Effectiveness of a surgical anastomosis simulation model in hybrid supervised and independent thoracic surgery...

Simulation is an increasingly important component of surgical training that often involves time-limited in-person sessions. The aim of this study is to assess the influence of a surgical simulation model used in a hybrid learning environment, including supervised and self-directed practice and to evaluate its effect on the development of technical skills in thoracic surgery trainees practicing pulmonary artery and bronchial anastomoses.

Sixteen postgraduate year 6 and 7 trainees participated. The group was split into 2 training sessions: part A, dedicated to the pulmonary artery anastomosis technique, and part B, focused on the bronchial anastomosis. Participants attended an in-person demonstration followed by a hands-on practice session led by an experienced thoracic surgeon. Participants then completed an anastomosis and were assessed independently by 2 thoracic surgeons. Time to task completion (TTC), technical skill scores, and watertightness test results were recorded. Subsequently, trainees performed 10 self-directed practice sessions using the simulation model at home, documenting the results of their TTC and watertightness tests. Upon the completion of independent practice sessions, trainees were evaluated by the same 2 raters during in-person assessments.

The performance evaluation included a task-specific checklist, an overall impression of ability, an independent performance rating, and recorded TTC. In part A (n = 9), average task-specific checklist scores improved from 3.9 out of 7 to 6.3 out of 7 (62%; P = .016). In part B (n = 5), task-specific checklist scores improved from 4.1 out of 6 to 5.5 out of 6 (34%; P = .059). The overall impression of ability score averages increased from 3.1 out of 5 to 4.4 out of 5 (part A, 42%; P = .008) and 2.6 out of 5 to 4.7 out of 5 (part B, 81%; P = .039), whereas the independent performance rating scores improved from 2.7 out of 5 to 4.5 out of 5 (part A, 67%; P = .011) and 2.6 out of 5 to 4.7 out of 5 (part B, 81%; P = .018). Average TTC decreased by 1:47 minutes (part A, P = .119) and 4:15 minutes (part B, P = .005). All participants achieved watertight anastomoses by the end of training.

Hybrid simulation training is a feasible and effective method for refining and mastering surgical skills. Study participants demonstrated statistically significant performance improvements in almost all categories. A reduction in TTC and an ability to achieve a watertight anastomosis were noted, indicating an anticipated positive trend toward skill mastery. Hybrid simulation training is an effective educational approach that can help address the shortage of hands-on training opportunities among thoracic surgery trainees by providing added flexibility for practice at their own convenience.