Basic Cardiac Surgery Skills on Sale for $22.50: An Aortic Anastomosis Simulation Curriculum

Abstract

Current resident and student duty-hour restrictions necessitate efficient training, which may be aided by simulation. Data on the utility of low-cost simulation in cardiothoracic surgery are scant. We evaluated the effect and value of a low-cost, low-fidelity aortic anastomosis simulation curriculum. Twenty participants (11 medical students, 9 residents) completed an aortic anastomosis on a porcine heart as a pretest. Participants were then provided access to a 14-minute online video created by a cardiac surgeon and given a low-cost task trainer for self-directed practice. Five weeks later, participants performed another aortic anastomosis on a porcine heart as a posttest. Pretest and posttest performances were filmed, deidentified, and graded blindly and independently by two cardiac surgeons using a standardized assessment tool (perfect score, 110; passing score, 58 or higher). Participants were surveyed anonymously after the posttest. The mean (SD) aortic anastomosis performance score improved significantly from pretest (53.3 [25.3]) to posttest (83.6 [15.3]; p < 0.001). Pass rates also improved significantly (35% versus 95%, p < 0.001). Medical students' scores improved most (p = 0.01). All 20 participants reported improved confidence in performing the task, and 18 believed that the online video was essential to better performance. The cost of the curriculum totaled $22.50 per participant, with 6 hours of total staff time required for assessment. An aortic anastomosis training and simulation curriculum improves the skills of student and resident trainees with minimal expense and staff time commitment. Such a curriculum may be of great value to both cardiothoracic training programs and their trainees.