title: Impact of endovascular simulator training on vascular surgery as a career choice in medical students.
abstract: OBJECTIVE
  The primary goal of this study was to determine whether exposure to endovascular simulator training increases interest in vascular surgery among medical students. Secondary goals were to determine whether interest in vascular surgery is inversely related to the time after exposure, to identify factors associated with interest, and to identify students' characteristics that positively influence performance metrics.
  
  
  METHODS
  This was a prospective, randomized, crossover study comprising 80 medical students who were randomized into group A (n = 40) and group B (n = 40). Participants completed a survey of their interest in vascular surgery and attitudinal factors using Vascular Surgery Interest Form (VSIF) before exposure to the simulator (pretest). At 1 month after exposure of group A to the simulator, both groups were tested using VSIF (test). Upon completion of testing, group B was exposed to simulator training, whereas group A received no further training. At 2 months after exposure of group B to the simulator, both groups were posttested using VSIF, which asked the students' level of interest in vascular surgery using a 1 to 10 scale. Performance metrics were recorded during each exposure. Differences among cohort demographics were determined using Pearson χ(2) analysis. Differences in interest were determined with paired sample correlations. Linear regression and analysis of variance were used to correlate VSIF responses with interest and the performance metrics.
  
  
  RESULTS
  Both student cohorts had significant increases in interest after exposure to simulation. In group A, test interest (mean ± standard deviation) was significantly higher than pretest and posttest interests (5.51 ± 1.73 vs 4.00 ± 1.88 vs 4.18 ± 1.82; P < .05). In group B, posttest interest was significantly higher than pretest and test interests (5.62 ± 2.03 vs 3.96 ± 1.61 vs 4.08 ± 1.64; P < .05). The increase in interest was reciprocally related to the time passed since the initial exposure. Resident and attending lifestyle, length of training, radiation concerns, gender identification of a mentor, and personality fit with occupation were not correlated with interest. Sex, medical school year, comfort with endovascular procedures, willingness to work long hours, interest in performing percutaneous procedures, and commitment to surgical career did not affect impact performance metrics.
  
  
  CONCLUSIONS
  One exposure of students to endovascular simulator training is associated with an increase in vascular surgery interest. Acquired interest is reciprocally related to the time demonstrating the temporal importance of the exposure.
authors.affiliation: Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA. jovan.markovic@duke.edu
authors.forename: Jovan
authors.initials: J
authors.lastname: Markovic
authors.forename: Chris
authors.initials: C
authors.lastname: Peyser
authors.forename: Ted
authors.initials: T
authors.lastname: Cavoores
authors.forename: Erin
authors.initials: E
authors.lastname: Fletcher
authors.forename: David
authors.initials: D
authors.lastname: Peterson
authors.forename: Cynthia
authors.initials: C
authors.lastname: Shortell
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D002321:Career Choice; D016009:Chi-Square Distribution; D002983:Clinical Competence; D003198:Computer Simulation; D003194:Computer-Assisted Instruction; D018592:Cross-Over Studies; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods*; D057510:Endovascular Procedures / Q000193:education*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016014:Linear Models; D008297:Male; D008955:Models, Cardiovascular; D009657:North Carolina; D011446:Prospective Studies; D013337:Students, Medical; D011795:Surveys and Questionnaires; D013663:Teaching / Q000379:methods*; D013997:Time Factors; D014656:Vascular Surgical Procedures / Q000193:education*; D055815:Young Adult