was also similar between cohorts. There was significant improvement on the POST-test (3.6 vs. 1.5) assessed on the simulator for the entire group, with the residents assigned to the SIMULATION group outperforming the CONTROL group (4.0 vs. 3.3) on the simulator and in the live patient OR assessment (3.5 vs. 2.5).
CONCLUSIONS: Implementation of an intensive simulation-based endovascular curriculum during the vs. rotation improved the technical skill of surgical residents on a high-fidelity simulator, and translated to improved live OR performance beyond the usual teaching obtained from standard clinical rotations.
AUTHOR DISCLOSURES: R. L. Dalman, Nothing to disclose; T. Krummel, Nothing to disclose; J. T. Lee, Nothing to disclose; A. Peruzzaro, Nothing to disclose.
Posted April 2012