Good University Teaching Inspires Medical Students for Cardiothoracic and Vascular Surgery

Objectives: Only few medical students choose to specialize in cardiothoracic or vascular surgery (CTVS). Therefore, students might attribute little relevance to CTVS courses or lectures during medical education. We sought to implement a curricular CTVS teaching program that transfers universally applicable skills to the students, conveys the diversity of opportunities within CTVS, and consequently increases the interest for CTVS among medical students.

Methods: The course block in CTVS that is compulsory for fifth year students was restructured with the aims to provide teaching in small groups (n = 3) and to teach practical skills frequently used in CTVS (central venous line placement, arterial blood gas analysis, arterial and venous functional testing, chest tube placement, suturing of a vascular anastomosis). Furthermore, focused patient examination and case presentation to the group in a structured setting, a visit to the intensive care unit and attendance at a cardiac surgical procedure with live broadcasting via a head-mounted camera were included. A total of 396 students evaluated the course block over 3 semesters using a standardized questionnaire. The results are given as school grades (1 = very good to 6 = insufficient).

Results: The course block was designed to extend over three days with three lecturers per week exclusively assigned to the teaching activity. Ten students per week participated and were separated into three small groups. The overall rating of the block course was 1.40 (rank 2 of all block courses, semester 1), 1.40 (rank 2, semester 2). Before semester 3, the time frames were extended according to students' comments and chest tube placement was included in the skills lab. Thereafter, the block course reached an overall rating of 1.37 (rank 1 among all block courses in our university). In sub-analyses, students gave high ratings for organization (1.2), lecturers’ support (1.1), time management (1.1), and structure of the course (1.0). Students also claimed that the block course had improved their theoretical knowledge (2.1), practical skills (1.5), and competence to act (1.8).

Conclusion: Despite representing an exotic specialty for most students, CTVS teaching programs can become relevant and appreciated parts of medical education. Key factors to success are rigorous organization, interactive small group teaching, and teaching of practical and communicational skills. The program should transfer the wide-ranging field of activities in CTVS.