An interactive solution for anesthesiology residents to learn fundamentals of cardiopulmonary bypass

Jacob Schaff
Charles Hill
Larry Chu


Introduction: Cardiopulmonary bypass (CPB) involves transferring over the functions of the heart and lungs from the patient to a bypass machine that is managed by a specialist – the perfusionist.  This allows the surgeons to operate on the heart in many ways that would have been impossible otherwise.  Once the operation is complete, the work is transferred from the machine back to the heart and lungs of the patient – this requires that the anesthesiologist, perfusionist, and surgeon communicate efficiently and effectively.

The Targeted Problem: Cardiothoracic anesthesia is challenging and exciting, particularly for first rotation anesthesiology residents.  While it varies somewhat from institution to institution, the cardiac operating rooms introduce new medications, workflows, and members of the OR team.  There is a dynamic that exists between a seasoned anesthesiologist, perfusionist, and surgeon that is like a well-oiled machine.  As a result, this often leaves the anesthesiology resident quite confused at best.

Current anesthesia textbooks often provide some information about CPB, hidden amongst chunks of text within a broad chapter on anesthesia for cardiac surgery that approaches 100 pages.  As this is usually the first real-life exposure to CPB, anesthesiology residents often lack an understanding of the overall process of CPB, making assimilation of this knowledge difficult.

The Proposed Solution: Many different learning modalities were reviewed and assessed for the optimal platform to present this material.  Ultimately, the iBooks / iBooks Author platform was chosen for several reasons.  Foremost, it provides an interactive tool that allows learners to engage learning.  It also allows residents nationwide access to the modules via an individual file on a protected server or the iBooks store.

While text is an important component of most books, iBooks allowed the authors to distribute this text behind a graphic-heavy interface to promote interactive learning.  Processes are difficult to describe with text and static images.  iBooks allows for rich interactive interface including: short videos, self-tutorial presentations, animations, interactive images, and pop-over text interaction. 

At the beginning of each module, clear and concise learning objectives were stated to highlight salient learning points.  In addition, self-assessment tools (multiple choice and matching questions) were integrated throughout the content to ensure that learners were grasping the concepts and understanding the most important facts of the module before progressing.  At the end of each chapter, a key concepts section was included for “book-end” learning to aid in retention.  Additionally a glossary was created for two purposes: indexed words throughout the text can reference real-time definitions with the touch of a finger and glossary terms can be studied in a flashcard mode for further review.

Conclusion: To the authors’ knowledge, no interactive resources on the iBooks platform have been created to aid learners in gaining knowledge about CPB.  The authors hope this to be a useful tool for anesthesiology residents as an accessible, easy to use primer to learn about CPB. 

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