Richard H. Feins, MD

The Agency for Healthcare Research and Quality (AHRQ) has awarded a three-year, $1.05 million grant to the University of North Carolina at Chapel Hill to study use of simulators for cardiac surgery training. The multi-institution project will study whether resident physicians who are learning cardiothoracic surgery can become safer surgeons by using surgery simulators to acquire skills before they operate on people.

Richard H. Feins, M.D., a thoracic surgeon in the Division of Cardiothoracic Surgery at UNC, is principal investigator of the project, which will involve cardiothoracic surgery residents at UNC and physicians and residents at seven other institutions:

Massachusetts General Hospital (Jennifer Walker, M.D.); Mayo Clinic (Harold Burkhart, M.D.), Johns Hopkins University (John Conte, M.D.), University of Rochester (George Hicks, M.D.), Stanford University (James Fann, M.D.), Vanderbilt University (Jonathan Nesbitt, M.D.), University of Washington (Nahush Mokadam, M.D.).

In most surgical training, technical skills are taught by apprenticeship: residents learn surgery in the operating room, doing parts or all of real operations on real patients. Dr. Feins’ study intends to show that training in cardiac surgical techniques can be improved by using surgery simulation technology combined with a rigorous, simulation-based curriculum.

The project will determine the effectiveness of using simulator-based training of resident surgeons in component tasks and overall procedures based on six modules: three types of cardiac surgical operations and three significant adverse events that can occur during cardiac surgery. The procedures will be taught using a computer-controlled, tissue-based cardiac surgery simulator which has been shown to realistically duplicate the actual patient undergoing cardiac surgery. The simulators are mannequins with computer-controlled pig hearts placed inside the chest area.

Assessment data from each site will be entered into a study database which will be developed and managed at the University of North Carolina. While the study will test the hypothesis that cardiac surgery residents can be trained to be safer surgeons by using appropriate simulator-based training, the results should apply equally well across a broad spectrum of surgical practice.

AHRQ is part of the U.S. Department of Health and Human Services. The grant period is May 1, 2011, to April 30, 2014.

A 2011 article in Endeavors, UNC’s research magazine, describes the simulation training. Read the article here.