Using simulation for interventional radiology training

Abstract

ABSTRACT. Debate on the existence of innate skills has all but evaporated in the light of evidence that it is only the hours spent in deliberate practice that correlate with even the most elite levels of expertise. A range of simple to advanced technologies stands to address some of the many challenges to effective training of 21st century, procedural medicine. Simulation could train and assess behaviours remotely from patients, in complete safety, reducing the risks of inexperienced trainees learning critical tasks in patients while contributing to certification and revalidation. Understanding the strengths and limitations of these devices, determining and improving their effectiveness and identifying their roles, as well as those of individuals and teams, represents a cornerstone of successful adoption into the interventional radiology curriculum. This requires a simulation strategy that includes standards for simulator documentation.

Simulator based angiography education in neurosurgery: results of a pilot educational program: Table 1

“…Finally, there are data suggesting that even skilled interventional practitioners continue to benefit from simulation courses even after independent clinical practice 20. Therefore, a thorough understanding of the strengths and limitations of simulation devices is necessary such that the implementation of simulator based training into residency education can be optimized 21 22. The greatest limitations to simulator based education are the potential incongruence of simulator skills with actual clinical skills, high cost and poor tactile or haptic feedback.…”

Human Thiel-Embalmed Cadaveric Aortic Model with Perfusion for Endovascular Intervention Training and Medical Device Evaluation

“…This approach uniquely provides arterial access from the common femoral arteries and potentially other peripheral vessels to conduct interventions. A great advantage of this model is pulsatile flow within the vessels which allows palpation or ultrasound identification of target vessels followed by standard vascular access technique, providing a closer simulation of the human experience in comparison with animal models, or synthetic and virtual models [10]. Simple virtual training simulators such as Mentice (VIST LAB, Mentice AB, Gothenburg, Sweden) and anatomical simulators with fluoroscopic imaging, such as silicon vascular phantoms (Elstrat, Switzerland), are beneficial tools for gaining basic interventional skills and procedural knowledge but are limited to individual learning and do not provide the complexity of human anatomy, the haptic properties and realism of clinical simulation that the cadaveric model can provide (Table 3).…”

Simulation-based surgical education

“…Maran and Glavin describe two types of simulator fidelity: physical or engineering fidelity, which describes the replication of the physical characteristics of the real task, and psychological fidelity, which describes the reality of representation of the real task skills by the simulation. Continuous research and technological developments attempt to improve the levels of fidelity by improving the visual and haptic representations of the simulated task . Any increase in engineering fidelity leads to an increase in computational power demands and cost, creating a challenge for developers to create simulators that have the appropriate physical fidelity with the least computational power and cost, so that the simulator can be made widely available.…”

“…Surgical training has traditionally been based on long apprenticeships, during which trainees learned in the workplace by practising on patients, supervised by their mentors. Contemporary circumstances, such as the introduction of the European Working Time Directive, shorter training duration and shorter patient admission times, have reduced the time available for apprenticeship training …”