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J Thorac Cardiovasc Surg 2009;138:1065-1066
© 2009 The American Association for Thoracic Surgery

Editorial

Simulation in cardiothoracic surgery: A paradigm shift in education?

Department of Anaesthesia, Harvard Medical School; Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, Mass; Center for Medical Simulation, Cambridge, Mass; and Society for Simulation in Healthcare, Cambridge, Mass

Received for publication July 23, 2009; accepted for publication July 23, 2009.

^_* Address for reprints: Daniel B. Raemer, PhD, Research and Development Director, Center for Medical Simulation, 65 Landsdowne St, Cambridge, MA 02139. (Email: draemer@partners.org).

The first 20% of the full text of this article appears below.

In April 2007, a Visioning Simulation in Cardiothoracic Surgery Conference was held at our facility in Cambridge, Massachusetts, under the auspices of the Thoracic Surgery Foundation for Research and Education, to explore ideas about the applicability of simulation in the field.¹ A "boot-camp" for demonstrating simulation applied to cardiothoracic surgery trainees was reported in the Journal accompanied by an editorial calling for the reform of education that would include simulation techniques.^2,3 In March 2008, the report of the Thoracic Surgery Foundation for Research and Education Visioning Conference was published in the Journal, outlining a framework to consider incorporating simulation into a new educational paradigm. That article was accompanied by an "Expert Commentary" by Richard H. Feins, MD, supporting the concept of integrating simulation in cardiothoracic surgery education and articulating 4 challenges to its success.⁴ These hurdles are to (1) change the model of education from an exclusive apprenticeship to a hybrid that would accommodate learning episodes outside the clinic, (2) retrain educators to effectively use simulation, (3) provide adequate simulator technology for the job, and (4) conduct research to determine whether this technique is truly as effective as it intuitively seems. So, what does simulation offer and where are we with respect to these challenges a little more than a year later? There have been pilot programs, demonstration projects, some new product prototypes, and a modicum of research. I would suggest that although progress seems slow, the current momentum could be . . . [Full Text of this Article]