Vascular Trauma: Training the Surgeon of the Future

Significant changes in residency programs and exposure to vascular trauma cases during training and professional career, as well as new approaches to management of vascular injury, including the developments of endovascular techniques, mandate a reappraisal of how both vascular specialists and general surgeons are prepared to manage vascular trauma. New strategies in delivering both technical and nontechnical skills training are required to deliver quality care to the patient with a vascular injury. While specialist vascular surgeons will deliver some of this care, there are many situations where this is not practical; so nonvascular specialists must also have a skill set to deal with a patient whose complex injury includes a vascular injury. The ideal curriculum with unambiguous goals and with testable competencies is being defined. Courses are being developed to deliver vascular trauma training that uses a synthesis of techniques, including animal-model training, human cadaveric training, and simulation-based training. It has been recognized that crew resource management (CRM), as utilized in other safety critical industries such as aviation, is an important component in minimization of errors and requires team-based training. This chapter explores the current positions and solutions and looks to how, through future-defined curricula, surgeons may best use the technologies available to gain the necessary expertise to deliver the best care to patients with vascular injury.