Computer Modeling to Evaluate the Impact of Technology Changes on Resident Procedural Volume

Area of Science:

• Thoracic Surgery Training
• Medical Simulation
• Surgical Education Metrics

Background:

• Resident training case volumes are affected by technological advancements and simulation.
• Developing metrics is crucial for programs to determine resident capacity based on institutional case volume.

Purpose of the Study:

• To evaluate a case distribution simulation model for assessing program-level mediastinoscopy and endobronchial ultrasound (EBUS) volumes.
• To determine the necessary case volumes for training thoracic surgery residents.

Main Methods:

• A computer model simulated case distribution using annual case volume, trainee numbers, and rotation length.
• Institutional case volume data from 2011-2013 were used for 10,000 simulated years.
• Predicted the likelihood of 4 residents meeting board requirements over a 2-year program.

Main Results:

• Mean annual mediastinoscopy volume was 43 cases.
• Under post-2012 requirements, the probability of residents meeting mediastinoscopy volume increased to 88% (from 6% pre-2012).
• Including endobronchial ultrasound (EBUS) in post-2012 simulations decreased the likelihood of meeting all case requirements to 23%.

Conclusions:

• The simulation model offers a metric to predict resident case requirement attainment amidst changing and inequitable case distribution.
• This model can be applied to various procedures and diagnoses for curriculum and scheduling development.
• It aids in managing resident training in response to evolving procedural volumes.