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26 September 2018
The Cardiac Simulation lab in action

There’s an electric atmosphere in the operating theatre of the Faculty of Health Sciences, as Dr Taha Gwila and his team focus with intense concentration on the fleshy exposed heart beating rhythmically in the opened chest of the patient lying in front of them. The enormous demands of open-heart surgery are evident to everyone looking on. But there’s a catch. 

The patient is faceless and rubberised. The red liquid flowing in the pipes that network from the body is not blood. And the pulsating heart was beating in the body of a pig not too long ago. 

Cutting edge technology
 
This Cardiac Simulation laboratory supplied by Medtronic is the newest addition to the School of Biomedical Sciences’ clinical simulation and skills unit. 

“There’s nothing like this in Africa, and only a few in the world,” says a beaming Prof Francis Smit, Head of Cardiothoracic Surgery at the Faculty of Health Sciences.
He explains that this new cutting edge medical technology will revolutionise the way cardiac surgeons and other health professionals are trained and assessed.

Practicing specific procedures

The simulation facilities give students with various levels of competency the opportunity to practice specific procedures in their own time and at their own pace.
“Traditionally training followed the apprentice model, where surgeons started with simple tasks and worked their way up. They assisted senior personnel and their exposure to procedures depended on the conditions presented by the patients before them,” explains Prof Smit.

The simulation technology now enables them to repeatedly practise a certain procedure without any risk to a patient. A sophisticated electronic grading system gives detailed feedback after each session, so they know in which areas to improve.  

Simulated emergencies

The system also allows trainers to create a medical emergency that the trainees then have to deal with.

“Assisting senior surgeons with high levels of competency means that in the past, trainees would often never get the chance to experience these kinds of complications during operating procedures. Now we give them a chance to build that confidence so they’ll be able to handle different situations.”  

Training hub for Africa
 

The UFS cardiothoracic programme is being designed to become a training hub for the whole of Southern Africa, combining distance learning with an on-site high-fidelity simulation and assessment centre.

“This is 100% real!” says an excited Dr Gwila after successfully completing his first simulation session. “As a Senior Registrar at the Cardiothoracic Department I’ve done similar procedures on real patients and there’s really no difference at all. Every registrar should do this before ever touching a real body.”

News Archive

First doctorate in Thoracic Surgery in Africa awarded
2009-05-12

The University of the Free State (UFS) has become the first university in Africa to award a Ph.D. degree in Thoracic Surgery. The degree was conferred on Prof. Anthony Linegar from the university’s Department of Cardiothoracic Surgery during its recent graduation ceremony.

Thoracic surgery is a challenging subspecialty of cardiothoracic surgery. It began in South Africa in the 1940s and is a broad medico-surgical specialist discipline that involves the diagnosis, operative and peri-operative treatment of acquired and congenital non-cardiac ailments of the chest.

Prof. Linegar became the first academic to conduct a mixed methods analysis of this surgical specialty, which included a systematic review of all the research done in this field in South Africa. The title of his thesis is A Model for the Development of Thoracic Surgery in Central South Africa. The research was based on the hypothesis of a performance gap between the burden of disease in the community and the actual service provision. It makes use of systems theory and project management concepts to develop a model aimed at the development of thoracic surgery.

The research proved that there is a significant under provision of clinical services in thoracic surgery. This was quantified to a factor of 20 times less than should be the case, in diseases such as lung and oesophagus cancer. According to Prof. Linegar, there are multiple reasons for this. Listed amongst these reasons is the fact that thoracic surgery is not part of the undergraduate education in medical training. There tends to be a low level of awareness amongst clinicians as to what the thoracic surgeon offers their patients. The diagnostic and referral patterns in primary and secondary health facilities, where diseases must be picked up and referred early, are not functioning well in this regard. In addition, relatively few cardiothoracic surgeons express an interest in thoracic surgery.

Prof. Linegar’s model is named the ATLAS Mode, which is an acronym for the Advancement of Thoracic Surgery through Analysis and Strategic Planning. It includes the raising of awareness of the role of the specialist thoracic surgeon in the treatment of patients with thoracic diseases as part of the solution to the problem. Furthermore, it aims to develop an accessible and sustainable specialist service that adequately provides for the needs of the community, and that is appropriately represented in health administration circles.

His promoters were Prof. Gert van Zyl, Head of the School of Medicine at the UFS, Prof. Peter Goldstraw, from the Imperial College of London, United Kingdom (UK) and Prof. Francis Smit, Head of the Department of Cardiothoracic Surgery at the UFS.

Prof. Linegar has been with the UFS since 2004, is a graduate from Stellenbosch University in 1984 and completed his postgraduate training in Cardiothoracic Surgery at the University of Cape Town. He was granted a Fellowship in Thoracic Surgery at the Royal Brompton Hospital in London, UK and has since held consultant positions at the UFS, Stellenbosch University and in private practice. He has been involved in registrar training since returning from the UK in 1994 and has extensive experience in intensive care medicine. He has published widely, has presented papers at many international conferences, has been invited as a speaker on many occasions and has won awards for best presentation on three occasions.

Media Release
Issued by: Lacea Loader
Assistant Director: Media Liaison
Tel: 051 401 2584
Cell: 083 645 2454
E-mail: loaderl.stg@ufs.ac.za  
12 May 2009
 

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