Evaluation of skill-acquisition process in mitral valve repair techniques: a simulation-based study

J Surg Educ. 2013 May-Jun;70(3):318-25. doi: 10.1016/j.jsurg.2013.01.009.


Introduction: Increased patient awareness, duty-hour restrictions, escalating costs, and time constraints in the operating room have revolutionized surgical education. A bovine heart model was designed for training in mitral valve repair procedures. In this article, we aimed to share our experience with this model and to test the validity of simulation with respect to skill acquisition during the training course.

Methods: After reviewing instructional video recordings of mitral valve repair techniques, 5 junior residents (first and second year) and 5 senior residents (year 4 or higher), who had no experience in mitral valve repair surgery previously, performed mitral valve repair techniques on bovine heart model in a three-month period. Nine different internet videos demonstrating surgical techniques were watched prior to performance in each case. Different text books were studied before the study course. Following repair in each case, the left ventricle of each bovine heart was statically pressurized, the coaptation depth was measured, and the regurgitation (if any) was scored. Each performance was recorded. At the end of the study, video records were evaluated in a blind fashion by 3 different surgeons experienced in mitral valve repair techniques. The monthly scores obtained were statistically analyzed.

Results: The mean coaptation depth values measured on a monthly basis were as follows: 2.75±0.63, 4.90±0.91, and 6.55±0.88 for the junior residents and 4.30±0.65, 5.45±0.68, and 7.00±0.64mm for the senior residents. Regurgitation scores noted were 2.20±0.52, 1.65±0.58, and 0.10±0.30 for the junior residents and 1.50±0.60, 0.65±0.67, and 0.70±0.65 for the senior residents During the study period, the practice improved in terms of the aforementioned parameters in both groups (p<0.05).

Conclusions: This simulation model of mitral valve repair helped in skill acquisition on monthly basis in both resident groups.

MeSH terms

  • Animals
  • Cardiovascular Surgical Procedures / education*
  • Cattle
  • Clinical Competence*
  • Education, Medical, Graduate / methods*
  • Educational Measurement
  • Humans
  • Internship and Residency
  • Mitral Valve / surgery*
  • Task Performance and Analysis
  • Video Recording