Study Characteristics and Structure are as follows: All Left-handed cardiac surgeons and residents attending the 2024 EACTS annual meeting (october 2024) are invited to any of the 3-day 8-endoscopic sessions as part of this study trial. The Left-handed cardiac surgeons and residents may participte in any of the sessions which best fits their schedule. Time frame includes all three days of endoscopic simulation sessions as walk-ins according to the availability of each surgeon. The exclusion criteria will be experienced endoscopic left-handed surgeons who are already experts. Left-handed surgeons will be randomized to either the standard right-handed guided simulation training session or to a Left-handed tailored simulation session. Study Intervention: Left-handed surgeons and residents will be randomized to either a 2-hour Left-handed tailored-guided session (Group 1) or a standard right-handed guided 2-hour endoscopic simulation training session (Group 2). Setting: EACTS 2024 annual meeting (october 2024 - 3-day convention) Group 1 will be guided by a left-handed intructor using Left-handed endoscopic suture maps Group 2 will be guided by a right-handed intructor using Standard right-handed suture maps Pre-course tests will evaluate accuracy and time of endoscopic suture placement in comparison to post-course tests to assess improvements. Pre-session assessments will be carried out evaluating endoscopic suture placement accuracy and time to suture placement. These include: 1. Time to suture placement under \<60 seconds 2. Accuracy of suture placement considered to be between 2-8 mm 3. Suture placement locations will be both Anterior and Posterior annular placements Post-skills sessions assessment: finalizing the 2-hour workshop the participants will be asked to repeat both the anterior and posterior annular endoscopic suture placement. Final study evaluations and delta time comparisons will be performed to determine if Left-handed surgeons guided by left-handed surgeons outperform or at least fair better then when guided by right-handed instructors.
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Delta time difference of suture placement
Timeframe: From the randomisation (start of the training) to the end of two-hours training
improvement in seconds taken to perform mitral suturing
Timeframe: this will be performed during a two hour course