Using software-based simulation for resident physician training in the management of temporary pacemakers

An understanding of epicardial pacing is essential for the postoperative management of patients having cardiac surgery. By developing a software-based epicardial pacing program to be used with the existing patient simulator, resident physicians may be exposed to various clinical scenarios that might be encountered while caring for a postoperative heart patient. This experience will assist junior residents with no prior experience to become familiar and competent in the management of epicardial pacemakers.

The simulation session used the human patient simulator in combination with an internally developed computer program using Flash animation to present arrhythmias and various epicardial pacing interventions commonly used in the postoperative period. By modeling the Flash animation software after a pulse generator, the user is able to make adjustments (type of pacing, rate of pacing, and chamber output) as if using an actual pulse generator. A group of 15 anesthesiology residents who had minimal or no epicardial pacing experience underwent the simulation training. Feedback was obtained by an anonymous postscenario questionnaire.

A detailed description of the scenario and computer program is provided. All participants provided positive feedback and have strongly agreed that the simulation session improved their understanding and management of epicardial pacemakers.

Our experience with epicardial pacing simulation was demonstrated to be effective in increasing the confidence of junior anesthesiology residents with little or no prior experience with regard to the management of temporary pacemakers.