Simulation in cardiac surgery: current evidence

Abstract

Simulation permeated healthcare curricula and has become a powerful teaching tool to improve manual and cognitive skills in medicine today. Amongst other skill sets, cardiothoracic anaesthetists are expected to make safe life-saving decisions to improve patient outcome during rare critical events. These stressful situations require leadership and problem solving skills from all medical personnel, which traditional learning by “apprenticeship” may not cover. This narrative review looks at current simulation modalities used in cardiothoracic anaesthesia, which include critical scenarios for the placement of arterial and central venous lines, as well as the interpretation of the pulmonary artery catheter derived data. Simulation in transthoracic and transoesophageal echocardiography has proven to be very useful. Of particular importance in cardiothoracic clinical practice is simulation for cardiopulmonary bypass, veno-arterial and veno-venous extracorporeal membrane oxygenation. Trainees’ working hour regulations may affect patient safety, because of decreased exposure to real life patient-related scenarios. The complexity of patient interventions in a high-stakes discipline like cardiothoracic anaesthesia may necessitate the development of further simulation-enhanced educational processes.