Training for infrainguinal bypass surgery.

BACKGROUND: Despite satisfactory results for surgery performed by trainees, vascular surgeons need to improve training methods to ensure that aspiring surgeons are adequately trained with less clinical exposure during fewer dedicated years of training. OBJECTIVES: To review the wide range of workshop, laboratory and seminar-room based methods available to train for the diverse range of skills required for distal arterial revascularisation. Training methods include anastomotic suturing skills with bench-top training apparatus, working with realistic plastic models and prosthetic conduits, cadaveric dissections and virtual-reality simulations. Many of these also provide excellent opportunities for objective assessment of technical skills and trainees' progress. DESIGN AND METHODS: A review of the literature on surgical education, surgical skills training and assessment. An evaluation of some of the apparatus, facilities, training curricula and courses, currently available to European trainees, is carried out. CONCLUSIONS: Many methods are now available to allow focused training for particular skills in non-clinical settings. Objective tools are also available that allow assessment of trainees at many levels or practicing surgeons. These technical skills assessment methods are important for trainees and surgeons who, in the future, will increasingly need to demonstrate competence in vascular surgery.