Quantitative assessment of technical performance during hands-on surgical training of me arterial switch operation using 3-dimensional primed heart models

被引：23

作者：

Hussein, Nabil ^{[1
,2
]}

Honjo, Osami ^{[1
,2
]}

Haller, Christoph ^{[1
,2
]}

Coles, John G. ^{[1
,2
]}

Hua, Zhongdong ^{[4
]}

Van Arsdell, Glen ^{[5
,6
]}

Yoo, Shi-Joon ^{[1
,3
]}

机构：

[1] Univ Toronto, Hosp Sick Children, Dept Paediat, Div Cardiol, Toronto, ON, Canada

[2] Univ Toronto, Hosp Sick Children, Dept Surg, Div Cardiovasc Surg, Toronto, ON, Canada

[3] Univ Toronto, Hosp Sick Children, Dept Diagnost Imaging, Toronto, ON, Canada

[4] Chinese Acad Med Sci & Peking Union Med Coll, Fuwai Hosp, Div Pediat Cardiac Surg Ctr, Beijing, Peoples R China

[5] Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Los Angeles, CA 90095 USA

[6] Univ Calif Los Angeles, Mattel Childrens Hosp, Dept Surg, Los Angeles, CA 90095 USA

来源：

JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY | 2020年 / 160卷 / 04期

关键词：

congenital heart surgery; simulation; education; assessment; arterial switch operation; 3D printing; SIMULATION; REPAIR; TIME;

D O I：

10.1016/j.jtcvs.2019.11.123

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective: Data supporting the use of hands-on simulation in congenital heart surgery are promising but primarily qualitative. This study aimed to demonstrate if there was an objective improvement in time and technical performance of the arterial switch procedure on 3-dimensional printed heart models by surgeons using a validated assessment method. Methods: A total of 30 surgeons of varying experience performed the arterial switch procedure twice on 3-dimensional printed models with transposition of the great arteries during the Hands-on Surgical Training courses. Surgeons' performances were recorded and retrospectively assessed for both time and performance using the Hands-on Surgical Training-Congenital Heart Surgery tool, a validated procedure-specific assessment tool for the arterial switch. Results: A total of 60 videos were scored. Eighty percent of surgeons (24/30) had improved from their first attempt. The mean total score of the first attempt performance compared with the second was 103 and 120, respectively, with a mean difference in score of 17 (95% confidence interval, 10-24). All surgeons were statistically significantly quicker in their second attempt. The mean time for the first attempt compared with the second was 1 hour, 28 minutes, 4 seconds and 1 hour, 5 minutes, and 45 seconds, respectively, with a mean difference of 0 hours, 22 minutes, 19 seconds (95% confidence interval, 0 hours, 15 minutes, 22 seconds to 0 hours, 25 minutes, 34 seconds). Conclusions: This is the first study to demonstrate an objective improvement in time and technical performance of the arterial switch procedure on 3-dimensional printed heart models. This supports the evidence that simulation in the form of deliberate practice with constructive, objective feedback is fundamental in the training of future congenital heart surgeons. These simulations and assessments should be incorporated to create structured, standardized training curricula within congenital heart surgery.

引用

页码：1035 / 1042

页数：8

共 18 条

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