Kardiochirurgia i Torakochirurgia Polska

Full text

2/2026 vol. 23
Review paper

The evolution of cardiothoracic surgery training: from apprenticeship to AI-assisted simulation

Vasileios Leivaditis 1
,
Francesk Mulita 2
,
Vasiliki Androutsopoulou 3
,
Andreas Antonios Maniatopoulos 4
,
Elias Liolis 5
,
Konstantinos Tasios 6
,
Konstantinos Nikolakopoulos 7
,
Chrysa Andrikopoulou 8
,
Paraskevi Katsakiori 8
,
Nikolaos G. Baikoussis 9

  1. Department of Cardiothoracic and Vascular Surgery, Westpfalz Klinikum, Kaiserslautern, Germany

  2. Second Department of Surgery, Medical School, Democritus University of Thrace, Alexandroupolis, Greece

  3. Department of Cardiothoracic Surgery, Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece

  4. Department of Electrical and Computer Engineering, Democritus University of Thrace, Xanthi, Greece

  5. Department of Oncology, General University Hospital of Patras, Greece

  6. John Radcliffe Hospital Emergency Department, University Hospitals NHS Foundation Trust, Headley Way, Headington, Oxford OX3 9DU, UK

  7. Department of Vascular Surgery, General University Hospital of Patras, Greece

  8. Department of Surgery, General Hospital of Eastern Achaia - Unit of Aigio, Greece

  9. Department of Cardiac Surgery, Ippokrateio General Hospital of Athens, Greece

Kardiochirurgia i Torakochirurgia Polska 2026; 23 (2): 142-162

DOI: https://doi.org/10.5114/kitp.2026.163273
Data publikacji online: 2026/07/21
Article file
The evolution.pdf
Confronting perimenopausal women’s knowledge of coronary heart disease with their health behaviours. Controversial role of hormone replacement therapy in the protection of coronary heart disease
  1. Zakkar M, Benedetto U, Angelini GD, Murphy G, Shah R, Jahangiri M, Page R. Cardiothoracic surgery training in the United Kingdom. J Thorac Cardiovasc Surg 2019; 157: 1948-1955.
  2. Mennander A, Gudbjartsson T, Jeppsson A, Hjortdal V, Tønnessen T. Specialist training for cardiothoracic surgery in the Nordic countries. J Thorac Cardiovasc Surg 2020; 159: 1002-1008.
  3. Deboever N, Bayley EM, Vaporciyan AA, Antonoff MB. Traits of the current traditional pathway cardiothoracic surgery training pool: results of a cross-sectional study. J Thorac Cardiovasc Surg 2023; 165: 1743-1750.
  4. Van Way C 3rd. War and trauma: a history of military medicine – part II. Mo Med 2016; 113: 336-340.
  5. Abbott KL, Kendrick DE, Chen X, Krumm AE, Jones AT, George BC. How many attempts are needed to achieve general surgery board certification? J Surg Educ 2021; 78: 885-888.
  6. Murad H. Reflections on the cardiac surgery practiced in the 1970s when compared with the current practice. Braz J Cardiovasc Surg 2019; 34: V-VII.
  7. Smith BK, Yamazaki K, Tekian A, Brooke BS, Mitchell EL, Park YS, Holm- boe ES, Hamstra SJ. Accreditation council for graduate medical education milestone training ratings and surgeons’ early outcomes. JAMA Surg 2024; 159: 546-552.
  8. Girma SM, Hiwot T, Aliye NJ, Yimam E, Awad AK. Equity in the cardiothoracic surgical workforce: addressing training gaps and workforce distribution in Africa – a narrative review. BMC Surg 2025; 25: 176.
  9. Diodato M, Chedrawy EG. Coronary artery bypass graft surgery: the past, present, and future of myocardial revascularisation. Surg Res Pract 2014; 2014: 726158.
