Surgical Training Experience and Procedure Simulator Summer 2015

Participants: Amy Cohn, Rishindra Reddy, F. Jacob Seagull, Mark Daskin, Billy Pozehl, Brooke Szymanski, Roshun Sankaran, Tiffany Ballard, Tyler Grenda

Project Contact:  Billy Pozehl,

Project Synopsis: The purpose of this project is to address challenges in scheduling surgical residents, ensuring that they get adequate training opportunities, and to educate clinicians about the impact that randomness (such as in the arrivals of opportunities to perform certain surgical procedures) can have on planned activities. For example, consider the case of training fellows in the University of Michigan Cardiothoracic training program to perform heart and lung transplants. There are four fellows who each must perform 20 transplants in a two-year program to attain their certification. According to historical case data, the University Hospital sees approximately 40 cases per year. In theory, the cases can be equitably distributed amongst the fellows so that each should receive the 20 cases necessary over the program duration. In practice, the fellows work a rotating call schedule to comply with ACGME rest rules. This call schedule determines who will actually perform a transplant when the opportunity arises. Because transplants are randomly occurring events, it is unlikely that the transplants are split up evenly amongst the fellows, leading to significant challenges in certifying every fellow. As our simulator shows, it turns out the probability of successfully certifying all four fellows is only about 5%.

Understanding these challenges can allow program facilitators to make informed decisions about their existing program structure and plan for appropriate changes. The Surgical Training Experience and Procedure Simulator (STEPS) is a tool developed at CHEPS which allows users to visualize and assess the impact of variability on planned activities within a training program given specific requirements and constraints input by the user.

Papers, Presentations, & Posters:




Acknowledgments: We gratefully acknowledge the financial support of The Seth Bonder Foundation, The Doctors Company Foundation, the University of Michigan Department of Surgery, the University of Michigan College of Engineering SURE Program, and the MCubed Program. We also thank all prior CHEPS students and collaborators who have contributed to this project.