TY - JOUR
T1 - A fresh cadaver laboratory to conceptualize troublesome anatomic relationships in vascular surgery
AU - Mitchell, Erica L.
AU - Sevdalis, Nick
AU - Arora, Sonal
AU - Azarbal, Amir F.
AU - Liem, Timothy K.
AU - Landry, Gregory J.
AU - Moneta, Gregory L.
PY - 2012/4
Y1 - 2012/4
N2 - Objective: Opportunities are declining for residents to participate in complex open vascular surgical operations. Open simulation using fresh cadavers potentially can be used to familiarize residents with complex vascular exposures. We evaluated the use of fresh cadavers to assist resident comprehension of complex anatomic relationships in vascular surgery. Methods: Twenty-two postgraduate year (PGY) 3 (n = 12) and PGY 4 (n = 10) general surgery residents attended five structured 4-hour cadaver skills laboratories. Residents performed five conceptually difficult and infrequently encountered operative vascular exposures: the supraclavicular subclavian and vertebral arteries, supraceliac aorta, superior mesenteric artery, proximal and distal renal arteries, and common iliac artery bifurcations. Residents were tested (oral board examination style with percentage correct of a predetermined checklist) in their knowledge and understanding of the anatomic relationships before and after the cadaver laboratories. Participants' self-reported confidence in performing these complex vascular exposures was also measured before and after the course using the operative confidence score (1 = not confident; 5 = highly confident) for each exposure. Results: Participation in the course resulted in increases in participant comprehension and self-reported operative confidence in the supraclavicular subclavian and vertebral arteries, supraceliac aorta, superior mesenteric artery, renal arteries, and iliac bifurcation exposures. Before vs after the course, the mean oral examination scores were 5% vs 87%, 26% vs 94%, 19% vs 86%, 30% vs 88%, and 29% vs 87%, respectively (all P <.001), and mean operative confidence scores were 1.1 vs 2.9, 1.3 vs 3.5, 1.2 vs 3.2, 1.2 vs 3, and 1.5 vs 3.9, respectively (all P < 0.001). Conclusions: Fresh cadaver laboratories can provide a learner-centered and safe environment for acquiring procedural understanding and operative confidence of complex vascular exposures. This may allow for the transformational change essential to becoming a competent vascular surgeon.
AB - Objective: Opportunities are declining for residents to participate in complex open vascular surgical operations. Open simulation using fresh cadavers potentially can be used to familiarize residents with complex vascular exposures. We evaluated the use of fresh cadavers to assist resident comprehension of complex anatomic relationships in vascular surgery. Methods: Twenty-two postgraduate year (PGY) 3 (n = 12) and PGY 4 (n = 10) general surgery residents attended five structured 4-hour cadaver skills laboratories. Residents performed five conceptually difficult and infrequently encountered operative vascular exposures: the supraclavicular subclavian and vertebral arteries, supraceliac aorta, superior mesenteric artery, proximal and distal renal arteries, and common iliac artery bifurcations. Residents were tested (oral board examination style with percentage correct of a predetermined checklist) in their knowledge and understanding of the anatomic relationships before and after the cadaver laboratories. Participants' self-reported confidence in performing these complex vascular exposures was also measured before and after the course using the operative confidence score (1 = not confident; 5 = highly confident) for each exposure. Results: Participation in the course resulted in increases in participant comprehension and self-reported operative confidence in the supraclavicular subclavian and vertebral arteries, supraceliac aorta, superior mesenteric artery, renal arteries, and iliac bifurcation exposures. Before vs after the course, the mean oral examination scores were 5% vs 87%, 26% vs 94%, 19% vs 86%, 30% vs 88%, and 29% vs 87%, respectively (all P <.001), and mean operative confidence scores were 1.1 vs 2.9, 1.3 vs 3.5, 1.2 vs 3.2, 1.2 vs 3, and 1.5 vs 3.9, respectively (all P < 0.001). Conclusions: Fresh cadaver laboratories can provide a learner-centered and safe environment for acquiring procedural understanding and operative confidence of complex vascular exposures. This may allow for the transformational change essential to becoming a competent vascular surgeon.
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U2 - 10.1016/j.jvs.2011.09.098
DO - 10.1016/j.jvs.2011.09.098
M3 - Article
C2 - 22209607
AN - SCOPUS:84859155451
SN - 0741-5214
VL - 55
SP - 1187
EP - 1194
JO - Journal of Vascular Surgery
JF - Journal of Vascular Surgery
IS - 4
ER -