Journal of Surgical Simulation 2022; 9: 91 - 98

Published: 12 September 2022


Original article

Development and delivery of a national pilot programme of home-based simulation for vascular anastomosis training

Rachel Falconer, Catriona M. Semple, Kenneth G. Walker, Jennifer Cleland and Angus J.M. Watson
Corresponding author: Rachel Falconer, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, UK. Email:


Background: Simulation for acquisition of technical skills in vascular surgery is an increasingly important educational resource, particularly in the COVID-19 era. However, there is a need to provide more equitable access to regular technical skills practice for UK trainees.

Methods: A programme of home-based simulation for technical skill acquisition in vascular anastomosis was developed and delivered to all ST3 vascular trainees in the UK and Ireland over 4 months. Each trainee was provided with a kit box and access to dedicated online learning resources. Trainees were able to practice each task multiple times before uploading a video of their final performance to a file-sharing platform. Written feedback was then provided by a vascular consultant using a previously validated assessment matrix.

Results: Twenty-four ST3 vascular trainees were enrolled in the VASIMULATION programme. Of these, 15 of 24 (63%) completed one or more tasks, although only one trainee completed all tasks. The median number of days for task completion was 19 days (range, 3–73 days). The post-programme survey was completed by 7 of 15 (47%) trainees who had completed at least one task. Both the models and kit boxes received positive feedback, and all trainees agreed that the range of tasks was appropriate for ST3 vascular trainees. The quality of feedback received was rated as excellent (43%), very good (43%) or good (14%) although 57% stated they had some difficulty uploading a video of their task performance for feedback. All respondents believed participation in the programme had improved their confidence in performing an end-to-side anastomosis, and 86% believed that it had improved their technical ability.

Conclusions: VASIMULATION is the first national programme of home-based open vascular simulation training. It demonstrated that technical skills training can be delivered remotely, which could help to overcome geographic disparities in access to simulation. However, further work is needed to evaluate strategies to maximize trainee engagement.


simulation; training; open vascular surgery; vascular skills

Supplementary material

Supplementary Video 1. Arteriotomy and patch closure. Available online at:
Supplementary Video 2. End-to-side anastomosis. Available online at:
Supplementary Video 3. Parachute technique. Available online at:
Supplementary file. Modified Objective Structured Assessment of Technical Skills (OSATs) matrix. Available online at: