Surgical resident training using real-time simulation of cardiopulmonary bypass physiology with echocardiography

Background: With increasing complexity of medical care and continuing limitations on medical education, the use of simulation is becoming ever more important. Several simulators have been developed to teach procedural-based surgical tasks. The care of the cardiac surgical patient requires an in-depth understanding of physiology, particularly as pertains to cardiopulmonary bypass. We describe the use of the Human Patient Simulator (HPS) to teach perioperative fundamentals to surgical residents. Methods: General surgery residents from the University of Kentucky participated in an interactive simulation pilot program. The METI (Medical Education Technology, Inc, Sarasota, Florida) HPS was used with custom programming to demonstrate simulated intraoperative and postoperative physiology related to cardiopulmonary bypass. Didactics, in addition to intraoperative echocardiographic images, were provided. Fund of knowledge was assessed by a computerized pre- and posttest that was administered to the trainees, and self-assessment data were collected using a Likert scale. Results: Nineteen general surgery residents participated. An overall improvement in performance on the test was demonstrated from 63% correct to 85% correct. In general, residents found the simulation useful, appreciated the opportunity to treat crisis situations without risk of harm to a patient, and felt they could apply the knowledge gained from this program in their future practice. Conclusions: Simulation serves as a useful adjunct to medical education. We have demonstrated the use of the HPS to provide a real-time simulation of the physiology of cardiopulmonary bypass and postoperative care. We plan to use this system as part of our standard curriculum of training rotating residents and junior fellows and anticipate this system could be used as part of future cardiothoracic simulations.