Simulator Training in Interventional Cardiology

Abstract

Simulator training provides the opportunity to acquire and practise technical skills in a safe, controlled and reproducible environment without the risk of harming patients. Although there is no evidence to prove that patient outcomes are worse if trainees undertake interventional procedures, there is an inevitable concern that procedures may not be as safe or successful if undertaken by doctors in training. 1,2 Experiential training in the workplace exposes patients to the theoretical risks of the learning curve of trainees, especially in the radial era. 3 Further, as catheter laboratory (cath lab) scheduling time is precious, having trainees undertaking procedures that inevitably take longer can be difficult to justify when the focus is on lab efficiency. Simulator training has the potential to offer focussed training opportunities that allow both the time and space to develop interventional skills. 4 These skills can then be analysed and critiqued without any risk of patient harm or impact on the cath lab schedule.Enthusiasm for simulation training has increased dramatically over recent years because advances in technology have allowed the delivery of authentic simulated training opportunities.Despite a broad body of evidence supporting the use of simulation in medicine, there are still some concerns when this evidence is extrapolated to less studied specialties. 5 Simulation training enhances learning, especially when used alongside traditional, apprentice models of training, and it is now increasingly recognised in cardiology and interventional training programs. 6,7 In interventional cardiology the evidence and experience of simulation continues to grow, although presently there are no studies that have documented a positive effect on patient outcomes.As mentioned, many healthcare settings have restricted the weekly working hours for doctors in training due to an increasing demand on cath lab schedules. 8,9 Institutions are becoming risk averse and often limit training opportunities through fear that patient outcomes might be lowered when procedures are undertaken by doctors in training. 1These two factors reduce exposure to practical procedures thus weakening the skills and experience of future specialists. Experience is an essential component of becoming an independent operator.Solutions are therefore required to enhance and increase training opportunities and simulation is one of the most useful practical options. Supervised simulated training experiences away from the bedside in a controlled, authentic environment will allow trainees to explore and develop techniques and consolidate their learning without exposing patients to risk, as has been seen in other medical specialties. The Role of Simulation in Other Medical SpecialtiesSimulation is a long established form of medical training. 10 The early cardio-pulmonary resuscitation dolls are a simple but effective way of delivering the core elements of resuscitation training by providing a safe environment to practise and rehearse tasks, algorithms and al...

National Survey on Training in Pediatric Cardiology by the “Junges Forum” of the DGPK

“…After evaluation of simulator training, fellows reported manual improvement, faster learning, and increased comfort with the procedure of the trainee. [8][9][10][11] In surgical specialties, the independent execution of substeps (within the entire procedure) is done to enhance trainee motivation and help them become gradually adept at complicated procedures. 12,13 This concept could also apply to complex procedures in the catheterization laboratory, whereas simple procedures such as closures of the atrial septal defect, balloon dilatation of coarctation, pulmonary stenosis, or closure of a patent ductus arteriosus could be excellent teaching procedures.…”

COVID-19 and the Digitalisation of Cardiovascular Training and Education—A Review of Guiding Themes for Equitable and Effective Post-graduate Telelearning

“…As an extension from existing efforts, simulation-based teaching (SBT) and learning should also form a greater core in the cardiovascular medicine curriculum (5). Cardiovascular medicine training programmes need a mix of what is required for medical and surgical training, incorporating essential elements that provide training in emergency/acute care scenarios, routine patient care, and also non-invasive/invasive diagnostic and therapeutic procedures (6). Other medical and surgical specialties, at both undergraduate and post-graduate levels, can thus extrapolate educational innovations developed during COVID-19 to training delivery through this pandemic and into the future (7).…”

“…SBT has existed for some time and can be an effective mode of procedural learning especially during these COVID-19 times. Simulator training has widely been accepted as an important tool for procedural training and is seen as an integral future development for interventional cardiology and electrophysiology training programs worldwide (6). After assessment of specific training needs, it can be used to enhance existing skills or to learn new ones.…”

Management of percutaneous coronary intervention complications

“…Simulation training provides trainees with an opportunity to develop technical and non-technical catheterisation/interventional skills without exposing patients to their learning curve 48. Recent evidence supports a role for simulation in accelerating the learning curve with individual/patient and institutional benefits, through reduced radiation exposure and procedural time, respectively 49.…”