Development of a saphenous vein harvest model for simulation-based assessment

There is a need to develop a realistic model of open saphenous vein harvesting for simulation training and assessment. The purpose of this study was to develop a novel simulated model of this procedure and to examine its viability by examining participants’ performance and feedback on this model. A total of 14 participants (cardiac surgeons, residents, students) conducted open saphenous vein harvesting on a portable, noncommercial, simulated vein model (complete with artificial vein, subcutaneous tissue, and skin) within an operating room. Surgical assistance was provided by a cardiac resident. Participants provided feedback through questionnaires and interviews. Technical performance was rated by 2 blinded raters using a global rating scale for operative technical skills. Quantitative analyses demonstrated that participants considered the model to be realistic and useful. Analyses of performance ratings indicated that the model could be used as a reliable indicator of skill level, given that raters were able to use performance scores to discriminate participants according to their level of experience at a high level of accuracy. Participants with a higher level of experience performed significantly better than those with a lower level of experience. Qualitative analyses revealed the model was considered to be most beneficial to learn procedural steps of vein harvesting and basic surgical skills. Results provide support for the technical fidelity of this model and its ability to identify skill level for assessment of vein harvesting. Future work should examine transfer of surgical skills from simulator to clinical practice to assess its viability for training.