A novel homemade simulator for training and assessing competency of totally implantable venous access port implantation via venous cutdown.

Total implantable venous access port (TIVAP) by cephalic vein cutdown (CVCD) is one of the first procedures surgery residents can be performed independently under supervision. There is currently a lack of affordable simulators for teaching and assessing TIVAP competency to improve patient safety. A panel of 10 experts divided the TIVAP by CVCD procedure into 9 steps. A homemade, low-cost ($3 USD) simulator was then designed for practicing standardized procedural steps in the context of a simulation-based mastery learning course. Residents were given a simulator for at-home practice and completed a survey evaluating the simulator and their learning experience. Twenty-eight first-year surgery residents participated in the course and completed the survey. They were highly satisfied with the simulator (mean score = 8.7 of 10) and generally agreed with its anatomical appearance and functional fidelity. They also appreciated the educational value of using this simulator to learn and practice basic techniques and procedural steps. Our novel, homemade simulator of CVCD TIVAP implantation is a cost-effective way of achieving procedural competence of a basic operation for inexperienced surgery residents. We envision the same principle can be applied to other procedures to enhance resident education.

Educational project: low cost porcine model for venous cutdown training.

OBJECTIVE: to describe and evaluate the acceptance of a porcine experimental model in venous cutdown on a medical education project in Southwest of Brazil. METHOD: a porcine experimental model was developed for training in venous cutdown as a teaching project. Medical students and resident physicians received theoretical training in this surgical technique and then practiced it on the model. After performing the procedure, participants completed a questionnaire on the proposed model. This study presents the model and analyzes the questionnaire responses. RESULTS: the study included 69 participants who used and evaluated the model. The overall quality of the porcine model was estimated at 9.16 while the anatomical correlation between this and human anatomy received a mean score of 8.07. The model was approved and considered useful in the teaching of venous cutdown. CONCLUSIONS: venous dissection training in porcine model showed good acceptance among medical students and residents of this institution. This simple and easy to assemble model has potential as an educational tool for its resemblance to the human anatomy and low cost.

Educational project: low cost porcine model for venous cutdown training / Projeto de ensino: modelo porcino de baixo custo para treinamento de dissecção venosa

ABSTRACT Objective: to describe and evaluate the acceptance of a porcine experimental model in venous cutdown on a medical education project in Southwest of Brazil. Method: a porcine experimental model was developed for training in venous cutdown as a teaching project. Medical students and resident physicians received theoretical training in this surgical technique and then practiced it on the model. After performing the procedure, participants completed a questionnaire on the proposed model. This study presents the model and analyzes the questionnaire responses. Results: the study included 69 participants who used and evaluated the model. The overall quality of the porcine model was estimated at 9.16 while the anatomical correlation between this and human anatomy received a mean score of 8.07. The model was approved and considered useful in the teaching of venous cutdown. Conclusions: venous dissection training in porcine model showed good acceptance among medical students and residents of this institution. This simple and easy to assemble model has potential as an educational tool for its resemblance to the human anatomy and low cost.

RESUMO Objetivo: descrever e avaliar a aceitação de um modelo experimental porcino no aprendizado de dissecção venosa em projeto de educação médica no sudoeste do Brasil. Método: um modelo experimental porcino foi desenvolvido para treinamento em dissecção venosa como projeto de ensino. Estudantes de medicina e médicos residentes receberam treinamento teórico sobre esta técnica cirúrgica e em seguida a praticaram no modelo. Após realizar o procedimento, os participantes preencheram um questionário sobre o modelo proposto. Este estudo apresenta o modelo e analisa as respostas ao questionário. Resultados: o estudo contou com 69 participantes que utilizaram e avaliaram o modelo. A qualidade geral do modelo porcino foi estimada em 9,16 enquanto a correlação anatômica entre este e a anatomia humana recebeu o escore médio de 8,07. O modelo foi aprovado e considerado útil no ensino da dissecção venosa. Conclusão: o treinamento de dissecção venosa em modelo porcino apresentou boa aceitação entre estudantes e residentes de medicina desta Instituição. Este modelo simples e de fácil confecção, tem potencial como instrumento de aprendizado por sua semelhança com a anatomia humana, e baixo custo.

