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Simulation-based endovascular skills assessment: the future of credentialing?
- Source :
-
Journal of vascular surgery [J Vasc Surg] 2008 May; Vol. 47 (5), pp. 1008-1; discussion 1014. Date of Electronic Publication: 2008 Apr 18. - Publication Year :
- 2008
-
Abstract
- Objectives: Simulator-based endovascular skills training measurably improves performance in catheter-based image-guided interventions. The purpose of this study was to determine whether structured global performance assessment during endovascular simulation correlated well with trainee-reported procedural skill and prior experience level.<br />Methods: Fourth-year and fifth-year general surgery residents interviewing for vascular fellowship training provided detailed information regarding prior open vascular and endovascular operative experience. The pretest questionnaire responses were used to separate subjects into low (<20 cases) and moderate (20 to 100) endovascular experience groups. Subjects were then asked to perform a renal angioplasty/stent procedure on the Procedicus Vascular Intervention System Trainer (VIST) endovascular simulator (Mentice Corporation, Gothenburg, Sweden). The subjects' performance was supervised and evaluated by a blinded expert interventionalist using a structured global assessment scale based on angiography setup, target vessel catheterization, and the interventional procedure. Objective measures determined by the simulator were also collected for each subject. A postsimulation questionnaire was administered to determine the subjects' self-assessment of their performance.<br />Results: Seventeen surgical residents from 15 training programs completed questionnaires before and after the exercise and performed a renal angioplasty/stent procedure on the endovascular simulator. The beginner group (n = 8) reported prior experience of a median of eight endovascular cases (interquartile range [IQR], 6.5-17.8; range, 4-20), and intermediate group (n = 9) had previously completed a median of 42 cases (IQR, 31-44; range, 25-89, P = .01). The two groups had similar prior open vascular experience (79 cases vs 75, P = .60). The mean score on the structured global assessment scale for the low experience group was 2.68 of 5.0 possible compared with 3.60 for the intermediate group (P = .03). Scores for subcategories of the global assessment score for target vessel catheterization (P = .02) and the interventional procedure (P = .05) contributed more to the differentiation between the two experience groups. Total procedure time, fluoroscopy time, average contrast used, percentage of lesion covered by the stent, placement accuracy, residual stenosis rates, and number of cine loops utilized were similar between the two groups (P > .05).<br />Conclusion: Structured endovascular skills assessment correlates well with prior procedural experience within a high-fidelity simulation environment. In addition to improving endovascular training, simulators may prove useful in determining procedural competency and credentialing standards for endovascular surgeons.
- Subjects :
- Angioplasty instrumentation
Humans
Motor Skills
Radiography
Renal Artery Obstruction diagnostic imaging
Self-Assessment
Surveys and Questionnaires
Task Performance and Analysis
Treatment Outcome
Angioplasty education
Clinical Competence
Computer Simulation
Credentialing trends
Education, Medical, Continuing methods
Patient Simulation
Renal Artery Obstruction surgery
Stents
Subjects
Details
- Language :
- English
- ISSN :
- 0741-5214
- Volume :
- 47
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of vascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 18372149
- Full Text :
- https://doi.org/10.1016/j.jvs.2008.01.007