
pmid: 27568127
See related article on pages 1-9 Cognitive task analysis (CTA) is an established training paradigm in many fields, while being relatively new in surgical education. It has been validated in simulation, technical, and decision-making training. The use of CTA has also revealed to educators their own limitations, and can provide a useful framework from which to teach. In this issue of Seminars in Thoracic and Cardiovascular Surgery, Brewer et al describe development of a CTA-based smartphone application, teaching sternotomy, cannulation, cardiopulmonary bypass, and decannulation. It is visually appealing, user-friendly, and informative. In a prospective, randomized fashion, medical students using this application were compared with those using only traditional texts. Although both groups demonstrated improvement with education, the group using the application improved significantly more. The simulator has since been made publically available, and used worldwide. Several contemporary efforts have provided our trainees cognitive frameworks to navigate the complex landscape of cardiac surgery. The Thoracic Surgery Residents Association recognized the importance of procedural codification, solicited operative dictations from leading surgeons, and published a book. Our group recently developed a detailed manual of cardiopulmonary bypass and published a free e-book. Most recently, a multi-institutional consortium published a comprehensive Cardiac Surgery Simulation Curriculum using CTA liberally. The product by Brewer et al adds another such resource. CTA is particularly well-suited to cardiac surgery given the seemingly innumerable specifically ordered tasks. From the standpoint of a new learner, the steps of cannulation and bypass, not to mention opening and closing can be overwhelming. Tools providing them a mental roadmap during this phase could accelerate learning. The simulator presented here is quite polished and required significant development resources, but CTA can also be developed with modest investment. The first CTA in the Cardiac Surgery Simulation Curriculum involves memorizing and reciting the steps of cardiopulmonary bypass as detailed in a
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