  10. Zientara A, Hussein N, Bond C, Jacob KA, Naruka V, Doerr F, Nägele F, Pölzl L, Eid M, Jarral O, Cerqueira R, Haunschild J, Sádaba JR, Gollmann-Tepeköylü C. Basic principles of cardiothoracic surgery training: a position paper by the European Association for Cardiothoracic Surgery Residents Committee. Interact Cardiovasc Thorac Surg 2022; 35: ivac213.
  11. Loubani M, Sadaba JR, Myers PO, Cartwright N, Siepe M, Emmert MY, O’Regan DJ, Krieg P, Sergeant PT. A European training system in cardiothoracic surgery: is it time? Eur J Cardiothorac Surg 2013; 43: 352-357.
  12. Okoli CC, Nwanna-Nzewunwa OC, Buchanan S. Training and assessment of nontechnical skills in cardiothoracic surgery: current literature review. J Surg Educ 2025; 82: 103480.
  13. Inam H, Arshad H, Waqar U, Ahmad Zaidi SM, Ahmed S. Training in cardiothoracic surgery: the role for simulation. J Pak Med Assoc 2024; 74: 1316-1320.
  14. Obafemi OO, Mullis DM, Rogers AB, Lee AM. Characteristics of integrated thoracic surgery residency matriculants: a survey of program directors. Ann Thorac Surg 2022; 114: 1035-1042.
  15. Trehan K, Kemp CD, Yang SC. Simulation in cardiothoracic surgical training: where do we stand? J Thorac Cardiovasc Surg 2014; 147: 18-24.e2.
  16. Kenny L, Booth K, Freystaetter K, Wood G, Reynolds G, Rathinam S, Moorja-ni N. Training cardiothoracic surgeons of the future: the UK experience. J Thorac Cardiovasc Surg 2018; 155: 2526-2538.e2.
  17. Lammy S. Cardiothoracic-themed core surgical training programs in Scotland. J Thorac Cardiovasc Surg 2013; 146: 504-505.
  18. Nguyen VT, Losee JE. Time- versus competency-based residency training. Plast Reconstr Surg 2016; 138: 527-531.
  19. Fann JI, Feins RH, Hicks GL Jr, Nesbitt JC, Hammon JW, Crawford FA Jr; Senior Tour in Cardiothoracic Surgery. Evaluation of simulation training in cardiothoracic surgery: the Senior Tour perspective. J Thorac Cardiovasc Surg 2012; 143: 264-272.
  20. Kort KC, Pavone LA, Jensen E, Haque E, Newman N, Kittur D. Resident perceptions of the impact of work-hour restrictions on health care delivery and surgical education: time for transformational change. Surgery 2004; 136: 861-871.
  21. Wang TT, Ahmed K, Patel VM, Harling L, Jawad M, Darzi A, von Segesser LK, Athanasiou T. A competency framework in cardiothoracic surgery for training and revalidation – an international comparison. Eur J Cardiothorac Surg 2011; 40: 816-825.
  22. Feins RH, Burkhart HM, Conte JV, Coore DN, Fann JI, Hicks GL Jr, Nesbitt JC, Ramphal PS, Schiro SE, Shen KR, Sridhar A, Stewart PW, Walker JD, Mokadam NA. Simulation-based training in cardiac surgery. Ann Thorac Surg 2017; 103: 312-321.
  23. Ward A, Ranganath NK, Chen S, Wallen T, Kent AJ, Smith Iii DE, Kon ZN. Perceptions of training pathways from recent cardiothoracic surgery graduates. Heart Surg Forum 2021; 24: E684-E689.
  24. Antonoff MB, Luc JGY, Patterson GA, Meyers BF, Damiano RJ Jr, Moon MR. graduate subspecialty and perceptions of cardiothoracic surgery training: a 60-year retrospective study. Ann Thorac Surg 2019; 107: 285-293.
  25. Thoma B, Karwowska A, Samson L, Labine N, Waters H, Giuliani M, Chan TM, Atkinson A, Constantin E, Hall AK, Gomez-Garibello C, Fowler N, Tourian L, Frank J, Anderson R, Snell L, Van Melle E. Emerging concepts in the CanMEDS physician competency framework. Can Med Educ J 2023; 14: 4-12.
