Impact of simulation on the technical skills of vascular surgeons

Objectives To evaluate a workshop on endovascular aneurysm repair (EVAR) with respect to participant attendance and improvements in technical skills and procedural confidence among attending vascular surgeons and residents. Methods This prospective, single-center study was conducted at University of São Paulo School of Medicine. Twenty-one physicians (15 vascular surgeons and six vascular surgery residents) were enrolled to participate in a 20-hour workshop held over 2 days, combining theoretical and practical sessions, in a region of Brazil geographically distant from their place of residence and practice. Performance was evaluated at baseline (T1) and after training (T2) using the objective structured assessment of technical skills (OSATS), a procedure-specific rating scale, simulator metrics, satisfaction questionnaires, and a survey on changes in clinical practice. Results Nineteen physicians (13 vascular surgeons and six residents) attended the workshop, out of 21 initially enrolled. Significant improvements were observed in OSATS scores for residents (T1: 23.5 [interquartile range, IQR 23.0–24.3] vs. T2: 36.5 [IQR 34.5–37.3]; p=0.0090) and specialists (T1: 26.0 [IQR 25.5–29.5] vs. T2: 35.5 [IQR 33.5–39.5]; p=0.0011). Procedure-specific rating scale also increased for residents (15.0 [IQR 14.3–15.5] vs. 21.5 [IQR 20.8–22.3]; p=0.0139) and specialists (18.5 [IQR 15.5–20.5] vs. 23.0 [IQR 20.5–25.0]; p=0.0011). Participants reported high satisfaction regarding skill acquisition, familiarity with materials, and increased self-confidence (median 5.0, IQR 5.0–5.0). The simulator was rated highly for realism and educational value (median 5.0, IQR 4.0–5.0). A survey at 12 months post-workshop showed that the acquired skills were consistently applied in routine clinical practice. Conclusion A 20-hour EVAR workshop improved technical performance across different levels of experience and had good attendance. The workshop enhanced procedural understanding, device handling, and overall procedural workflow.