Virtual Reality SIMulator and digital PORTfolio in CardioThoracic Surgery

Cardiothoracic surgerical training has remained broadly similar since its inception in the 1960s, following the Halsteadean model of observership and residency. Given the increasing complexity of the surgical techniques, increasing patient numbers as well as multimorbidity of the patient population, European working time directive, and increasing scrutinty of surgical outcomes, the training systems for the cardiothoracic multidisciplinary team are no longer able to meet their requirements. We applied for this project to develop innovative digital training tools including 2 Virtual Reality simulators and a Smart Portfolio System (SPS) to ameliorate these issues within training. Specifically we targeted areas that had a particularly urgent need for improvement including: 1) Resuscitation after cardiac surgery, which is a complex and high stress emergency situation, requiring the whole team to be highly trained in order to save a patient for which current training is infrequent and of varying quality 2) Education of perfusionists and the multidisciplinary team in best practices and emergency situations 3) Quantifying and objectifying the education of surgical residents, ensuring support & equality for trainees and safety for patients

The project objectives were: 1. To create two dedicated VR-based CPR and ECC simulation modules (WP 2–3) 2. To run pilot training sessions to improve and validate the VR-modules. (WP2-4) 3. To develop a protocol, guidelines, and instructions for trainers and trainees on how to use the VR-simport and assess these simulation and skills training using SPS (WP 4) 4. To disseminate the results of the validation steps to ensure uptake and implementation of the program internationally

The results of this project included the development, testing, validation, and dissemination of the VR CPR resuscitation simulator, the VR ECC perfusion simulator, and SPS for the CTS MDT. Development and testing were done iteratively and included stakeholders from all partner centres, generating feedback on which improvements could be made, ensuring the needs from all centres were met. Validation studies were performed for the project results (see 'Other Documents section) which demonstrated that the project results performed better than conventional training, and were highly rated by trainees (97% agreed or strongly agreed that WP3 was a useful training tool for perfusionists). Other results included the implementation of WP4 SPS in centres across Europe in cooperation with the European Association of Cardiothoracic Surgery (EACTS), with a total 13366 procedures registered, and interactive guidelines produced for trainers and trainees. For WP2 and WP3, over 1100 teachers & trainees have been trained in VR since the beginning of the project, implemented in 10 countries, with participants from over 30 countries. Additionally, we published 7 papers in international journals including Nature Cardiology.