  26. Hussein N, Eid M, Olsthoorn J, Nägele F, Loubani M, Quintana E, Borger M, van Brakel T, Sádaba JR, Clark S, Myers P. The European Association for Cardio-Thoracic Surgery-core curriculum for the cardiac/cardiovascular surgeon. Eur J Cardiothorac Surg 2025; 67: ezaf230.
  27. Marin-Cuartas M, Vervoort D, Contreras JR, Garcia-Villareal OA, Escobar A, Ferrari J, Quintana E, Sadaba R, Mestres CA, Carosella VC, Almeida RMS, Dayan V; Latin American Association of Cardiac and Endovascular Surgery (LACES). Perspectives in training and professional practice of cardiac surgery in Latin America. Braz J Cardiovasc Surg 2023; 38: 1-14.
  28. Martin JA, Regehr G, Reznick R, MacRae H, Murnaghan J, Hutchison C, Brown M. Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg 1997; 84: 273-278.
  29. Schüttpelz-Brauns K, Narciss E, Schneyinck C, Böhme K, Brüstle P, Mau-Holzmann U, Lammerding-Koeppel M, Obertacke U. Twelve tips for successfully implementing logbooks in clinical training. Med Teach 2016; 38: 564-569.
  30. Kim JS, Hernandez RA, Smink DS, Yule S, Jackson NJ, Shemin RJ, Kwon MH. Nontechnical skills training in cardiothoracic surgery: a pilot study. J Thorac Cardiovasc Surg 2022; 163: 2155-2162.e4.
  31. Seymour NE. VR to OR: a review of the evidence that virtual reality simulation improves operating room performance. World J Surg 2008; 32: 182-188.
  32. Rölfing JD, Sloth SB, Falstie-Jensen T, Mygind-Klavsen B, Elsøe R, Jen- sen RD. Opportunity to perform – should simulation-based surgical training be provided on demand or on supply? J Med Educ Curric Dev 2023; 10: 23821205231219429.
  33. Yean LE, Hashim SAB. Role of surgical simulation on self-reported confidence level on cardiothoracic surgical trainees. J Cardiothorac Surg 2024; 19: 293.
  34. Villanueva C, Xiong J, Rajput S. Simulation-based surgical education in cardiothoracic training. ANZ J Surg 2020; 90: 978-983.
  35. Ribeiro IB, Ngu JMC, Lam BK, Edwards RA. Simulation-based skill training for trainees in cardiac surgery: a systematic review. Ann Thorac Surg 2018; 105: 972-982.
  36. Kantor T, Mahajan P, Murthi S, Stegink C, Brawn B, Varshney A, Reddy RM. Role of eXtended Reality use in medical imaging interpretation for pre-surgical planning and intraoperative augmentation. J Med Imaging 2024; 11: 062607.
  37. Greene CL, Minneti M, Sullivan ME, Baker CJ. Pressurized cadaver model in cardiothoracic surgical simulation. Ann Thorac Surg 2015; 100: 1118-1120.
  38. Vaporciyan AA, Yang SC, Baker CJ, Fann JI, Verrier ED. Cardiothoracic surgery residency training: past, present, and future. J Thorac Cardiovasc Surg 2013; 146: 759-767.
  39. Chan PG, Schaheen LW, Chan EG, Cook CC, Luketich JD, D’Cunha J. Technology-enhanced simulation improves trainee readiness transitioning to cardiothoracic training. J Surg Educ 2018; 75: 1395-1402.
  40. Arjomandi Rad A, Vardanyan R, Thavarajasingam SG, Zubarevich A, Van den Eynde J, Sá MPBO, Zhigalov K, Sardiari Nia P, Ruhparwar A, Weymann A. Extended, virtual and augmented reality in thoracic surgery: a systematic review. Interact Cardiovasc Thorac Surg 2022; 34: 201-211.
  41. Babar ZUD, Max SA, Martina BG, Rosalia RA, Peek JJ, van Dijk A, Sadeghi AH, Mahtab EAF. Virtual reality simulation as a training tool for perfusionists in extracorporeal circulation: establishing face and content validity. JTCVS Tech 2023; 21: 135-148.
  42. Suresh D, Aydin A, James S, Ahmed K, Dasgupta P. The role of augmented reality in surgical training: a systematic review. Surg Innov 2023; 30: 366-382.
