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.

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“…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.…”