60.11 Bridging the Learning Gap: Surgery Trainees Hone Vascular Trauma Skills via High-Fidelity Simulation

Posted on May 12, 2025

N. Chernetskii1,2, E. Chao2, C.S. Decker1,2, M.J. Klein1,2  1NYU Grossman School of Medicine, Surgery, New York, NY, USA 2NYC Health+Hospitals, Surgery, New York, NY, USA

Introduction:

Advancing developments of endovascular approaches and subspecialty vascular care have significantly diminished general surgery residents’ exposure to essential vascular techniques in trauma. This has led to a notable deficiency in preparedness among residency graduates in handling basic vascular emergencies. The Open Surgical Simulation System (OS3) is a high-fidelity trauma surgery model that allows for skill acquisition through hands-on practice. 

Methods:
We evaluated the effect of a new OS3 surgical skills curriculum on residents' self-assessed knowledge, technical skills, and confidence using pre- and post-course surveys with 5-point Likert scales. Procedures performed included resuscitative thoracotomy (RT), laparotomy (EXP), splenectomy (SPL), hepatorrhaphy (LIV), nephrectomy (NEPH), arterial shunting (SHUNT), and small bowel resection (SBR). Determinants of skill self-assessments, perceived challenges, and course utility for skill acquisition were analyzed using linear regression modeling.  

Results:
35 housestaff completed the simulation and surveys. Each increasing PGY level above 2 was associated with increases in self-assessment of knowledge, skills, and experience (p < 0.05); prior ATOM/ASSET course participation was not. Of 66 trainees surveyed, 48% described vascular techniques (21 SHUNT, 11 aortic cross-clamping) as the most difficult to perform due to inexperience. Overall, the OS3 simulation significantly increased trainees’ confidence in performing RT, EXP, SPL, LIV, RPE, and SBR (p < 0.02).  

Conclusion:
When self-assessing technical skills in trauma, almost half of surveyed general surgery trainees describe significant difficulty with essential vascular procedures such as shunting and aortic cross-clamping. The OS3 may allow for consistent and readily reproducible training in these and other procedures to alleviate this confidence gap.