Division of Vascular and Endovascular Surgery, University of California, Davis, Sacramento, California 95817, USA.
J Surg Educ. 2009 Nov-Dec;66(6):330-5. doi: 10.1016/j.jsurg.2009.07.004.
High-fidelity procedure simulation has been found useful for training vascular surgery residents in endovascular procedures, but the costs of acquiring, maintaining, and operating simulators represent a barrier to routine use of endovascular simulation in vascular surgery programs. Providing simulation training opportunities through regional centers may make simulation more cost effective, but the costs and benefits of this approach have not been reported previously. We reviewed participation costs in a regional simulation program to provide a benchmark for comparison with other training options.
Simulation-based training was offered annually from 2004 to 2007 to the 11 vascular surgery fellowships in Washington, Oregon, California, Arizona, and Utah. Participation was at the discretion of the program directors and fellows. Sessions were designed to offer individualized, hands-on training with 2-4 participants per 2-day session. SimSuite (Medical Simulation Corporation, Denver, Colorado) simulators were used.
During the 4-year period, participation by invited programs averaged 75%. Ten of 11 programs in the western United States region participated, with 34 fellows participating during the 4 years of the program. In addition, 2 program directors or faculty attended sessions to participate as learners, and 8 other individuals were allowed to participate (including 7 senior surgery residents and 1 vascular surgery fellow from out of the region). The average participant costs for travel, which include transportation, lodging, and meals, were $571. Simulation facility expenses, which included use of the simulator, computer-based training modules, and instructional support by an educational specialist, averaged $1055 per participant. Surgical faculty spent 12 hours per 2-day session instructing and in other direct educational activities. Costs for this time were not calculated separately.
Vascular surgery fellows' participation in simulation training at regional centers offers program directors a lower cost alternative for providing high-fidelity simulation training, compared with acquiring and operating an endovascular procedure simulator at their individual institutions.
高保真度的手术模拟已被证明对血管外科住院医师的血管内手术培训非常有用，但购买、维护和操作模拟器的成本成为了血管外科学术领域模拟训练常规应用的障碍。通过区域中心提供模拟培训机会可能会使模拟训练更具成本效益，但这种方法的成本和效益以前并未报道过。我们回顾了区域模拟项目的参与成本，为与其他培训方案进行比较提供了一个基准。
从 2004 年到 2007 年，每年向华盛顿、俄勒冈、加利福尼亚、亚利桑那和犹他的 11 个血管外科研究员提供基于模拟的培训。参与培训由项目主任和研究员自行决定。培训课程旨在提供个性化的实践培训，每次为期两天的培训课程有 2 到 4 名参与者。使用的是 SimSuite（科罗拉多州丹佛市的医疗模拟公司）模拟器。
在 4 年期间，受邀项目的参与率平均为 75%。美国西部 11 个地区中有 10 个地区参与了该项目，4 年来共有 34 名研究员参与了该项目。此外，2 名项目主任或教员参加了培训课程作为学习者参与，还有 8 名其他人员（包括 7 名来自该地区以外的高级外科住院医师和 1 名血管外科研究员）也被允许参加。每位参与者的旅行费用（包括交通、住宿和餐饮）平均为 571 美元。模拟设施费用（包括模拟器的使用、基于计算机的培训模块以及由教育专家提供的教学支持）平均每位参与者为 1055 美元。每两天的培训课程，外科教员花费 12 小时进行指导和其他直接教学活动。这部分时间的成本没有单独计算。
与在各自机构购买和操作血管内手术模拟器相比，血管外科住院医师在区域中心参加模拟培训为项目主任提供了一种成本更低的选择，可用于提供高保真度的模拟培训。
