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Simulation-Based Skill Training for Trainees in Cardiac Surgery: A Systematic Review.

Igo B Ribeiro1, Janet M C Ngu1, Buu-Khanh Lam1

  • 1Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.

The Annals of Thoracic Surgery
|December 18, 2017
PubMed
Summary

Simulation-based training significantly improves cardiac surgery trainee learning outcomes, especially for junior residents. However, further research is needed to assess skill transfer to the operating room and patient results.

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Area of Science:

  • Medical Education
  • Surgical Training
  • Simulation Technology

Background:

  • Simulation-based training is crucial for addressing deficits in cardiac surgery education.
  • This review systematically evaluates the evidence on outcomes and quality of simulation-based skills training for cardiac surgery trainees.

Purpose of the Study:

  • To identify and summarize existing evidence on the outcomes of simulation-based skills training in cardiac surgery.
  • To assess the methodological quality of studies evaluating simulation-based training for cardiac surgery trainees.

Main Methods:

  • A systematic literature search was conducted across MEDLINE, Embase, and ERIC databases.
  • Studies included peer-reviewed publications on simulation-based skill training in cardiac surgery, focusing on performance outcome measures.
  • Data extraction followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, assessing simulator type, trainee level, and assessment tools.

Main Results:

  • Out of 16 studies, only 4 were randomized controlled trials; most were observational, with 43.7% being single-group pre-post tests.
  • Low-fidelity simulators were prevalent (81.2%), and most studies (81.3%) were of high methodological quality (Medical Education Research Study Quality Instrument score ≥ 12).
  • While learning outcome effect sizes were high (2.2), assessment tool validation was absent, and no studies measured skills transfer to the operating room or patient outcomes.

Conclusions:

  • Simulation-based skill training demonstrates a strong positive association with improved learning outcomes for cardiac surgery trainees.
  • Junior residents showed the most significant benefits from simulation-based training.
  • Further research should focus on behavior-level outcomes and skills transfer to enhance the assessment of simulation training's value.