Four-year experience with a regional program providing simulation-based endovascular training for vascular surgery fellows.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Dawson
David L
DL
Division of Vascular and Endovascular Surgery, University of California, Davis, Sacramento, California 95817, USA. david.dawson@ucdmc.ucdavis.edu <david.dawson@ucdmc.ucdavis.edu>
Lee
Eugene S
ES
Hedayati
Nasim
N
Pevec
William C
WC
D000328:Adult; D017130:Angioplasty / Q000191:economics / Q000193:education*; D002983:Clinical Competence; D003162:Competency-Based Education / Q000191:economics* / Q000379:methods; D003198:Computer Simulation / Q000191:economics; D003194:Computer-Assisted Instruction; D003362:Cost-Benefit Analysis; D004503:Education, Medical, Graduate / Q000458:organization & administration; D004521:Educational Measurement; D005257:Fellowships and Scholarships / Q000458:organization & administration; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D008297:Male; D017145:Models, Educational; D015397:Program Evaluation; D012016:Reference Values; D014656:Vascular Surgical Procedures / Q000191:economics / Q000193:education