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25 April 2018 Photo Oteng Mpete
UFS and Medtronic collaboration set to enhance cardiac
From the left: Zampieri Luigi: Medtronic; Dania Choucair: Medtronic; Peter Fuller: Medtronic; Prof Francis Petersen: UFS Rector and Vice-Chancellor; Prof Gert van Zyl:Dean of the Faculty of Health Sciences, and Eline Visser: Medtronic.

A new Cardiac Simulation laboratory will be opened and hosted within the School of Biomedical Sciences’ Clinical Simulation and Skills Unit, at the University of the Free State’s Bloemfontein Campus. The new laboratory is a result of a partnership between Medtronic and UFS. 

The new laboratory will be used to enhance training for cardiothoracic, cardiology, vascular surgery, anaesthesiology and multiprofessional teams   such as doctors, nurses and allied health professionals. The establishment of the laboratory will be made possible by the generous provision of equipment for the establishment and operation of the Cardiac Simulation laboratory by Medtronic.  

Prioritising of patients at the heart of collaboration 

The development of a Cardiac Simulation laboratory at the UFS will not only benefit the training of specialists in various fields of specialisation but will also improve patient safety and reduce complication and mortality rates. The UFS is proud to be part of this initiative to train healthcare professionals to the benefit of the patients.

The Medtronic and UFS contract signing was attended by key stakeholders who included Prof Francis Smit: Head of Cardiothoracic Surgery; Prof Mathys Labuschagne: Head of the Clinical Simulation and Skills Unit; Prof Gert van Zyl: UFS Dean of the Faculty of Health Sciences and Prof Francis Petersen: UFS Rector and Vice-Chancellor. In attendance from Medtronic were Dania Choucair: Medtronic Director Clinical Research and Medical Education; Peter Fuller: Medtronic Country Director; Zampieri Luigi: Business Director   Cardiovascular Group; and Eline Visser: Business Manager   Structural Heart.

The Cardiac Simulation laboratory will make use of part task trainers, medium- and high- fidelity simulation as well as virtual-reality simulation to develop integrated interdisciplinary simulation programmes. These programmes are essential for proficiency development through deliberate practice and should become a statutory requirement for future trainees.

Objective and improved quality of training  

Standard cardiothoracic surgical training programmes are still based on the apprentice model. It implies that registrars in all programmes will attain surgical competency in addition to theoretical training fulfilling minimum statutory requirements for licensing and independent practice. It is highly dependent on surgical volumes, attitude of trainers and perceived surgical ability of the trainee. At best, it produces a mixed bag of competency levels. 

Well-designed integrated interdisciplinary simulation programmes offer an alternative that allows for deliberate practice in an organised step-wise progression model, with inbuilt assessment and feedback systems. This allows for proficiency training rather than competency training in which clear objectives can be met.

The UFS cardiothoracic programme is being designed as a hub and spoke model for South Africa and sub-Saharan Africa, combining distance learning with an onsite high-fidelity simulation and assessment centre. Off-site training in crew resource management or CRM (which addresses communication, decision-making, team-building and maintenance, workload management and situational awareness management), educational theory, surgical theory and basic bench model simulation will be provided. 

Multidisciplinary streams of knowledge 
According to Profs Francis Smit and Mathys Labuschagne, the role of simulation is a dynamic process of continuous movement between theory, simulation and clinical exposure.  “We strive to create an environment where there is free flow between these different components. Registrars and students come from different educational and cultural backgrounds in South Africa and Sub-Saharan Africa and by allowing deliberate practice for students with different needs to practice in their own time is contributing tremendously to students’ individual outcomes and development in the specialty.” 

This dynamic fulfils the needs of students with different competency levels and previous clinical exposure. Debriefing and formative assessment per session are pre-requisites for attending high-fidelity and virtual-reality simulation sessions at the Cardiac Simulation laboratory, because this kind of feedback contributes to the clinical and surgical development as well as inter-professional collaboration of the trainees. 

News Archive

Medical team performs first hybrid procedure in the Free State
2014-12-08

The days when a heart operation meant hours in an operating theatre, with weeks and even months of convalescing, will soon be something of the past.

A team of cardiologists from the University of the Free State’s (UFS) Faculty of Health Sciences once again made medical history when they performed the first hybrid procedure in the Free State.

The Department of Paediatric Cardiology, in conjunction with the Department of Cardiothoracic Surgery, performed this very successful procedure on a 45-year-old woman from Kuruman.

During the procedure of 30 minutes, the patient’s thorax was opened up through a mini thoracotomy to operate on the beating heart.

“The patient received an artificial valve in 2011. Due to infection, a giant aneurism developed from the left ventricle, next to the aorta. Surgery would pose a very high risk to the patient. Furthermore, her health was such that it would contribute to problems during open-heart surgery,” explains Prof Stephen Brown, Head of the UFS’s Department of Paediatric Cardiology.

“After the heart was opened up through a mini thoracotomy, the paediatric cardiologists performed a direct puncture with a needle to the left ventricle cavity. A Special sheath was then placed in the left ventricle to bypass the catheters. Aided by highly advanced three-dimensional echocardiography and dihedral X-ray guidance, the opening to the aneurism, located directly below the artificial aorta valve, was identified and the aneurism cannulated.”
 
During the operation, a special coil, called a Nester Retractor, was used for the first time on a patient in South Africa to obtain stasis of extravasation and ensure the stability of devices in the aneurism.

“This is highly advanced and specialist work, as we had to make sure that the aneurism doesn’t rupture during manipulation and the devices had to be positioned in such a way that it doesn’t cause obstruction in valve function or the coronary artery. The surgical team was ready all the time to switch the patient to the heart-lung machine should something go wrong, but the procedure was very successful and the patient was discharged after a few days.”

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