Sustained Supervised Practice on a Coronary Anastomosis Simulator Increases Medical Student Interest in Surgery, Unsupervised Practice Does Not

Background. Given declining interest in cardiothoracic (CT) training programs during the last decade, increasing emphasis has been placed on engaging candidates early in their training. We examined the effect of supervised and unsupervised practice on medical students' interest in CT surgery. Methods. Forty-five medical students participated in this study. Participants' interest level in surgery, CT surgery, and simulation were collected before and after a pretest session. Subsequently, participants were randomized to one of three groups: control (n = 15), unsupervised training on a low-fidelity task simulator (n = 15), or supervised training with a CT surgeon or fellow on the same simulator (n = 15). After 3 weeks, attitudes were reassessed at a posttest session. Interest levels were compared before and after the pretest using paired t tests, and the effects of training on interests were assessed with multiple linear regression analyses. Results. After the pretest session, participants were significantly more interested in simulation (p = 0.001) but not in surgery or CT surgery. After training, compared with control group participants, supervised trainees demonstrated a significant increase in their interest level in pursuing a career in surgery (p = 0.028) and an increasing trend towards a career in CT surgery (p = 0.060), whereas unsupervised trainees did not. Conclusions. Supervised training on low-fidelity simulators enhances interest in a career in surgery. Practice that lacks supervision does not, possibly related to the complexity of the simulated task. Mentorship efforts may need to involve sustained interaction to provide medical students with enough exposure to appreciate a surgical career. (C) 2013 by The Society of Thoracic Surgeons