Multipurpose Simulator for Technical Skill Development in Thoracic Surgery

Background. Our appreciation for the increased role of simulation in surgical education has led us to develop a simulator for effective training of fundamental invasive thoracic skills. Materials and Methods. Study subjects were fourth year medical students (MS-4, n = 6) rotating on a surgery clerkship, and surgical interns (PGY-1, n = 6). All subjects completed demographic surveys and rated their comfort level performing the thoracic skills. A computerized instructional module was given to all participants. Additionally, interns attended a boot camp with didactics, live demonstrations, and supervised practice sessions. Subjects were asked to perform a thoracentesis and insert a chest tube on the models, repetitively, during three sessions, and their skills were rated. Participants were asked to rate their comfort levels performing the procedure before and after the sessions. Results. Interns reported a greater exposure to surgery (9.7 +/- 3.2 wk versus 6 +/- 1.8 wk; P = 0.03). Although interns were initially faster, operative times were comparable by the third session. Initially, technical skill ratings for thoracentesis were significantly lower in the MS-4 group (P < 0.03). The scores significantly increased by the final simulation (P <= 0.04), and were similar to the PGY-1 skill ratings. Significant improvement with chest tube placement each week (P <= 0.05), resulted in scores comparable to the intern group as well. Both groups reported higher comfort levels after the simulation sessions. Conclusions. Our simulation trainers were effective educational tools for fundamental thoracic procedures. Our study demonstrates improved technical skill and higher comfort levels with the simulated procedures. (C) 2010 Elsevier Inc. All rights reserved.