A Cardiac Surgery Mini-Elective Increases Specialty Knowledge Acquisition Among Pre-Clinical Medical Students
Keywords:Cardiothoracic surgery education, Simulation, medical student education
Background: The introduction of integrated thoracic surgery residency programs has led to increased recruitment efforts of medical students to pursue a career in cardiac surgery. With little representation of cardiac surgery in medical school curriculum, we assessed a cardiac surgery mini-elective's efficacy in improving perceived knowledge among medical students.
Methods: Preclinical medical students were offered the opportunity to participate in a cardiac surgery mini-elective, which consisted of five 2-hour sessions. These sessions consisted of didactic and simulation components and covered topics including cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO), aortic disease, aortic valve replacement (AVR), transplant and left ventricular assist devices (LVAD), and coronary artery bypass grafting (CABG). Students completed pre- and post-session surveys describing their perceived knowledge in these topics.
Results: Overall, 22 students completed at least one session of the mini-elective. Fourteen (73.7%) of the students were male. Fifteen (68.2%) students completed at least three out of five sessions. The post-session survey responses showed significantly higher perceived knowledge compared with pre-session responses for all survey prompts of all five sessions. The CPB/ECMO and aortic disease sessions showed the greatest increase in post-session familiarity and perceived knowledge after the session (P < 0.001) compared with the CABG, AVR, and transplant/LVAD sessions (P < 0.05).
Conclusions: Beyond developing interest in cardiac surgery, these data indicate that a well-planned didactic and surgical simulation program may build confidence in students' knowledge of various cardiac surgical topics. Further studies will need to address how this increase in perceived ability lasts over time and impacts career selection.
Anderson TN, Shi R, Schmiederer IS, Miller SE, Lee EW, Hasty BN, Lin DT, Lau JN. 2020. Preclinical Surgical Preparatory Course and the NRMP Match: Early Exposure and Surgical Recruitment a 10-Year Follow-Up. J Surg Educ. 77:e103-e109.
Bennett SR, Morris SR, Mirza S. 2018. Medical Students Teaching Medical Students Surgical Skills: The Benefits of Peer-Assisted Learning. J Surg Educ. 75:1471-1474.
Bridgeman A, Findlay R, Devnani A, Lim D, Loganathan K, McElnay P, West D, Coonar A. 2016. Inspiring the next generation of Cardiothoracic Surgeons: an easily reproducible, sustainable event increases UK undergraduate interest in the specialty. Interact Cardiovasc Thorac Surg. 22:106-108.
Campwala I, Aranda-Michel E, Watson GA, Hamad GG, Losee JE, Kilic A, Sultan I. 2020. Impact of a Surgical Subspecialty Roundtable on Career Perception for Preclerkship Medical Students. J Surg Res. S0022-4804:30678-8.
Coyan GN, D'Angelo MP, Kilic A, Gleason TG, Luketich JD, Aranda-Michel E, Okusanya O, Schuchert MJ, Kinnunen A, Sultan I. 2019. Evaluation of a simulation-based mini-elective on medical student interest in cardiac surgery. J Card Surg. 34:901-907.
Coyan GN, Kilic A, Gleason TG, Schuchert MJ, Luketich JD, Okusanya O, Kinnunen A, Sultan I. 2020. Medical student perceptions of a career in cardiothoracic surgery: Results of an institutional survey. J Thorac Cardiovasc Surg. 159:1906-1912.
Davis TA, Yesantharao PS, Yang SC. 2019. Where Do We Begin? Building Blocks to Establish a Cardiothoracic Surgery Interest Group. Ann Thorac Surg. 107:1854-1859.
Electronic Residency Application Service. ERAS 2021 Participating Specialties & Programs. https://services.aamc.org/eras/erasstats/par/display.cfm?NAV_ROW=PAR&SPEC_CD=46. Accessed December 2, 2020.
Haggerty KA, Beaty CA, George TJ, Arnaoutakis GJ, Baumgartner WA. 2014. Increased exposure improves recruitment: early results of a program designed to attract medical students into surgical careers. Ann Thorac Surg. 97:2111–2114.
Kilcoyne MF, Do-Nguyen CC, Han JJ, Coyan GN, Sultan I, Roberts MB, Carpenter AJ. 2020. Clinical Exposure to Cardiothoracic Surgery for Medical Students and General Surgery Residents. J Surg Educ. 77:1646-1653.
Lou X, Enter D, Sheen L, Adams K, Reed CE, McCarthy PM, Calhoon JH, Verrier ED, Lee R. 2013. Sustained supervised practice on a coronary anastomosis simulator increases medical student interest in surgery, unsupervised practice does not. Ann Thorac Surg. 95:2057-2063.
Macfie R, Walcott-Sapp S, Watson J, Haley C, Dewey E, Schipper P. 2018. Association Between Simulation Curriculum and Learners' Confidence and Interest in Cardiothoracic Surgery. JAMA Surg. 153:968-969.
Markovic J, Peyser C, Cavoores T, Fletcher E, Peterson D, Shortell C. 2012. Impact of endovascular simulator training on vascular surgery as a career choice in medical students. J Vasc Surg. 55:1515-21.
Moulton CA, Dubrowski A, Macrae H, Graham B, Grober E, Reznick R. 2006. Teaching surgical skills: what kind of practice makes perfect? a randomized, controlled trial. Ann Surg. 244:400-9.
National Resident Matching Program, 2000-2020. Results and Data: 2000-2020 Main Residency Match. National Resident Matching Program, Washington, DC.
Preece R, Ben-David E, Rasul S, Yatham S. 2018. Are we losing future talent? A national survey of UK medical student interest and perceptions of cardiothoracic surgery. Interact Cardiovasc Thorac Surg. 27:525-529.
Sood V, Reddy RM. 2012. An analysis of preclinical students' perceptions of cardiothoracic surgical procedures. Ann Thorac Surg. 94:800-806.
Smood B, Nguyen SN, Kelly JJ, Han JJ. 2020. Integrated cardiothoracic surgery: Developing a successful residency application. J Thorac Cardiovasc Surg. 160:167-174.
Tesche LJ, Feins RH, Dedmon MM, Newton KN, Egan TM, Haithcock BE, Veeramachaneni NK, Bowdish ME. 2010. Simulation experience enhances medical students' interest in cardiothoracic surgery. Ann Thorac Surg. 90:1967–1974.
Trehan K, Zhou X, Yang SC. 2015. Is medical student interest in cardiothoracic surgery maintained after receiving scholarship awards? Ann Thorac Surg. 100:926–931.
Yanagawa B, Ribeiro R, Naqib F, Fann J, Verma S, Puskas JD. 2019. See one, simulate many, do one, teach one: cardiac surgical simulation. Curr Opin Cardiol. 34:571-577.
Zhu Y, Goldstone AB, Woo YJ. 2019. Integrated thoracic surgery residency: current status and future evolution. Semin Thorac Cardiovasc Surg. 31:345–349.