  43. Faizan Siddiqui M, Jabeen S, Alwazzan A, Vacca S, Dalal L, Al-Haddad B, Jaber A, Ballout FF, Abou Zeid HK, Haydamous J, El Hajj Chehade R, Kalmatov R. Integration of augmented reality, virtual reality, and extended reality in healthcare and medical education: a glimpse into the emerging horizon in LMICs-a systematic review. J Med Educ Curric Dev 2025; 12: 23821205251342315.
  44. Doerr F, Eid M, Naruka V, Hussein N. Simulation is a key element in the optimization of training in thoracic surgery. Eur J Cardiothorac Surg 2023; 63: ezad146.
  45. Buléon C, Mattatia L, Minehart RD, Rudolph JW, Lois FJ, Guillouet E, Philip- pon AL, Brissaud O, Lefevre-Scelles A, Benhamou D, Lecomte F, Group TSAWS, Bellot A, Crublé I, Philippot G, Vanderlinden T, Batrancourt S, Boithias- Guerot C, Bréaud J, de Vries P, Sibert L, Sécheresse T, Boulant V, Delamar- re L, Grillet L, Jund M, Mathurin C, Berthod J, Debien B, Gacia O, Der Saha- kian G, Boet S, Oriot D, Chabot JM. Simulation-based summative assessment in healthcare: an overview of key principles for practice. Adv Simul 2022; 7: 42.
  46. Sip M, Puslecki M, Dabrowski M, Klosiewicz T, Zalewski R, Ligowski M, Goszczynska E, Paprocki C, Grygier M, Lesiak M, Jemielity M, Perek B. Extended cardiopulmonary resuscitation: from high fidelity simulation scenario to the first clinical applications in Poznan out-of-hospital cardiac arrest program. Perfusion 2022; 37: 46-55.
  47. Puœlecki M, Ligowski M, D¹browski M, Stefaniak S, £adziñska M, £adziñski P, Pawlak A, Zieliñski M, D¹browska A, Artyñska A, Gezela M, Sobczyñski P, Szarpak £, Perek B, Jemielity M. BEST Life-”Bringing ECMO Simulation To Life”-how medical simulation improved a Regional ECMO Program. Artif Organs 2018; 42: 1052-1061.
  48. Evans MA, Namburi N, Allison HR, Saleem K, Lee LS. Nontechnical skills for surgeons as a framework to evaluate cardiopulmonary bypass management skills of resident trainees. J Surg Educ 2023; 80: 965-970.
  49. Hussein N, Zientara A, Gollmann-Tepeköylü C, Loubani M. Is it time to incorporate hands-on simulation into the cardiothoracic surgery curriculum? Interact Cardiovasc Thorac Surg 2022; 34: 564-565. Erratum in: Interact Cardiovasc Thorac Surg 2022; 34: 514.
  50. Fann JI, Sullivan ME, Skeff KM, Stratos GA, Walker JD, Grossi EA, Verrier ED, Hicks GL Jr, Feins RH. Teaching behaviors in the cardiac surgery simulation environment. J Thorac Cardiovasc Surg 2013; 145: 45-53.
  51. Ismail Fawaz H, Forestier G, Weber J, Idoumghar L, Muller PA. Accurate and interpretable evaluation of surgical skills from kinematic data using fully convolutional neural networks. Int J Comput Assist Radiol Surg 2019; 14: 1611-1617.
  52. Fraulini NW, Marraffino MD, Garibaldi AE, Johnson CI, Whitmer DE. Adaptive training instructional interventions: a meta-analysis. Mil Psychol 2025; 37: 479-493.
  53. Higgins M, Madan CR, Patel R. Deliberate practice in simulation-based surgical skills training: a scoping review. J Surg Educ 2021; 78: 1328-1339.
  54. Colborn K, Brat G, Callcut R. Predictive analytics and artificial intelligence in surgery-opportunities and risks. JAMA Surg 2023; 158: 337-338.
  55. Rahimi AM, Uluç E, Hardon SF, Bonjer HJ, van der Peet DL, Daams F. Training in robotic-assisted surgery: a systematic review of training modalities and objective and subjective assessment methods. Surg Endosc 2024; 38: 3547-3555.
