Pilot Study Evaluating Implementation of an Education Module and/ or Clinical Simulation on Cardioplegia to Perfusion Students, Medical Students, Prospective Medical Students, and Allied Health Professionals

Abstract

Cardiac Surgery, utilizing Cardiopulmonary Bypass (CPB) managed under perfusionists, is a high-risk surgical specialty vulnerable to the development of medical errors. As medical errors are attributable to one third of adverse events, specifically those stemming from lack of non-technical skills. it is important for perfusion students to be adequately prepared prior to graduation. This pilot study, responding to the recommendations of student and preceptors at the University of Arizona, is meant to redesign and utilize more modern technology to update lecture material for perfusion students and interested prospective and current medical students, residents, and other medical professionals on the topic of Cardioplegia (CPG). The pilot study was made of up three sections. The first was the revamping of CPG Lecture material utilizing modern technology for Perfusion students. The second was the creation and implementation of two rounds of simulations and a training session over CPG delivery and catastrophe management for perfusion students. The two rounds of 14 simulation scenarios and a training session created utilizing the Califia BIOMED Simulations Inc. The third portion was the creation of a didactic module introducing CPB and CPG for medical students and those currently involved in the medical field. Perfusion students’ (N=6) knowledge and understanding was shown to increase by an average of 36.67% (p=0.0625) for the total group increasing their average scores from 48% to 85%. Students also reported positive engagement and increased comfort following the module. Post simulation, the total student group (N=6) decreased their average time for correction by 53%. The overall quality of reaction increased by an average of 20% (p=0.000). First year students’ (N=4) overall score increased by 31% (p=0.000) closing the observed difference in quality by 66% from round 1 to round 2. Second year students (N=2) overall increased scores by an average of 7% (p=0.023) but had higher initial and final scores overall. The total student group reported a 14% increase in reported confidence in general and a 15% increase in their confidence handling cardioplegia related disasters independently. The lecture for the medical community observed a poor retention rate to completion to completion of 29%, but still saw an average increase in understanding of 26% (p=0.0002)(N=14). The didactic lecture increased students’ understanding of the mechanisms, results, and delivery parameters around cardioplegia, better preparing them for their chosen field of study and increasing their overall comfort and confidence in the clinical setting. Simulation training not only demonstrated distinct improvements in technical and non-technical skills, as demonstrated with the time and quality assessments, but also allowed students to be more confident in their practice which, as they reported, increased their own ability as a perfusionist. These enhancements are extremely valuable resulting from an education tool indicated for both classes of students. The trending results also indicated that simulations are able to bring less experienced students up to a higher caliber of quality in less time than clinical training can alone. The medical field lecture increased understanding and context for cardiopulmonary and cardioplegia from a perfusion standpoint. Limited participation indicates the need for reevaluation of the format, recruitment, and retention methods used in this study. Keywords: Cardiopulmonary Bypass, Perfusion Students, Medical Field, Education, Advancements, Lecture Material, Simulations