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A prospective randomized study assessing optimal method for teaching vascular anastomoses.

Samuel Schwartz1, Michael de Virgilio1, Patrick Chisum1

  • 1Department of Surgery, Harbor-UCLA Medical Center, Torrance, CA; Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA.

Annals of Vascular Surgery
|January 15, 2014
PubMed
Summary
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One-on-one teaching significantly improves vascular anastomosis skills in surgical residents compared to group teaching. This method leads to faster skill acquisition and fewer errors in performing vascular anastomoses.

Area of Science:

  • Surgical Education
  • Medical Simulation
  • Vascular Surgery Training

Background:

  • Laboratory skills training is a mandatory component of general surgery residency programs.
  • The most effective method for teaching vascular anastomosis (VA) skills remains undefined.
  • One-on-one instruction is hypothesized to accelerate skill acquisition more effectively than large-group settings.

Purpose of the Study:

  • To compare the efficacy of one-on-one versus group teaching methods for vascular anastomosis (VA) skills in surgical residents.
  • To evaluate the impact of different teaching modalities on resident performance in VA procedures.
  • To assess the utility of a high-fidelity model for VA training.

Main Methods:

  • Sixteen junior surgical residents were randomized into either group teaching (GT) or one-on-one teaching (1-on-1) sessions using a standardized VA model.

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  • Residents performed baseline and post-session VAs, which were video-recorded.
  • Performance was assessed by blinded experts using a scoring system evaluating total errors, time, global rating, and anastomosis quality (leak/patency).

    • Main Results:

    • Both GT and 1-on-1 teaching groups showed significant improvements in reducing errors and time, and increasing global ratings after two sessions.
    • The 1-on-1 group demonstrated statistically significant greater improvements in reducing anastomotic time and errors compared to the GT group.
    • A high-fidelity VA model proved effective for junior residents' skill development.

    Conclusions:

    • A high-fidelity vascular anastomosis model is a valuable training tool for junior general surgery residents.
    • Both group and one-on-one teaching methods lead to significant skill improvements in vascular anastomosis after limited sessions.
    • One-on-one teaching yields superior results in improving vascular anastomosis skills compared to group teaching.