Related Experiment Video
Updated: Jan 7, 2026
A Training and Testing System for Performing Vascular Reconstruction In Vitro
Published on: October 26, 2019
Enhancing Technical Skill Acquisition And Reducing Evaluation Bias Through Simulation-Based Vascular Anastomosis
Jorge Sulca Flores1, Kenneth Lynch2, Carla C Moreira2
1School of Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Objective:
To evaluate the effectiveness of video replay in simulation-based vascular anastomosis training on technical skill acquisition, alignment between resident self-assessments and faculty evaluations, and reduction of potential evaluator bias.
Methods:
Over the course of 3 years, 31 PGY-2 general surgery residents completed a 7-week structured vascular anastomosis training program at a single academic institution. Training included simulation-based practice and video-recorded pre- and post-test performances of end-to-side anastomoses. Two independent surgical attendings reviewed blinded videos; residents conducted unblinded self-assessments. Performance was evaluated using a modified Mini-Objective Structured Assessment of Technical Skills (MOSAT) and a Global Rating Scale (GRS), with a total score of 62. Paired and unpaired t-tests were used for statistical analysis.
Results:
Significant improvements were observed in both self-assessed and faculty assessed technical scores (p < 0.0001). Residents' self-assessments increased from a mean of 29.1 to 46.6 (p < 0.0001), while attending scores rose from 29.6 to 49.9 (p < 0.0001). Mean leak volume decreased by 15.3 mL (p < 0.0001), while completion time showed no significant change. At baseline, no differences were found between resident and attending scores. Post-test, attendings rated resident performance significantly higher than residents did in GRS and overall scores (p = 0.024 and p = 0.033, respectively), particularly in domains such as flow of operation and instrument handling. At pre-test, attending scores rated female residents significantly higher than male residents in anastomosis (p = 0.024) and overall score (p = 0.040). Post-test, no significant gender differences were observed in any category or in overall scores (p = 0.541).
Conclusions:
Simulation-based vascular training using blinded video replay has been shown to improve technical skills significantly and may reduce gender-based evaluation bias. Despite access to performance footage, residents tend to underestimate their abilities compared to faculty assessments.
