Cardiac Surgery Simulation Curriculum Simulation-based training in surgical skills and decision making Richard H. Feins, M.D. Harold M. Burkhart, M.D. Daniel N. Coore, Ph.D. John V. Conte, M.D. James I. Fann, M.D. George L. Hicks, M.D. Nahush A. Mokadam, M.D. Jonathan C. Nesbitt, M.D. Paul S. Ramphal, M.D. ID: 18232890 K. Robert Shen, M.D. www.lulu.com Jennifer D. Walker, M.D. 5 800114 229565 Fall 08 Cardiac Surgery Simulation Curriculum Simulation-based training in surgical skills and decision making Funded by U.S. Department of Health and Human Services (HHS) Agency for Healthcare Research and Quality Grant # R18HS020451 Project Investigators: Richard H. Feins, M.D., University of North Carolina at Chapel Hill, Chapel Hill, NC (Principal Investigator) Harold M. Burkhart, M.D., Mayo Clinic, Rochester, MN Daniel N. Coore, Ph.D., University of the West Indies, Mona, Jamaica John V. Conte, M.D., Johns Hopkins University, Baltimore, MD James I. Fann, M.D., Stanford University, Palo Alto, CA George L. Hicks, M.D., University of Rochester, Rochester, NY Nahush A. Mokadam, M.D., University of Washington, Seattle, WA Jonathan C. Nesbitt, M.D., Vanderbilt University, Nashville, TN Paul S. Ramphal, M.D., University of the West Indies, Mona, Jamaica K. Robert Shen, M.D., Mayo Clinic, Rochester, MN Jennifer D. Walker, M.D., Massachusetts General Hospital, Boston, MA Copyright © 2015 by Richard H. Feins, University of North Carolina at Chapel Hill, on behalf of the authors and the Thoracic Surgery Directors Association (TSDA), which will share the curriculum with cardiothoracic surgery educators on behalf of the authors. This curriculum was prepared as part of a multi-institution study of cardiac surgery simulator training for resident physicians that was funded by the Agency for Healthcare Quality and Research (AHRQ) under grant # R18HS020451. No part of this document may be reproduced, distributed or used without permission. iv Table of Contents Contributors ...................................................................................................................................................................................... xi Preface ................................................................................................................................................................................................. xiii About the Simulator .................................................................................................................................................................... xv Acknowledgments....................................................................................................................................................................... xix Introduction .........................................................................................................................................................................................1 1. Cardiopulmonary Bypass (CPB) Module ........................................................................3 Overview - CPB Module ..............................................................................................................................................................4 CPB Session 1: Fundamentals of CPB and Aortic Cannulation ...........................................................................5 Overview............................................................................................................................................................................................ 5 Prerequisites ..................................................................................................................................................................................... 5 A. Fundamentals of Cardiopulmonary Bypass Training .............................................................................................. 6 Teaching Plan .................................................................................................................................................................................. 6 Assessment Tools ........................................................................................................................................................................... 8 B. Aortic Cannulation Component Task Simulation ..................................................................................................... 9 Objectives .......................................................................................................................................................................................... 9 Equipment Required ..................................................................................................................................................................... 9 Simulation Set-up ....................................................................................................................................................................... 10 Conduct of the Simulation ...................................................................................................................................................... 10 Assessment Tools ........................................................................................................................................................................ 11 CPB Session 2: Venous Cannulation, Cardioplegia and Aortic Cross-Clamping .................................. 12 Overview......................................................................................................................................................................................... 12 Prerequisites .................................................................................................................................................................................. 12 Objectives ....................................................................................................................................................................................... 12 Equipment Required .................................................................................................................................................................. 13 Simulators and Set-up .............................................................................................................................................................. 14 Conduct of the Simulation ...................................................................................................................................................... 14 Assessment Tools ........................................................................................................................................................................ 16 CPB Sessions 3, 4: Full Cardiopulmonary Bypass Run .......................................................................................... 17 Prerequisites .................................................................................................................................................................................. 17 Objectives ....................................................................................................................................................................................... 17 Teaching Plan ............................................................................................................................................................................... 18 Equipment Required .................................................................................................................................................................. 18 Conduct of the Simulation ...................................................................................................................................................... 18 Assessment Tools ........................................................................................................................................................................ 18 2. Coronary Artery Bypass Grafting (CABG) Module.....................................................21 Overview – CABG Module..................................................................................................................................................... 22 Objectives ....................................................................................................................................................................................... 22 CABG Session 1: Fundamentals of CABG/End-to-side Anastomosis .......................................................... 26 Overview......................................................................................................................................................................................... 26 Prerequisites .................................................................................................................................................................................. 26 Goals ................................................................................................................................................................................................. 26 Objectives ....................................................................................................................................................................................... 26 Teaching Plan ..............................................................................................................................................................................