In this study, we selected the heart, kidney and vena cava for the models. Each organ was only used for one session, but by multiple participants. The organs were not re-frozen because the multiple repairs precluded their Depsipeptide mouse re-use. It may be possible to use other organs, such as spleen or liver. However, cannulation of the porcine splenic vessels may Afatinib mouse be difficult because of their size. The repair of the kidney affords a similar experience to that of a spleen or liver, but was preferred because of the increased number of organs as well as the size of the kidney being conducive to easy cannulation and handling compared

to the liver. Ex-vivo training with a circulation pump model is suitable for basic hemostatic practice for residents. This training is easy to prepare and allows residents to practice hemostatic skills repeatedly, which may lead to earlier mastery some skill. Furthermore, this training is clearly advantageous from the ethical point of view compared with

live tissue training. The concept of 3R is crucial regarding the ethics of using animal tissue in medical research and education. This training contributed to the Replacement and Reduction components of the 3R principle. The design of this model satisfies both reality and ethics. There are some limitations to the sense LY2606368 cost of reality encountered in this model. This training does not use blood so that coagulation is completely absent compared to live tissue. For example, during repair of the IVC injury in this model, the oozing from the needle holes cannot be stopped. Another limitation is the lack of a physiologic L-gulonolactone oxidase effect of bleeding. For example, the cardiac injury repair is easier in this ex-vivo model than in a live animal because it cannot offer the same motion during systole as a live heart. Donias et al made a beating heart model in an ex-vivo setting for coronary

artery anastomosis training using a foot pump [14]. The cardiac muscle does not contract by itself so that the reality of ex-vivo training is not the same as that in a live animal. Precise re-creation is impossible using this model, but the practice afforded here may facilitate learning with a live animal model and requires further study. An important aspect of this training is the close faculty participation required. Each organ used constituted a “”station”" and we felt it was important to have each station manned by a faculty member throughout the training, such that the time faculty time requirement is significant. Including the lecture time (1 hour) and laboratory time (5 hours), a total of 16 person-hours of faculty time are needed to conduct the session. The effectiveness of simulation training can be defined in several ways, such as improved clinical performance following simulation training, improved patient safety following such training, or effects on the practitioner.