Surgical model pig ex vivo for venous dissection teaching in medical schools.

PURPOSE: To investigate a method for development of surgical skills in medical students simulating venous dissection in surgical ex vivo pig model. METHODS: Prospective, analytical, experimental, controlled study with four stages: selection, theoretical teaching, training and assessment. Sample of 312 students was divided into two groups: Group A - 2nd semester students; Group B - students of 8th semester. The groups were divided into five groups of 12 students, trained two hours per week in the semester. They set up four models to three students in each skill station assisted by a monitor. Teaching protocol emergency procedures training were applied to venous dissection, test goal-discursive and OSATS scale. RESULTS: The pre-test confirmed that the methodology has not been previously applied to the students. The averages obtained in the theoretical evaluation reached satisfactory parameters in both groups. The results of applying OSATS scale showed the best performance in group A compared to group B, however, both groups had satisfactory medium. CONCLUSION: The method was enough to raise a satisfactory level of skill both groups in venous dissection running on surgical swine ex vivo models.

Surgical model pig ex vivo for venous dissection teaching in medical schools

Abstract Purpose: To investigate a method for development of surgical skills in medical students simulating venous dissection in surgical ex vivo pig model. Methods: Prospective, analytical, experimental, controlled study with four stages: selection, theoretical teaching, training and assessment. Sample of 312 students was divided into two groups: Group A - 2nd semester students; Group B - students of 8th semester. The groups were divided into five groups of 12 students, trained two hours per week in the semester. They set up four models to three students in each skill station assisted by a monitor. Teaching protocol emergency procedures training were applied to venous dissection, test goal-discursive and OSATS scale. Results: The pre-test confirmed that the methodology has not been previously applied to the students. The averages obtained in the theoretical evaluation reached satisfactory parameters in both groups. The results of applying OSATS scale showed the best performance in group A compared to group B, however, both groups had satisfactory medium. Conclusion: The method was enough to raise a satisfactory level of skill both groups in venous dissection running on surgical swine ex vivo models.

Competency-based training of basic trainees using human cadavers.

BACKGROUND: Increasing constraints on operative training in the clinical setting provide impetus for the development of alternative training models. Anatomy dissection courses utilizing human cadavers have been useful in imparting knowledge of human anatomy for surgical trainees. The present study evaluates the impact of competency-based technical skills instruction as an adjunct to cadaveric dissection courses on the procedural skills of basic surgical trainees (BST). METHODS: A single cohort of BST was prospectively evaluated regarding their self-reported confidence and competency in performing saphenous vein cutdowns immediately before and after an anatomy dissection course. RESULTS: Nine BST were evaluated (66% were male). One subject withdrew from the study, leaving eight BST for final analysis. Mean number of years since graduation from medical school was 2.5 years (range: 2-4 years). Seven BST were in their first year of training. All subjects had completed an early management of severe trauma (EMST) course. Total prior experience of saphenous vein cutdowns for all subjects was a single attempt on a sheep cadaver at the EMST course. The percentage of BST expressing little or no confidence in performing cutdowns decreased after the dissection course (50% vs 0, P < 0.05). Mean time taken for completion of cutdown decreased after the dissection course. (5 min 52 s vs 3 min 52 s, P < 0.05). Mean size of incision used to perform cutdown decreased after the course. (4.5 cm vs 3.4 cm, P < 0.05). The percentage of subjects experiencing complications during cutdown decreased after the course (38% vs 0, P < 0.05). CONCLUSIONS: Anatomy dissection courses using human cadavers may contribute to improving the confidence and competency of BST in performing saphenous vein cutdowns. Technical training components should be considered as an adjunct to future anatomy dissection courses involving surgical trainees.