Simulation in Medical Education (SiME) Seminar Series
DATE & TIME: Thursday, May, 22 @ 12 noon - pm (light lunch will be served)
LOCATION: Goodman Simulation Center
DIRECTIONS: H3552 (Stanford Hospital)
SPEAKER: James Fann, MD
AFFILIATION: Stanford University School of Medicine
DETAILS:
Abstract: Changes in surgical training curriculum, partly in response to patient safety concerns, financial pressures, and resident work hour limitations, have compelled surgical educators to evaluate more effective methods of teaching psychomotor skills. In cardiac surgery, assisting with and performing on-pump coronary artery bypass grafting supervised by attending staff is the current method of training in coronary anastomosis; however, the trainee may benefit from prior and concurrent simulation training in this and more advanced procedures. Technical challenges of beating heart surgery include coronary artery stabilization and performing accurate anastomosis on moving target vessels in an expeditious fashion. Synthetic non-beating and beating heart simulators and porcine heart models may provide visual and tactile feedback in performing coronary anastomosis and instill confidence in the participants. Simulators need to provide a realistic, graduated training experience and have valid educational objectives, but they also should be cost-effective and be of relatively low maintenance. Also of benefit would be simulation that allows the trainee to practice on his or her own time instead of being constrained by work hour limitations and the availability of animal laboratory facilities. We have developed a series of task stations and procedures that are intended to provide initial and follow-up training and practice of routine and complex cardiac surgical procedures for the resident. An important goal is to evaluate the effectiveness of these methods of simulation. We have evaluated distributed practice using a portable anastomosis task station and the beating heart model in training the techniques of coronary anastomosis. In general, we found that distributed practice using the anastomosis task station resulted in improvement in the ability to perform the anastomosis as assessed by time to completion and performance ratings not only with the task station but also with the beating heart simulation model. Not all residents improved, particularly with the task station, consistent with a “ceiling effect” with the simulator and a “plateau effect” with the trainee. Simulation may be useful in preparing residents for coronary anastomosis in the clinical setting and may provide an opportunity to identify the need and methods for remediation.
Bio: JAMES I. FANN, M.D., is associate professor of cardiothoracic surgery at Stanford University. He graduated with distinction from Northwestern University Medical School and completed training in General Surgery, Vascular Surgery and Cardiothoracic Surgery at Stanford University. He has been on the faculty in the Department of Cardiothoracic Surgery at Stanford University and VA Palo Alto since 1996. His areas of research and interest include cardiac surgery simulation, valvular heart disease, and minimally invasive cardiac surgery. He is the recipient of the Western Thoracic Surgery Association Doty Award to study cardiac surgery simulation and has established a cardiac surgery simulation center at the VA Palo Alto. His e-mail: jfann@stanford.edu
A light lunch will be served.
