Train early and with deliberate practice: simple coronary surgery simulation platform results in fast increase in technical surgical skills in residents and students

Abstract

OBJECTIVES The amount of intense and focused training with the specific goal to improve performance (i.e. deliberate practice) is a predictor of expert-level performance in multiple domains of psychomotor skill learning. Simulation training improves surgical skills in cardiac surgery. We established a training programme that enables early surgical exposure and assessment. We investigated the training effects in coronary surgery simulations in trainees with different levels of surgical experience. METHODS The early surgical exposure and assessment programme comprises a low- and high-fidelity simulation, self-organized training, instructed workshops and a stepwise challenge increase. Performance was assessed with a multidimensional skill matrix using video recordings. Two groups of trainees [students (N = 7), 1-/2-year residents (N = 6)] completed introductory training (pretraining, level 1) and two 3-week training periods (levels 2 and 3). Fellows (N = 6) served as controls. Residents and students underwent deliberate practice training with specific training targets. Fellows performed regularly scheduled coronary surgery cases. Entry and exit assessments were conducted for levels 2 and 3. RESULTS Fellows did not improve overall performance. Residents and students showed significant improvements in both technical accuracy and completion times. Residents reached an overall performance level comparable to fellows. Students reached similar accuracy of surgical skills with longer completion times [level 3 exit score/time: fellows 27 (24–29)/min; residents 27 (21–30)/min, P = 0.94; students 17 (17–25)/min, P = 0.068]. CONCLUSIONS Deliberate practice training resulted in a fast and substantial increase in surgical skills in residents and students. Unexperienced residents reach performance levels of fellows. Deliberate practice simulation programmes should be a mandatory component of surgical training.

Impact of a 36-hour Nonstop Training Course on Academic, Physical, and Mental Skills as well as Psychological Stress Perception in Cardiac Surgery Residents

“…All procedures were prospectively analyzed by a coach/mentor (handling, motion, and time) as previously published. 7 Surgical Modules…”

“…Surgical performance was evaluated based on the EASE methodology criteria (handling, motion, and time). 7 Analog-Visual-Scale and Multidimensional Sensibility Questionnaire All candidates received a questionnaire with a 0 to 10 scale regarding the degree of individual motivation, stress, and irritability level, modified from a protocol published by Machado et al 8 Additionally, the correlations among the three bipolar scales (good/bad mood, wakefulness/fatigue, and calmness/restlessness) were addressed using the standard questionnaire used to evaluate the degree of humor in the German-speaking populations. 9…”

How to Build a Simulation Center for Surgery

“…Substantiated by evidence in previous research, simulation-based training has emerged as a potent avenue for acquiring surgical expertise. [1][2][3][4][5] In lieu of traditional trial-and-error learning, simulation-based training offers a structured pathway to mastering surgical skills. Simulation training should be an integral component of surgical education to achieve both fundamental and advanced surgical competencies.…”

SOCIUS Mentoring—A Novel Course to Encourage Students for a Career as Surgical Oncologists

“…Overall, study results suggest that students’ interest in surgical careers increase when they are supported early in the acquisition of surgical skills [ 6 ]. Despite proven positive effects on students’ research interest and career planning, systematic mentoring as well as skills training is only sporadically established in various medical fields [ 4 , 7 , 8 , 9 , 10 , 11 , 12 ].…”