Incorporating simulation in vascular surgery education

Abstract

The traditional apprenticeship model introduced by Halsted of "learning by doing" may just not be valid in the modern practice of vascular surgery. The model is often criticized for being somewhat unstructured because a resident's experience is based on what comes through the "door." In an attempt to promote uniformity of training, multiple national organizations are currently delineating standard curricula for each trainee to govern the knowledge and cases required in a vascular residency. However, the outcomes are anything but uniform. This means that we graduate vascular specialists with a surprisingly wide spectrum of abilities. Use of simulation may benefit trainees in attaining a level of technical expertise that will benefit themselves and their patients. Furthermore, there is likely a need to establish a simulation-based certification process for graduating trainees to further ascertain minimum technical abilities.

Association of Program Directors in Vascular Surgery (APDVS) survey of program selection, knowledge acquisition, and education provided as viewed by vascular trainees from two different training paradigms

“…8,9 One of the primary reasons may be the ability to have a one-to-one interchange, including feedback with the instructor, which is so embraced as the best way to learn by those taking this survey. [8][9][10][11] It may provide much more in terms of repetitive practice, altered degree of difficulty, individualized learning, and tangible outcomes in a controlled environment. [7][8][9][10][11][12] It may provide an environment to train and promote teamwork.…”

“…[8][9][10][11] It may provide much more in terms of repetitive practice, altered degree of difficulty, individualized learning, and tangible outcomes in a controlled environment. [7][8][9][10][11][12] It may provide an environment to train and promote teamwork. 8,9,13 Even low technology models may be used to determine some degree of competence before advancement to the clinical arena.…”

“…[7][8][9][10][11][12] It may provide an environment to train and promote teamwork. 8,9,13 Even low technology models may be used to determine some degree of competence before advancement to the clinical arena. 14 Although general surgery programs appear ahead of vascular surgery programs in incorporating simulation into training, it is interesting that most general surgery residents believe it does improve their skills at all levels, but the senior residents are less impressed with its benefits.…”

“…15 Many surgical leaders interested in education see it fitting well into a comprehensive educational program for training surgeons and, in particular, vascular surgeons. 9,16,17 Certainly, this is an area that may need to be considered-and is being considered-by program directors to improve the educational experience of their residents with measures to determine progress.…”

A randomized comparison of a 3-week and 6-week vascular surgery simulation course on junior surgical residents' performance of an end-to-side anastomosis

“…Simulation training has been proposed as an important complement to the operative experience of surgical residents for the acquisition and assessment of surgical skills. [1][2][3][4][5][6] The benefits of surgical simulation training have been clearly demonstrated for laparoscopic and endovascular procedures. [7][8][9][10][11] Although the effectiveness of simulation training has not been as widely investigated in open vascular surgery as it has in other surgical disciplines, evidence for its benefit is emerging.…”