ABSTRACT
INTRODUCTION: Simulators supporting the development of technical skills for complex procedures are gaining prominence. Safe performance of complex procedures requires effective team interactions. Our research group creates 'whole' procedure simulations to produce the psychological fidelity of clinical settings. Recruitment of real interventional team (IT) members has proved challenging. Actors as a simulated team are expensive. We hypothesised that medical students and trainees in a vascular unit could authentically portray members of the endovascular suite for carotid stenting. METHODS: This paper describes the evaluation of a training programme for a simulated IT. Participants rated the extent to which programmes objectives were met and realism of simulations. Researchers' field notes provided insight into strengths and weaknesses of the programme. RESULTS: Seven members from the vascular unit undertook training. Learning objectives were largely met. Nineteen simulations with 13 interventionalists were performed. Realism levels were at least moderate. Simulated IT members reported increased understanding of teamwork and roles in the endovascular suite. DISCUSSION: A simulated IT proved feasible. Authentic psychological fidelity complemented the physical fidelity of the simulated suite. Although there were areas for development in training, this approach might contribute considerably to interventionalist training and increase knowledge and skills of vascular trainees and medical students.
Subject(s)
Anesthesiology/education , Attitude of Health Personnel , Blood Vessel Prosthesis Implantation/education , Education, Medical/organization & administration , Interprofessional Relations , Patient Simulation , Adult , Clinical Competence , Competency-Based Education/methods , Female , Humans , Male , Models, Cardiovascular , Program Evaluation , Stents , Young AdultABSTRACT
We report the case of a 47-year-old man who presented with several episodes of left precordial pain, one of which had been severe, but was unrelated to exertion or posture. Transthoracic echocardiography and cardiovascular magnetic resonance showed evidence of congenital partial absence of the left pericardium and severe tricuspid regurgitation. Both diagnoses were confirmed at surgery when the pericardial defect was repaired and the tricuspid valve was replaced at the same operation. He went on to make a good recovery.
Subject(s)
Heart Defects, Congenital/surgery , Heart Valve Prosthesis Implantation/methods , Pericardium/abnormalities , Tricuspid Valve Insufficiency/surgery , Chest Pain/diagnosis , Chest Pain/etiology , Combined Modality Therapy , Echocardiography, Transesophageal , Follow-Up Studies , Heart Defects, Congenital/diagnosis , Humans , Male , Middle Aged , Pericardium/surgery , Risk Assessment , Treatment Outcome , Tricuspid Valve Insufficiency/diagnostic imagingABSTRACT
We report the case of a 12-year-old boy with a hypoplastic retroesophageal circumflex right-sided cervical aortic arch and coarctation. After the incidental finding of a heart murmur when the boy was 9 years old, cardiac magnetic resonance showed a right-sided cervical aortic arch, hypoplastic transverse arch, and separate origin of the left common carotid, right common carotid, right vertebral, and right subclavian arteries. The left subclavian artery arose from the proximal descending aorta next to the coarctation. An extra-anatomical ascending to descending aorta tube graft was inserted through a right lateral thoracotomy with good results.
