A Novel Multidimensional Fidelity Framework for Cardiac Surgery Simulation: A Thematic Literature Review.

Area of Science:

• Medical Education
• Surgical Simulation
• Cardiovascular Surgery

Background:

• Simulation-based training is growing in cardiac surgery.
• Simulation fidelity in cardiac surgery is not well-defined.
• A novel multidimensional framework is needed to analyze fidelity.

Purpose of the Study:

• To examine literature on simulation fidelity in cardiac surgery.
• To develop a multidimensional framework for analyzing fidelity themes.
• To provide guidance for designing effective cardiac surgical simulations.

Main Methods:

• Keyword-based literature review of cardiac surgical simulation studies (2000-2020).
• Thematic analysis of 26 included articles using a hybrid coding approach.
• Identification of fidelity themes and subthemes within physical, surgical, and interactional dimensions.

Main Results:

• Seven key themes of simulation fidelity were identified: environmental, equipment, anatomical, physiological, procedural, perceptual, and psychological.
• Subthemes for three levels of realism were generated for each theme.
• A multidimensional framework for surgical simulation fidelity was established.

Conclusions:

• The developed fidelity framework offers educators guidance for cost-effective simulation design.
• Selective utilization of fidelity dimensions and levels aligns with learning objectives.
• This framework supports optimal resource allocation for competency-based surgical training.