Article Data

  • Views 2234
  • Dowloads 179

Original Research

Open Access

Repeated participation in the cadaver-based educational seminar for trauma surgery (C-BEST) could maintain training effects: skill retention at a 2-year follow-up

  • Hiroshi Homma1
  • Jun Oda1
  • Hidefumi Sano1
  • Shinichi Kawata2
  • Masahiro Itoh2

1Department of Emergency and Critical Care Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku, 160-0023 Shinjuku-ku, Tokyo, Japan

2Department of Anatomy, Tokyo Medical University, 6-1-1 Shinjuku, 160-8402 Shinjuku-ku, Tokyo, Japan

DOI: 10.22514/sv.2021.146 Vol.18,Issue 2,March 2022 pp.88-96

Submitted: 14 June 2021 Accepted: 20 July 2021

Published: 08 March 2022

*Corresponding Author(s): Hiroshi Homma E-mail:


Although the effectiveness of cadaver surgical training has been clarified, the decline in training effects over time has become a problem. This study examined whether repeated participation in cadaver-based educational seminar for trauma surgery (C-BEST) could suppress the decline in training effects. Basic and advanced C-BEST have pelvic package (PP) and fasciotomy of the lower extremity (FLE) as common training skills. For participants of these skills twice each, we examined the changes in a 10-point self-assessment of confidence levels (SACL) at six time points: (1) before the seminar of basic C-BEST, (2) immediately after basic C-BEST, (3) half a year after basic C-BEST, (4) before advanced C-BEST, (5) immediately after advanced C-BEST, and (6) half a year after advanced C-BEST. Data were collected from 28 basic C-BESTs and 5 advanced C-BESTs conducted from January 2013 to January 2020. Statistical analysis was performed by comparing SACL results from seminar evaluations at the six points, with significance at P < 0.05. A total of 60 participants were enrolled (postgraduate year, 16.5 ± 5.7). The interval between basic and advanced C-BEST was 27.1 ± 6.9 months. In PP, the SACL did not decrease at all six points. In FLE, SACL did not decrease at all six points, had a greater increase before versus immediately after advanced C-BEST, and did not decrease thereafter (P < 0.05). After participants retook the seminar, FLE-like procedures, which are unfamiliar to nonorthopedic surgeons, had increased and maintained self-evaluation values, whereas PP-like procedures, which are familiar to abdominal surgeons, had maintained high self-evaluation values. Therefore, repeated seminar participation could maintain the effects of cadaver training.


Cadaver-based educational seminar for trauma surgery (C-BEST); Skill retention; Repeated participation; 2-year follow-up; Self-assessment of confidence levels; Pelvic package; Fasciotomy of the lower extremity

Cite and Share

Hiroshi Homma,Jun Oda,Hidefumi Sano,Shinichi Kawata,Masahiro Itoh. Repeated participation in the cadaver-based educational seminar for trauma surgery (C-BEST) could maintain training effects: skill retention at a 2-year follow-up. Signa Vitae. 2022. 18(2);88-96.


[1] McNeill A, Anstee A, Hoare T. Advanced ultrasound-guided biopsy simulation training using cadaveric phantoms: cadaver day. Clinical Radiology. 2020; 75: 798.e23–798.e25.

[2] Michels NR, Vanhomwegen E. An educational study to investigate the efficacy of three training methods for infiltration techniques on self-efficacy and skills of trainees in general practice. BMC Family Practice. 2019; 20: 133.

[3] Moiraghi A, Perin A, Sicky N, Godjevac J, Carone G, Ayadi R, et al. EANS Basic Brain Course (ABC): combining simulation to cadaver lab for a new concept of neurosurgical training. Acta Neurochirurgica. 2020; 162: 453–460.

[4] Frendø M, Konge L, Cayé-Thomasen P, Sørensen MS, Andersen SAW. Decentralized Virtual Reality Training of Mastoidectomy Improves Cadaver Dissection Performance: a Prospective, Controlled Cohort Study. Otology & Neurotology. 2020; 41: 476–481.

[5] Chai DQ, Naunton‐Morgan R, Hamdorf J. Fresh frozen cadaver workshops for general surgical training. ANZ Journal of Surgery. 2019; 89: 1428–1431.

[6] Homma H, Oda J, Yukioka T, Hayashi S, Suzuki T, Kawai K, et al. Effectiveness of cadaver-based educational seminar for trauma surgery: skills retention after half-year follow-up. Acute Medicine & Surgery. 2017; 4: 57–67.

