Practice improves performance on a coronary anastomosis simulator, attending surgeon supervision does not

Area of Science:

• Surgical Education
• Medical Simulation
• Cardiothoracic Surgery Training

Background:

• Simulation is increasingly used in surgical training, but evidence of its effectiveness is limited.
• Coronary anastomosis is a critical skill in cardiothoracic surgery.
• The role of supervision in simulation-based training requires further investigation.

Purpose of the Study:

• To evaluate the impact of supervised versus unsupervised simulation training on coronary anastomosis performance in medical students.
• To compare the effectiveness of different training modalities on surgical skill acquisition.

Main Methods:

• A randomized controlled trial involving 45 medical students using a low-fidelity simulator.
• Participants were assigned to a control group, unsupervised training group, or supervised training group.
• Performance was assessed via videotaped coronary anastomosis attempts before and after a 4-week training period, rated by blinded cardiothoracic surgeons.

Main Results:

• All groups showed significant improvement in anastomosis scores after training.
• Both supervised and unsupervised training groups demonstrated significantly greater improvement compared to the control group.
• No significant difference in performance improvement was observed between the supervised and unsupervised training groups.

Conclusions:

• Practice with low-fidelity simulators enhances a range of surgical skills for trainees.
• Attending-level supervision provides limited additional benefit over unsupervised practice for coronary anastomosis.
• Unsupervised simulation practice may be a viable and sufficient method for skill development in inexperienced surgical trainees.