  56. Cristofari H, Jung MK, Niclauss N, Toso C, Kloetzer L. Teaching and lear- ning robotic surgery at the dual console: a video-based qualitative analysis. J Robot Surg 2022; 16: 169-178.
  57. Probst P. A review of the role of robotics in surgery: to DaVinci and Beyond! Mo Med 2023; 120: 389-396.
  58. Wang TT, Ahmed K, Patel VM, Harling L, Jawad M, Darzi A, von Segesser LK, Athanasiou T. A competency framework in cardiothoracic surgery for training and revalidation – an international comparison. Eur J Cardiothorac Surg 2011; 40: 816-825.
  59. Mitzman B, Smith BK, Varghese TK Jr. Resident training in robotic thoracic surgery. Thorac Surg Clin 2023; 33: 25-32.
  60. Badhwar V, Wei LM, Geirsson A, Dearani JA, Grossi EA, Guy TS, Balkhy HH, Gillnov AM, Sutter FP, Melnitchouk S, Bonatti J, Murphy DA, Chitwood WR Jr. Contemporary robotic cardiac surgical training. J Thorac Cardiovasc Surg 2023; 165: 779-783.
  61. Nguyen TC, Tang GHL, Nguyen S, Forcillo J, George I, Kaneko T, Thourani VH, Bavaria JE, Cheung AW, Reardon MJ, Mack MJ. The train has left: can surgeons still get a ticket to treat structural heart disease? J Thorac Cardiovasc Surg 2019; 157: 2369-2376.e2.
  62. Papanikolaou IG, Haidopoulos D, Paschopoulos M, Chatzipapas I, Loutradis D, Vlahos NF. Changing the way we train surgeons in the 21th century: a narrative comparative review focused on box trainers and virtual reality simulators. Eur J Obstet Gynecol Reprod Biol 2019; 235: 13-18.
  63. Korzeniowski P, Barrow A, Sodergren MH, Hald N, Bello F. NOViSE: a virtual natural orifice transluminal endoscopic surgery simulator. Int J Comput Assist Radiol Surg 2016; 11: 2303-2315.
  64. Mahajan A, Hawkins A. Current implementation outcomes of digital surgical simulation in low- and middle-income countries: scoping review. JMIR Med Educ 2023; 9: e23287.
  65. Borg TM, Krishna A, Ghanem A. Surgical training for burns care in low-income countries: a literature review and critical appraisal. Burns 2022; 48: 1773-1782.
  66. Tansley G, Bailey JG, Gu Y, Murray M, Livingston P, Georges N, Hoogerboord M. Efficacy of surgical simulation training in a low-income country. World J Surg 2016; 40: 2643-2649.
  67. Martinerie L, Rasoaherinomenjanahary F, Ronot M, Fournier P, Dousset B, Tesnière A, Mariette C, Gaujoux S, Gronnier C. Health care simulation in developing countries and low-resource situations. J Contin Educ Health Prof 2018; 38: 205-212.
  68. Bedada AG, Hsiao M, Chilisa U, Yarranton B, Chinyepi N, Azzie G. Surgical simulation training for medical students: strategies and implications in Botswana. World J Surg 2022; 46: 1637-1642.
  69. Karamagioli E, Pikouli A, Chatzi E, Lykoudis PM, Schizas D. A review of remote surgical technologies and training strategies in low- and middle-income countries. Telemed J E Health 2026; 32: 236-249.
  70. Irfanullah EA, Chandra A, Solaiman RH, Siems C, Chethan S, Belani K, Harmon J. Simulation training in a lower middle-income country: supporting a new center and developing low-cost models for critical skill acquisition. Cureus 2023; 15: e40950.
  71. Puslecki M, Ligowski M, Kiel M, Dabrowski M, Stefaniak S, Sip M, Maciejewski A, Dabrowska A, Kiel-Puslecka I, K³osiewicz T, Misterski M, Buczkowski P, Szarpak L, Ruetzler K, Perek B, Czekajlo M, Jemielity M. Prototype of extracorporeal membrane oxygenation (ECMO) therapy simulator used in regional ECMO program. J Thorac Dis 2018; 10: 5073-5079.
