Efficacy of simulation training for beating heart coronary anastomosis using BEAT + YOUCAN simulator.

Abstract

We sought to evaluate our distributed practice program developed for training for beating heart anastomosis by employing a novel beating heart simulator. Eleven trainees watched and reviewed instructional video recordings of coronary anastomosis methods with a BEAT + YOUCAN training device, then performed coronary anastomosis procedures under a beating condition. Next, they participated in a four-hour training program developed by faculty surgeons. Ten different anastomosis components were assessed on a five-point rating scale (5, good; 3, average; 1, poor). After finishing the training program, each trainee again performed a coronary anastomosis procedure. Component scores were then compared before and after the training program. The mean time to completion of the procedure improved from 1033 ± 424 to 795 ± 201 s (p < 0.05). Assessment scores improved from 1.88 ± 0.41 to 2.57 ± 0.30 (p < 0.05). Improvements in some technical components related to handling of instruments were noted (p < 0.05), whereas no significant improvement was seen with arteriotomy, graft orientation, suture management, or knot tying after finishing the training program. Trainees who participated in our four-hour focused training program for coronary anastomosis with a novel beating heart simulator showed improved ability under the beating condition in regard to technical skills related to handling instruments.