A model of cardiopulmonary bypass staged training integrating technical and non-technical skills dedicated to cardiac trainees.
OBJECTIVE
To develop a standardized simulation-based curriculum to teach medical knowledge and technical, communication and critical thinking skills necessary to initiate and wean from cardiopulmonary bypass (CPB) to junior cardiac trainees (CTs) in France. Performance on post-curricular tests was compared between CTs who participated in the new curriculum to those who did not.


METHODS
The simulation-based curriculum was developed by content and education experts. Simulations sequentially taught the skills necessary for initiating and weaning from CPB as well as managing crises by adding fidelity and complexity to scenarios. Nine CTs were randomly assigned to the new curriculum (n=5) or the traditional curriculum (n=4). Skills were assessed using tests of medical knowledge and technical, communication (GRS) and critical thinking (SCT) skills. A two-sample Wilcoxon rank-sum test compared average scores between the two groups. Alpha of 0.05 was set to indicate statistically significant differences.


RESULTS
The resutls revealed that CTs in the new curriculum significantly outperformed CTs in the traditional curriculum on technical (18.2 vs 14.8, p=0.05) and communication (3.5 vs 2.2, p=0.013) skills. There was no significant difference between CTs in the new curriculum in the Script Concordance Test (16.5 vs 14.8, p=0.141) and knowledge tests (26.9 vs 24.6, p=0.14) compared to CTs in the traditional curriculum.


CONCLUSIONS
Our new curriculum teaches communication and technical skills necessary for CPB. The results of this pilot study are encouraging and relevant. They give grounds for future research with a larger panel of trainees. Based on the current distribution of scores, a sample size of 12 CTs per group should yield significant results for all tests.
Aix-Marseille Université, LBA-UMRT24, 13916, Marseille, France Hôpital d'Enfants de la Timone, Service de Chirurgie Thoracique et Cardio-vasculaire, 13385, Marseille, France Department of Cardiovascular Surgery, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada virginie.fouilloux@ap-hm.fr.
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Fouilloux
Department of Cardiac Surgery, Hôpital Charles Nicolle, Rouen, France.
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Doguet
Department of Critical Care Medicine and Division of Cardiology, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada.
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Kotsakis
The Learning Institute Department of Paediatrics, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada.
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Dubrowski
Aix-Marseille Université, LBA-UMRT24, 13916, Marseille, France.
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Berdah
D000818:Animals; D002315:Cardiopulmonary Bypass / Q000193:education*; D004502:Education, Medical, Continuing / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D018794:Problem-Based Learning / Q000379:methods*; D012756:Sheep
animal models; cardiopulmonary bypass; education; learning aids; technical and non-technical skills