Division of Cardiovascular Surgery, Department of Surgery, Labatt Family Heart Centre, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, England, UK.
Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2023;26:9-17. doi: 10.1053/j.pcsu.2022.12.001. Epub 2022 Dec 17.
Technical skill development in congenital heart surgery (CHS) is challenging due to numerous factors which potentially limit the hands-on operative exposure in surgical training. These challenges have stimulated the growth of simulation-based training through the development of 3D-printed models, providing hands-on surgical training (HOST). From its inception in 2015, the models used in the HOST program have constantly improved, and now include valvar/subvalvar apparatus and better materials that mimic real tissue. Evidence shows that deliberate, regular simulation practice can improve a surgeon's technical skills across the spectrum of CHS. Furthermore, surgical trainees who undergo simulation training are able to translate this improved performance into the operative environment with improved patient outcomes. Despite evidence to support the incorporation of simulation methods into congenital training, its widespread adoption into training curricula remains low. This is due to numerous factors including funding, lack of dedicated time or proctorship and access to models-all of which can be overcome with the newer generation of models and committed trainers. Training programs should consider incorporating simulation-methods as a routine component of congenital training programs.
由于诸多因素,先天性心脏病(CHS)的技术技能发展具有挑战性,这些因素可能限制了手术培训中的实际操作机会。这些挑战刺激了基于模拟的培训的发展,通过开发 3D 打印模型来提供实际手术培训(HOST)。自 2015 年成立以来,HOST 计划中使用的模型不断改进,现在包括瓣膜/瓣下装置和更逼真的模拟组织的材料。有证据表明,有目的的、定期的模拟练习可以提高外科医生在 CHS 各个方面的技术技能。此外,接受模拟训练的外科受训者能够将这种技能提升转化为手术环境中的实际操作,从而改善患者的预后。尽管有证据支持将模拟方法纳入先天性培训,但它在培训课程中的广泛应用仍然很低。这是由于众多因素造成的,包括资金、缺乏专用时间或监管以及对模型的访问——所有这些都可以通过新一代模型和有承诺的培训师来克服。培训计划应考虑将模拟方法作为先天性培训计划的常规组成部分。