  72. Abahuje E, Tuyishime E, Alayande BT. Global surgical simulation education, current practices, and future directions. Surgery 2025; 180: 109050.
  73. Robinson SJA, Ritchie AMA, Pacilli M, Nestel D, McLeod E, Nataraja RM. Simulation-based education of health workers in low- and middle-income countries: a systematic review. Glob Health Sci Pract 2024; 12: e2400187.
  74. Connors RC, Doty JR, Bull DA, May HT, Fullerton DA, Robbins RC. Effect of work-hour restriction on operative experience in cardiothoracic surgical residency training. J Thorac Cardiovasc Surg 2009; 137: 710-713.
  75. Geraci TC, Scheinerman J, Chen D, Kent A, Bizekis C, Cerfolio RJ, Zervos MD. Beyond the learning curve: a review of complex cases in robotic thoracic surgery. J Thorac Dis 2021; 13: 6129-6140.
  76. Aggarwal R. Just-in-time simulation-based training. BMJ Qual Saf 2017; 26: 866-868.
  77. Stephens EH, Odell D, Stein W, LaPar DJ, DeNino WF, Aftab M, Berfield K, Eilers AL, Groth S, Lazar JF, Robich MP, Shah AA, Smith DA, Stock C, Tchantchaleishvili V, Mery CM, Turek JW, Salazar J, Nguyen TC. A decade of change: training and career paths of cardiothoracic surgery residents 2003 to 2014. Ann Thorac Surg 2015; 100: 1305-1313.
  78. Klingensmith ME, Potts JR, Merrill WH, Eberlein TJ, Rhodes RS, Ashley SW, Valentine RJ, Hunter JG, Stain SC. Surgical training and the early specialization program: analysis of a national program. J Am Coll Surg 2016; 222: 410-416.
  79. Vardas PN, Stefanescu Schmidt AC, Lou X, Goldstone AB, Pattakos G, Fie- dler AG, Stephens EH, Tchantchaleishvili V. Current status of endovascular training for cardiothoracic surgery residents in the United States. Ann Thorac Surg 2017; 104: 1748-1754.
  80. Luthra S, Leiva-Juarez MM, Ismail AH, Tsang GM, Barlow CW, Velissaris T, Miskolczi S, Ohri SK. Is resident training safe in cardiac surgery? Ann Thorac Surg 2020; 110: 1404-1411.
  81. Leivaditis V, Beltsios E, Papatriantafyllou A, Grapatsas K, Mulita F, Kontodimopoulos N, Baikoussis NG, Tchabashvili L, Tasios K, Maroulis I, Dahm M, Koletsis E. Artificial intelligence in cardiac surgery: transforming outcomes and shaping the future. Clin Pract 2025; 15: 17.
  82. Mao RQ, Lan L, Kay J, Lohre R, Ayeni OR, Goel DP, Sa D. Immersive virtual reality for surgical training: a systematic review. J Surg Res 2021; 268: 40-58.
  83. Cedeno R, Bohlen J. Sexual Harassment and Prevention Training. 2024 Mar 29. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 36508513.
  84. Luton OW, James OP, Mellor K, Eley C, Hopkins L, Robinson DBT, Lebares CC, Powell AGMT, Lewis WG, Egan RJ. Enhanced stress-resilience training for surgical trainees. BJS Open 2021; 5: zrab054.
  85. Cerqueira RJ, Heuts S, Gollmann-Tepeköylü C, Syrjälä SO, Keijzers M, Zientara A, Jarral OA, Jacob KA, Haunschild J, Ariyaratnam P, Durko AP, Muller P, Myers PO, Sadaba JR, Lehtinen ML. Challenges and satisfaction in Cardiothoracic Surgery Residency Programmes: insights from a Europe-wide survey. Interact Cardiovasc Thorac Surg 2021; 32: 167-173.
  86. Stinson G, Sharaf OM, Valdes CA, Sharaf RM, Jimenez Contreras F, Brennan Z, Freeman KA, Manning E, Beaver TM, Jacobs JP. Applying to integrated thoracic surgery residency: a survey-based cost analysis. Ann Thorac Surg Short Rep 2023; 2: 309-314.
