{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:52:04Z","timestamp":1786125124644,"version":"build-2736575974"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2017,9,27]],"date-time":"2017-09-27T00:00:00Z","timestamp":1506470400000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/academic.oup.com\/journals\/pages\/about_us\/legal\/notices"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Surgical education relies on operative exposure with live patients. Carotid endarterectomy (CEA) demands an experienced surgeon with a very low complication rate. The high-risk nature of this procedure and the decline in number of CEAs performed annually has created a gap in residency training.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To develop a high-fidelity whole-task simulation for CEA that demonstrates content, construct, and face validity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Anatomically accurate models of the human neck were created using multilayered poly-vinyl alcohol hydrogels. Graded polymerization of the hydrogel was achieved by inducing crosslinks during freeze\/thaw cycles, stiffening the simulated tissues to achieve realistic tactile properties. Venous bleeding was simulated using pressure bags and a ventricular assistive device created pulsatile flow in the carotid. Ten surgeons performed the simulation under operating room conditions, and metrics were compared among experience levels to determine construct validity. Participants completed surveys about realism and usefulness to evaluate face validity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      A significant difference was found in operative measures between attending and resident physicians. The mean operative time for the expert group was 63.6 min vs 138.8 for the resident group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.002). There was a difference in mean internal carotid artery clamp time of 43.4 vs 83.2 min (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.04). There were only 2 hypoglossal nerve injuries, both in the resident group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.009).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>The whole-task CEA simulator is a realistic, inexpensive model that offers comprehensive training and allows residents to master skills prior to operating on live patients. Overall, the model demonstrated face and construct validity among neurosurgery and vascular surgeons.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opx209","type":"journal-article","created":{"date-parts":[[2017,9,27]],"date-time":"2017-09-27T09:56:26Z","timestamp":1506506186000},"page":"697-704","source":"Crossref","is-referenced-by-count":12,"title":["Development of a Whole-Task Simulator for Carotid Endarterectomy"],"prefix":"10.1227","volume":"14","author":[{"given":"Gabrielle","family":"Santangelo","sequence":"first","affiliation":[{"name":"School of Medicine and Dentistry, University of Rochester, Rochester, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doran","family":"Mix","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Strong Memorial Hospital, University of Rochester, Rochester New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Ghazi","sequence":"additional","affiliation":[{"name":"Department of Urology, Strong Memorial Hospital, University of Rochester, Rochester, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Stoner","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Strong Memorial Hospital, University of Rochester, Rochester New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G Edward","family":"Vates","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Strong Memorial Hospital, University of Rochester, Rochester, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan J","family":"Stone","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Strong Memorial Hospital, University of Rochester, Rochester, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,6]]},"reference":[{"issue":"2","key":"bib1-20231018","first-page":"27","article-title":"Objective structured assessment of technical skill (OSATS) for surgical residents","volume":"84","author":"Martin","year":"1997","journal-title":"J Neurosurg"},{"issue":"1","key":"bib2-20231018","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.jamcollsurg.2012.08.014","article-title":"Resident participation in index laparoscopic general surgical cases: impact of the learning environment on surgical outcomes","volume":"216","author":"Davis","year":"2013","journal-title":"J Am Coll Surg"},{"issue":"5","key":"bib3-20231018","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/j.jsurg.2011.03.010","article-title":"Sim one, do one, teach one: considerations in designing training curricula for surgical simulation","volume":"68","author":"Kolozsvari","year":"2011","journal-title":"J Surg Educ"},{"issue":"2","key":"bib4-20231018","doi-asserted-by":"crossref","first-page":"228","DOI":"10.3171\/2014.5.JNS131766","article-title":"The use of simulation in neurosurgical education and training. A systematic review","volume":"121","author":"Kirkman","year":"2014","journal-title":"J Neurosurg"},{"issue":"4","key":"bib5-20231018","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1016\/j.surg.2014.06.072","article-title":"Outcomes associated with resident involvement in laparoscopic colorectal surgery suggest a need for earlier and more intensive resident training","volume":"156","author":"Gorgun","year":"2014","journal-title":"Surgery"},{"issue":"4","key":"bib6-20231018","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1016\/j.jvs.2010.05.093","article-title":"Incorporating simulation in vascular surgery education","volume":"52","author":"Bismuth","year":"2010","journal-title":"J Vasc Surg"},{"issue":"10","key":"bib7-20231018","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1002\/bjs.5794","article-title":"Competence assessment of senior vascular trainees using a carotid endarterectomy bench model","volume":"94","author":"Black","year":"2007","journal-title":"Br J Surg"},{"issue":"20","key":"bib8-20231018","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1056\/NEJM199811123392002","article-title":"Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators","volume":"339","author":"Barnett","year":"1998","journal-title":"N Engl J Med"},{"issue":"3","key":"bib9-20231018","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1016\/j.jvs.2016.03.428","article-title":"Predictors of poor outcome after carotid intervention","volume":"64","author":"Dua","year":"2016","journal-title":"J Vasc Surg"},{"issue":"5","key":"bib10-20231018","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1016\/j.ejvs.2009.01.011","article-title":"Temporal trends in the risks of stroke and death due to endarterectomy for symptomatic carotid stenosis: an updated systematic review","volume":"37","author":"Rerkasem","year":"2009","journal-title":"Eur J Vasc Endovasc Surg"},{"issue":"10 suppl","key":"bib11-20231018","first-page":"S31","article-title":"The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST): stenting versus carotid endarterectomy for carotid disease","volume":"41","author":"Mantese","year":"2010","journal-title":"Stroke"},{"issue":"5","key":"bib12-20231018","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1161\/STROKEAHA.114.006276","article-title":"Surgeon case volume and 30-day mortality after carotid endarterectomy among contemporary medicare beneficiaries: before and after national coverage determination for carotid artery stenting","volume":"46","author":"Kumamaru","year":"2015","journal-title":"Stroke"},{"issue":"4","key":"bib14-20231018","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1016\/j.jvs.2012.08.109","article-title":"Simulator training on pulsatile vascular models significantly improves surgical skills and the quality of carotid patch plasty","volume":"57","author":"Duschek","year":"2013","journal-title":"J Vasc Surg"},{"issue":"5","key":"bib15-20231018","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1227\/NEU.0000000000000924","article-title":"Carotid endarterectomy surgical simulation model using a bovine placenta vessel","volume":"77","author":"Belykh","year":"2015","journal-title":"Neurosurgery"},{"issue":"1","key":"bib16-20231018","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1007\/S40037-015-0250-4","article-title":"The role of simulation in the development of endovascular surgical skills","volume":"5","author":"Nesbitt","year":"2016","journal-title":"Perspect Med Educ"},{"issue":"4","key":"bib17-20231018","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1002\/bjs.6938","article-title":"Assessment of surgical competence at carotid endarterectomy under local anaesthesia in a simulated operating theatre","volume":"97","author":"Black","year":"2010","journal-title":"Br J Surg"},{"issue":"5","key":"bib18-20231018","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1016\/j.ejvs.2006.12.018","article-title":"Training for carotid intervention: preparing the next generation.","volume":"33","author":"Black","year":"2007","journal-title":"Eur J Vasc Endovasc Surg"},{"issue":"4","key":"bib19-20231018","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1097\/SLA.0b013e3181642ec8","article-title":"Teamwork and error in the operating room: analysis of skills and roles","volume":"247","author":"Catchpole","year":"2008","journal-title":"Ann Surg"},{"issue":"1","key":"bib20-20231018","doi-asserted-by":"crossref","first-page":"27","DOI":"10.3171\/2015.1.JNS142452.test","article-title":"Contemporary carotid imaging: from degree of stenosis to plaque vulnerability","volume":"2016","author":"Brinjikji","year":"2016","journal-title":"J Neurosurg"}],"container-title":["Operative Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ons\/article-pdf\/14\/6\/697\/30207889\/opx209.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/01787389-201806000-00013","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:50:37Z","timestamp":1786121437000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01787389-201806000-00013"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9,5]]},"references-count":19,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.1093\/ons\/opx209","relation":{},"ISSN":["2332-4252","2332-4260"],"issn-type":[{"value":"2332-4252","type":"print"},{"value":"2332-4260","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,9,5]]}}}