Formative Assessment for Wedge Resection of Simulated Nodules Using an Ex-Vivo Porcine Lung Model

This study describes the development and implementation of a high-fidelity, low-cost simulation model to enhance training for video-assisted thoracoscopic surgery (VATS) wedge resection. The Kern model was used to create a curriculum that addresses educational needs through hands-on simulation with an ex-vivo porcine lung model. Lung nodules were simulated using grapes or cherry tomatoes bonded to the porcine lung with cyanoacrylate glue. An Objective Structured Assessment of Technical Skills (OSATS) tool was tailored to evaluate cognitive, affective, and psychomotor domains, providing targeted feedback from two independent thoracic surgical consultants. The scores of junior thoracic surgery residents were compared against senior thoracic surgery residents. The simulation successfully identified key areas of deficiency in trainee performance. The model is simple to set up and costs less than US $7, making it accessible for global training. This approach not only reduces reliance on traditional in-theatre methods, but also ensures ongoing skills development through repeated simulations and mentorship.

References

1. Suzuki K, Watanabe S ichi, Wakabayashi M, Saji H, Aokage K, Moriya Y, et al. A single-arm study of sublobar resection for ground-glass opacity dominant peripheral lung cancer. Journal of Thoracic and Cardiovascular Surgery. 2022 Jan 1;163(1):289-301.e2.
2. Cardoso SA, Suyambu J, Iqbal J, Cortes Jaimes DC, Amin A, Sikto JT, et al. Exploring the Role of Simulation Training in Improving Surgical Skills Among Residents: A Narrative Review. Cureus. 2023 Sep 4;
3. Khamis NN, Satava RM, Alnassar SA, Kern DE. A stepwise model for simulation-based curriculum development for clinical skills, a modification of the six-step approach. Surg Endosc. 2016 Jan 1;30(1):279–87.
4. Messick S. VALIDITY OF PSYCHOLOGICAL ASSESSMENT: VALIDATION OF INFERENCES FROM PERSONS’ RESPONSES AND PERFORMANCES AS SCIENTIFIC INQUIRY INTO SCORE MEANING. ETS Research Report Series. 1994 Dec;1994(2).
5. Chauvin SW. Applying educational theory to Simulation-based training and assessment in Surgery. Vol. 95, Surgical Clinics of North America. W.B. Saunders; 2015. p. 695–715.
6. Grossi S, Cattoni M, Rotolo N, Imperatori A. Video-assisted thoracoscopic surgery simulation and training: a comprehensive literature review. BMC Med Educ. 2023 Dec 1;23(1).
7. Haidari TA, Bjerrum F, Hansen HJ, Konge L, Petersen RH. Simulation-based VATS resection of the five lung lobes: a technical skills test. Surg Endosc. 2022 Feb 1;36(2):1234–42.
8. Jimenez M, Gomez-Hernandez MT. Teaching video-assisted thoracic surgery lobectomy—using an ex vivo simulation model. J Vis Surg. 2017 Mar 19;3:34–34.

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