title: Simulation-based training for thoracoscopy.
abstract: BACKGROUND
  An increasing proportion of thoracic procedures are performed using video-assisted thoracic surgery. This minimally invasive technique places special demands on the surgeons. Using simulation-based training on artificial models or animals has been proposed to overcome the initial part of the learning curve. This study aimed to investigate the effect of simulation-based training and to compare self-guided and educator-guided training.
  
  
  METHODS
  The study included a surgeon group (n = 10) and 30 randomized novices in 3 groups. A control group (n = 10) and the group of surgeons (n = 10) were tested with no previous simulator training. A self-guided training group (n = 10) and an educator-guided training group (n = 10) trained for 3 hours on 3 scenarios of increasing fidelity and difficulty before taking a standardized test consisting of performing a wedge resection on a porcine lung, which was recorded and assessed blindly and independently by 2 thoracoscopic experts using a modified version of a validated assessment tool.
  
  
  RESULTS
  Interrater reliability was acceptable (Spearman ρ = 0.73, P < 0.001). The control group and the self-guided training group performed significantly worse than the experienced surgeons (P = 0.012 and P = 0.010, respectively). There was no significant difference between the educator-guided training group and the experienced surgeons (P = 0.271).
  
  
  CONCLUSIONS
  This randomized study concerning simulation-based training for thoracoscopy showed that 3 hours of intensive simulator training with a dedicated educator enables novices to perform an acceptable wedge resection in a simple, simulated model. Although not significant, it seemed that having an educator present during training had a beneficiary effect. Transfer studies are required for further conclusions.
authors.affiliation: From the Centre for Clinical Education (J.M.B., L.K., C.L.K., C.R.), Department of Cardiothoracic Surgery (P.L., H.J.H., R.H.P.), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark, and Department of Anesthesia, The Wilson Centre (C.R.),University of Toronto and The University Health Network, Toronto, Canada.
authors.forename: Johanna Margareta
authors.initials: JM
authors.lastname: Bjurström
authors.forename: Lars
authors.initials: L
authors.lastname: Konge
authors.forename: Per
authors.initials: P
authors.lastname: Lehnert
authors.forename: Charlotte Loumann
authors.initials: CL
authors.lastname: Krogh
authors.forename: Henrik Jessen
authors.initials: HJ
authors.lastname: Hansen
authors.forename: René Horsleben
authors.initials: RH
authors.lastname: Petersen
authors.forename: Charlotte
authors.initials: C
authors.lastname: Ringsted
mesh_terms: D000818:Animals; D002983:Clinical Competence / Q000592:standards*; D003198:Computer Simulation; D003718:Denmark; D004195:Disease Models, Animal; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement / Q000379:methods; D013502:General Surgery; D006801:Humans; D008168:Lung / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods / Q000592:standards; D013337:Students, Medical; D025321:Surgery, Computer-Assisted / Q000379:methods* / Q000592:standards; D013552:Swine / Q000601:surgery; D013906:Thoracoscopy / Q000193:education* / Q000379:methods / Q000592:standards; D000078329:Workforce