Initial Experience with the “Early Surgical Exposure and Assessment” (EASE) Program: Early Training Leads to Rapid Improvement of Technical Skills and High Motivation in Residents and Students to Follow an Academic Surgical Career

Objectives: Multiple factors have reduced the number of medical students that seek a surgical career. We have established the EASE program to achieve early surgical exposure on a high skill level. The complete set of mandatory cardiac residency procedures is simulated within assessed and competitive multilevel modules within the first 3 years of residency (1 year CABG, 1 year aortic root and mitral valve surgery, 1 year tutor for students, and first/second year residents). We assessed feedback from participants, time, and financial demands and results from establishment of the “aortic root surgery with EASE” module.

Methods: A multilevel CABG simulation module had been established in the past showing rapid skill improvements. Participants demanded further skill programs. The experience led to the definition of the “EASE” program features: (1) early skill training; (2) component task training, multilevel simulation; (3) deliberate practice; self-organized training; (4) video assessment; (5) competition; (6) performance based certification; (7) after certification participants are allowed to perform assisted cardiac procedures; and (8) participants serve as program tutors. Simulation levels increase complexity: (1) instrument handling; (2) needle control; (3) assisted suturing; (4) high fidelity 3D model; and (5) with surgical loupes.

Results: For each module (CABG, aortic root, mitral valve), six cardiac surgeons, six first/second year residents, and six students competed in multiple levels. After an entry workshop and video assessment participants trained for 1 to 3 weeks for each block, followed by exit video assessment. Training resulted in rapid skill increase. Some young participants outperformed surgeons. Full data on the CABG program will be presented. Evaluation of the aortic root program is in progress and first data will be presented. Participants answered a questionnaire on program quality, career targets, and future improvements (e.g., research modules). The results show an unambiguously positive feedback and the need for structured, dedicated, and personalized training. The program can be achieved with little resources. Dedicated training time should be scheduled during working hours and free time.

Conclusion: Residents and students are keen to enter the EASE training program. Students are easier drawn toward a surgical career. Academic features (research, training) are easily incorporated. The establishment of additional modules is ongoing.