Hands-On Homework Good for Heart Surgeons-In-Training

Take-home simulators help residents in cardiac surgery do better in the operating room, Dr. Buu-Khanh Lam today told the Canadian Cardiovascular Congress 2011, co-hosted by the Heart and Stroke Foundation and the Canadian Cardiovascular Society.Dr. Lam and a multidisciplinary surgical team developed a kit – containing sutures, forceps, and miniature tubing – that can be taken home by trainees to practice a highly technical operation called microvascular anastomosis. The procedure, which involves joining two arteries together, is the "bread and butter" of coronary artery bypass surgery and is performed hundreds of thousands of times a year in North America, says Dr. Lam, director of surgical undergraduate education at the University of Ottawa and director of the University of Ottawa Heart Institute Valve Clinic.
It is difficult for residents to get enough surgical training for such a delicate procedure, he says, because cardiac cases are more complex, there are work hour restrictions for medical professionals, and the medical environment is more litigious. In addition, the high-stress environment of the operating room may not be conducive to the acquisition of a new skill. "We wanted to develop a training strategy so that new surgeons had more opportunities to practice on their own in order to become more proficient in the operating room," he explains.
To date the use of simulation in cardiac surgical training has been limited.
To test the benefits of at-home practice with the device, they recruited 39 first- and second-year surgical trainees. All received traditional tutorials and hands-on sessions. In addition, half of the trainees were also given the kit and asked to practice 10 more times and keep a log of practice hours.