Simulator Teaching of Cardiopulmonary Bypass Complications: A Prospective, Randomized Study

Abstract

Objective: Complications of cardiopulmonary bypass (CPB) are rare, but life-threatening events that need prompt and rehearsed actions involving a team. This is not adequately taught to cardiothoracic surgical trainees. The objective of this study was to assess the knowledge of cardiothoracic trainees required to manage these events after simulation-based vs. lecture-based teaching.

Participants and design: Totally, 17 cardiac surgical trainees with no formal teaching in intraoperative complications of CPB management were randomly assigned by computer to either a study group receiving simulation-based complications of CPB teaching via the Orpheus simulator (n = 9) or a control group receiving complications of CPB teaching via a lecture (n = 8). Each subject undertook a written test comprising 20 multiple choice questions on complications of CPB before and after teaching. Trainees were then asked to rate their satisfaction with each session from 1 to 5, with 5 being most satisfied.

Setting: St George Simulation and Clinical Skills Laboratory, St George's Hospital, London.

Results: There was no significant difference in the pretest scores between the 2 groups (p = 0.29). After teaching, both groups showed a statistically significant improvement in their knowledge (p < 0.05). The trainees in the simulation group performed better than the lecture-based group; however, this was not statistically significant (p = 0.21). Satisfaction levels in both the lecture session and the simulation session were very high with means of 4.4/5 and 4.8/5, respectively.

Conclusion: Despite the familiarity with CPB during surgery, the simulation group performed at least as well as the lecture group. Cardiothoracic trainees would benefit from formal teaching of complications of CPB management via either learning modality being incorporated into their training.

Keywords: Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; Systems-Based Practice; cardiopulmonary bypass; medical education; simulation training; surgery.