  87. Nassour I, Balentine C, Boland GM, Chu D, Habermann E, Holscher C, Idrees K, In H, Kimbrough MK, Mitchem J, Warner SG, Karakousis G; Committee on Academic Advancement of the Association for Academic Surgery. Successful mentor-mentee relationship. J Surg Res 2020; 247: 332-334.
  88. Reich HJ, Lou X, Brescia AA, Henn MC, Mehaffey JH, Frommel B, Han J, Mirocha J, Imai T. Mentorship effectiveness in cardiothoracic surgical training. Ann Thorac Surg 2021; 112: 645-651.
  89. Coleman NL, Berlin A, Fischkoff K, Lee-Kong SA, Blinderman CD, Nakagawa S. Annual structured communication skills training for surgery residents. J Surg Res 2023; 281: 314-320.
  90. Hashimoto DA, Rosman G, Rus D, Meireles OR. Artificial intelligence in surgery: promises and perils. Ann Surg 2018; 268: 70-76.
  91. Bissonnette V, Mirchi N, Ledwos N, Alsidieri G, Winkler-Schwartz A, Del Maestro RF; Neurosurgical Simulation & Artificial Intelligence Learning Centre. Artificial intelligence distinguishes surgical training levels in a virtual reality spinal task. J Bone Joint Surg Am 2019; 101: e127.
  92. Satapathy P, Hermis AH, Rustagi S, Pradhan KB, Padhi BK, Sah R. Artificial intelligence in surgical education and training: opportunities, challenges, and ethical considerations - correspondence. Int J Surg 2023; 109: 1543-1544.
  93. Soangra R, Sivakumar R, Anirudh ER, Reddy Y SV, John EB. Evaluation of surgical skill using machine learning with optimal wearable sensor locations. PLoS One 2022; 17: e0267936.
  94. Magalhães R, Oliveira A, Terroso D, Vilaça A, Veloso R, Marques A, Pereira J, Coelho L. Mixed reality in the operating room: a systematic review. J Med Syst 2024; 48: 76.
  95. Aurello P, Pace M, Goglia M, Pavone M, Petrucciani N, Carrano FM, Cicolani A, Chiarini L, Silecchia G, D’Andrea V. Enhancing surgical education through artificial intelligence in the era of digital surgery. Am Surg 2025; 91: 1942-1948.
  96. Qamar MA, Ullah I, Sahito AM, Almas T, Waris A, Kanawati MA, Almuhai- leej M, Dominari A. Global surgery initiatives for collaborative surgical education and research. Ann Med Surg 2021; 68: 102583.
  97. Fenton KN, Novick WM, Entwistle JW 3rd, Moffatt-Bruce SD, Sade RM; Cardiothoracic Ethics Forum. Global health initiatives in cardiothoracic surgery: ethical considerations and guidelines. J Thorac Cardiovasc Surg 2021; 161: 2114-2118.
  98. Kopanczyk R, Long MT, Satyapriya SV, Bhatt AM, Lyaker M. Developing cardiothoracic surgical critical care intensivists: a case for distinct training. Medicina 2022; 58: 1865.
  99. Escobar-Castillejos D, Noguez J, Bello F, Neri L, Magana AJ, Benes B. A review of training and guidance systems in medical surgery. Appl Sci 2020; 10: 5752.
  100. Cardoso SA, Suyambu J, Iqbal J, Cortes Jaimes DC, Amin A, Sikto JT, Valderrama M, Aulakh SS, Ramana V, Shaukat B, Patel T. Exploring the role of simulation training in improving surgical skills among residents: a narrative review. Cureus 2023; 15: e44654.

Copyright: © 2026 Polish Society of Cardiothoracic Surgeons (Polskie Towarzystwo KardioTorakochirurgów) and the editors of the Polish Journal of Cardio-Thoracic Surgery (Kardiochirurgia i Torakochirurgia Polska). This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (http://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
SUBMIT YOUR PAPER
Share
without publication fees
without publication fees
Coverage in
Indexed in
pubmed
Integrated with
plagiat pl
Editorial Policies
Sarajevo Declaration on Integrity and Visibility of Scholarly Publications