[7] Homma H, Oda J, Sano H, Kawai K, Koizumi N, Uramoto H, et al. Advanced cadaver-based educational seminar for trauma surgery using saturated salt solution‐embalmed cadavers. Acute Medicine & Surgery. 2019; 6: 123–130.

[8] Mackenzie CF, Garofalo E, Puche A, Chen H, Pugh K, Shackelford S, et al. Performance of Vascular Exposure and Fasciotomy among Surgical Residents before and after Training Compared with Experts. JAMA Surgery. 2017; 152: 581.

[9] Mackenzie CF, Bowyer MW, Henry S, Tisherman SA, Puche A, Chen H, et al. Cadaver-Based Trauma Procedural Skills Training: Skills Retention 30 Months after Training among Practicing Surgeons in Comparison to Experts or more Recently Trained Residents. Journal of the American College of Surgeons. 2018; 227: 270–279.

[10] Gunst M, O’Keeffe T, Hollett L, Hamill M, Gentilello LM, Frankel H, et al. Trauma operative skills in the era of nonoperative management: the trauma exposure course (TEC). The Journal of Trauma. 2009; 67: 1091–1096.

[11] James HK, Chapman AW, Pattison GTR, Griffin DR, Fisher JD. Systematic review of the current status of cadaveric simulation for surgical training. British Journal of Surgery. 2019; 106: 1726–1734.

[12] Van Bruwaene S, Schijven MP, Miserez M. Maintenance training for laparoscopic suturing: the quest for the perfect timing and training model: a randomized trial. Surgical Endoscopy. 2013; 27: 3823–3829.

[13] Moit H, Dwyer A, De Sutter M, Heinzel S, Crawford D. A Standardized Robotic Training Curriculum in a General Surgery Program. Journal of the Society of Laparoendoscopic Surgeons. 2019; 23: e2019.00045.

[14] Coleman R, Kogan I. An improved low-formaldehyde embalming fluid to preserve cadavers for anatomy teaching. Journal of Anatomy. 1998; 192: 443–446.

[15] Hayashi S, Homma H, Naito M, Oda J, Nishiyama T, Kawamoto A, et al. Saturated salt solution method: a useful cadaver embalming for surgical skills training. Medicine. 2014; 93: e196.

[16] Hayashi S, Naito M, Kawata S, Qu N, Hatayama N, Hirai S, et al. History and future of human cadaver preservation for surgical training: from formalin to saturated salt solution method. Anatomical Science International. 2016; 91: 1–7.

[17] Burns DM, Bell I, Katchky R, Dwyer T, Toor J, Whyne CM, et al. Saturated Salt Solution Cadaver-Embalming Method Improves Orthopaedic Surgical Skills Training. The Journal of Bone and Joint Surgery. American Volume. 2018; 100: e104.

[18] Shirai T, Hayashi S, Itoh M. Experience of Raising Flaps Using Cadavers Embalmed by Saturated Salt Solution Method. Plastic and Reconstructive Surgery. Global Open. 2015; 3: e543.

[19] Sullivan A, Elshenawy S, Ades A, Sawyer T. Acquiring and Maintaining Technical Skills Using Simulation: Initial, Maintenance, Booster, and Refresher Training. Cureus. 2019; 11: e5729.

[20] Nagase M, Kimoto Y, Sunami E, Matsumura G. A new human cadaver model for laparoscopic training using N-vinyl-2-pyrrolidone: a feasibility study. Anatomical Science International. 2020; 95: 156–164.

[21] Held JM, McLendon RB, McEvoy CS, Polk TM. A Reusable Perfused Human Cadaver Model for Surgical Training: an Initial Proof of Concept Study. Military Medicine. 2019; 184: 43–47.

[22] Nesbitt CI, Tingle SJ, Williams R, McCaslin JE, Searle R, Mafeld S, et al. Educational Impact of a Pulsatile Human Cadaver Circulation Model for Endovascular Training. European Journal of Vascular and Endovascular Surgery. 2019; 58: 602–608.

[23] Grabo D, Bardes J, Sharon M, Borgstrom D. Initial report on the impact of a perfused fresh cadaver training program in general surgery resident trauma education. The American Journal of Surgery. 2020; 220: 109–113.

[24] Grabo D, Polk T, Minneti M, Inaba K, Demetriades D. Brief report on combat trauma surgical training using a perfused cadaver model. Journal of Trauma and Acute Care Surgery. 2020; 89: S175–S179.

[25] Faizer R, Singal A, Ojo C, Reed AB. Development of a pulsatile cadaver-based simulation for training of open abdominal vascular surgery skills. Journal of Vascular Surgery. 2020; 72: 1076–1086.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time