Thoracoscopic lobectomy simulation produces sustained improvement in knowledge of pulmonary anatomy

There is growing interest in simulation in cardiothoracic surgery, but published simulation models lack evidence of educational effect. We hypothesized that a video-assisted thoracoscopic surgery (VATS) lobectomy simulation would improve general surgery resident knowledge of pulmonary anatomy.

A porcine tissue block was adapted from published models for simulated VATS lobectomy. A written knowledge test was developed internally based on general surgery objectives. All post-graduate year 2–4 general surgery residents (n = 31) at a single academic institution completed the test before and after participating in a VATS lobectomy skills lab, then repeated the written test 3 months later to assess knowledge retention. Likert-scale items were compared with Wilcoxon signed-rank test and test scores were compared with the paired t-test.

After completion of the lab, residents had improved confidence in their ability to place VATS ports (5-point Likert, median: 2 vs 3), perform a VATS lobectomy (median: 1 vs 3), and in their knowledge of pulmonary hilar anatomy (median: 2 vs 3), all p < 0.001. Written test scores improved from a pre-test average of 11.3 out of 22 points (± 3.1) to post-test average of 15.0 (± 3.1, p < 0.001). This improvement was sustained on repeat assessment 3 months later, with delayed re-test average of 16.3 (± 3.5, p < 0.001 vs pre-test).

VATS lobectomy simulation produced a durable improvement in general surgery resident knowledge of pulmonary anatomy. This study provides evidence of the educational impact of this popular simulation model and contributes validity evidence to simulation-based education in cardiothoracic surgery.