Arteriovenous anastomosis learning curve using low cost simulator

• Published in: Jornal vascular brasileiro Vol. 19; p. e20190144
• Main Authors: Antas, Jéssika da Silva, de Holanda, Ana Karolina Gama, Andrade, Achilles de Sousa, de Araujo, Alinne Mirlania Sabino, Costa, Isabella Guilherme de Carvalho, Dantas, Luciano Ribeiro, de Lima, Silvane Katerine Medeiros, Sarmento, Priscilla Lopes da Fonseca Abrantes
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) 11-11-2020
• Subjects: Original; arteriovenous anastomosis; simulation training; learning curve
• ISSN: 1677-5449; 1677-7301
• DOI: 10.1590/1677-5449.190144

In order to reduce difficulties with learning surgical techniques, supplementary tools for training were developed. This paper describes the learning curve followed by student volunteer research subjects who used an alternative model for practicing vascular anastomosis.
To evaluate the vascular anastomosis technique learning curve and development of manual skills using a low-cost experimental model.
Experimental and prospective study using end-to-side vascular anastomosis in latex balloons over five successive phases, initiated after theoretical and practical guidance given by experienced vascular surgeon. The study subjects were six undergraduate medical students from Universidade Federal da Paraíba (UFPB), João Pessoa, PB, Brazil, in their third to fifth years of the course. Cluster analysis was used to interpret the data collected on the quality of anastomoses and the time taken.
The time taken to perform anastomosis reduced for all students, with statistical differences from phase 1 compared to phases 4 and 5. There was also a trend to increasing scores on the quality index as the phases progressed. However, no statistical differences were detected using the Friedman test, which is appropriate for data measured with ordinal levels (quality was assessed on a scale of 1 to 5).
It was found that the training model used was effective for increasing learning of this technique. It is believed that future studies with larger samples or a higher number of phases could demonstrate both reduced time and improved quality of the anastomoses performed with statistical significance.