COMPLEX ISSUES IN CORONARY REVASCULARIZATION: Edited by Bobby Yanagawa and Subodh VermaSee one, simulate many, do one, teach one cardiac surgical simulationYanagawa, Bobbya; Ribeiro, Robertoa; Naqib, Faisala; Fann, Jamesb; Verma, Subodha; Puskas, John D.cAuthor Information aDivision of Cardiac Surgery, St. Michael's Hospital, Toronto, Ontario, Canada bDepartment of Cardiothoracic Surgery, Stanford University, Stanford, California cDivision of Cardiothoracic Surgery, Mount Sinai St. Luke's, New York, New York, USA Correspondence to Bobby Yanagawa, MD, PhD, FRCSC, Program Director, Division of Cardiac Surgery, University of Toronto, Toronto, Ontario, Canada; Assistant Professor, Division of Cardiac Surgery, St. Michael's Hospital, 30 Bond Street, 8th Floor, Bond Wing, Toronto, ON, Canada M5B 1W8. Tel: +1 416 864 5706; fax: +1 416 864 5031; e-mail: [email protected] Current Opinion in Cardiology: September 2019 - Volume 34 - Issue 5 - p 571-577 doi: 10.1097/HCO.0000000000000659 Buy Metrics Abstract Purpose of review To review the cardiac surgical simulation experience with a focus on data supporting its use. Recent findings Simulators have been used to improve trainee performance across multiple surgical domains. Few cardiac surgery residency programs have incorporated the use of simulation individually and Boot Camp programs in the United States and Canada have also introduced surgical simulation early in cardiac surgical training. Simulation curricula have some common elements: component tasks, deliberate practice, progressive operative responsibility, and coaching by an experienced surgeon. Cardiac surgical simulators can range from inexpensive, low-fidelity models for the practice of isolated skills to high-fidelity, operating room-scenarios. Multiple small studies have consistently demonstrated that the use of simulation improves qualitative and quantitative performance measures as well as overall resident confidence in clinical settings. To our knowledge, no study has demonstrated that use of simulation has led to improved quantitative performance measures in the operating room or patient outcomes. The barriers to wider use of surgical simulators include perceived lack of time and resources, the need for sustained practice and the lack of high-quality data to demonstrate clinical benefit. Summary Incorporation of cardiac surgery simulation has been slow in most residency programs. There is consistent data demonstrating that simulation improves resident performance measures of simulation-based tasks but whether this will lead to improved patient outcomes remains an open question. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.