Remote simulator training of coronary artery bypass grafting during the coronavirus disease 2019 pandemic

Kenichiro Takahashi; Chiharu Tanaka; Ryosuke Numaguchi; Yoshinori Kuroda; Hiroko Nemoto; Kunihiko Yoshino; Mika Noda; Yoshinori Inoue; Kumiko Wada; Committee of The Japanese Society for Cardiovascular Surgery Under Forty

doi:10.1016/j.xjon.2021.08.019

Remote simulator training of coronary artery bypass grafting during the coronavirus disease 2019 pandemic

JTCVS Open. 2021 Dec:8:524-533. doi: 10.1016/j.xjon.2021.08.019. Epub 2021 Aug 21.

Authors

Kenichiro Takahashi¹, Chiharu Tanaka², Ryosuke Numaguchi³, Yoshinori Kuroda⁴, Hiroko Nemoto⁵, Kunihiko Yoshino⁶, Mika Noda⁷, Yoshinori Inoue⁸, Kumiko Wada⁹; Committee of The Japanese Society for Cardiovascular Surgery Under Forty

Affiliations

¹ Department of Cardiovascular Surgery, Nippon Medical School, Tokyo, Japan.
² Department of Cardiovascular Surgery, Tokai University Hachioji Hospital, Tokyo, Japan.
³ Department of Cardiovascular Surgery, National Obihiro Hospital, Obihiro, Japan.
⁴ Department of Surgery II, Yamagata University Faculty of Medicine, Yamagata, Japan.
⁵ Department of Cardiovascular Surgery, Yokohama City University Hospital, Yokohama, Japan.
⁶ Department of Cardiovascular Surgery, St Luke's International Hospital, Tokyo, Japan.
⁷ Department of Cardiovascular Surgery, Fujita Health University, Aichi, Japan.
⁸ Department of Cardiovascular Surgery, National Hospital Organization Okayama Medical Center, Okayama, Japan.
⁹ Department of Cardiovascular Surgery, St Mary's Hospital, Kurume, Japan.

Abstract

Objectives: The coronavirus disease 2019 pandemic presents in-person exposure risk during surgical education. We aimed to validate the feasibility of fully remote faculty-supervised surgical training sessions focused on coronary artery bypass grafting using a synthetic simulator and online videochat software.

Methods: This observational study organized 24 sessions of 2-hour remote training. Each session involved 3 trainees, 1 faculty member, and 1 host. A total of 70 trainees and 24 faculty members were enrolled. The participants joined the remote sessions via online videochat and performed focused training in coronary artery anastomosis using a commercially available simulator. A survey was conducted to validate the feasibility of the remote sessions. Performance improvement of the trainees who repeatedly participated (n = 13) were analyzed comparing initial and final scores of various performance indicators.

Results: All trainees and faculty members were satisfied with the efficacy of the remote session. Additionally, most trainees (79%) and faculty members (95%) agreed that the remote training sessions were equivalent to conventional onsite training seminars. A significant improvement between initial and last sessions was observed in the scoring components of near side (3.4 ± 1.0 vs 4.1 ± 0.9; P = .02), far side (3.3 ± 0.8 vs 3.9 ± 0.8; P = .03), external appearance (3.5 ± 0.8 vs 4.2 ± 0.7; P = .01), and internal appearance (2.8 ± 0.9 vs 4.0 ± 0.9; P = .004).

Conclusions: Faculty-supervised remote surgical training sessions were executed with satisfactory results. This methodology may have important implications for surgical education during the coronavirus disease 2019 pandemic.

Keywords: CABG, coronary artery bypass grafting; COVID-19; COVID-19, coronavirus disease 2019; JSCVS, The Japanese Society for Cardiovascular Surgery; OFFJT, off-the-job training; U-40, Committee of the Japanese Society for Cardiovascular Surgery Under Forty; coronary artery bypass grafting; objective structured assessment of technical skills; off-the-job training; remote surgical education; simulation-based training.