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Simulation trainer for practicing emergent open thoracotomy procedures
Allan J Hamilton1, Hannes Prescher1, David E Biffar1
1Arizona Simulation Technology and Education Center, College of Medicine, University of Arizona Health Sciences Center, University of Arizona, Tucson, Arizona.
The Journal of Surgical Research
|May 12, 2015
Summary
A new, cost-effective Cardiothoracic (CT) Surgery trainer improved team performance in simulated emergent open thoracotomy (OT) procedures. This simulation training significantly reduced critical milestone times and overall procedure duration.
Area of Science:
- Medical Simulation
- Surgical Training
- Cardiothoracic Surgery
Background:
- Emergent open thoracotomy (OT) is a high-risk, low-frequency procedure.
- Simulation training is ideal for such procedures.
- A cost-effective Cardiothoracic (CT) Surgery trainer was developed.
Purpose of the Study:
- Assess the potential of a custom CT Surgery trainer.
- Improve technical and interprofessional skills during simulated emergent OT.
- Evaluate team performance in a critical care setting.
Main Methods:
- Modified a commercial mannequin torso with artificial tissue.
- Conducted three in situ simulations with a multidisciplinary CT team.
- Measured time to complete five critical milestones: diagnosis, code cart arrival, thoracotomy tray arrival, incision, and defibrillation.
Main Results:
- Average reduction of 29.5% in times to achieve critical milestones (P < 0.05).
- Overall improvement of 40% in complete OT procedure time.
- Procedure time improved by 7 min and 31 s from initial to final trial.
Conclusions:
- The CT Surgery trainer is effective for improving team performance.
- Simulation training enhances readiness for emergent bedside OT.
- Preliminary evaluation shows utility in coronary care unit settings.
