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December 23, 2005
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David L. Dawson, MD1, Jennifer Meyer2, Eugene S. Lee, MD, PhD1, William C. Pevec, MD1.
1University of California, Davis, Sacramento, CA, USA, 2Medical Simulation Corporation, Sacramento, CA, USA.
OBJECTIVES: Endovascular procedure simulators have been accepted as useful for training. The purpose of this study was to evaluate the role of simulation-based training in vascular surgery residencies.
METHODS: Residents from vascular surgery programs in a five-state area were invited to participate in a series of two-day endovascular training programs that utilized a high-fidelity endovascular procedure simulator (SimSuite®, Medical Simulation Corp, Denver, CO), didactic instruction, computer-based training, and tabletop procedure demonstrations. The curriculum covered arteriography and intervention for treatment of aortoiliac, renal, and carotid artery disease. Nine residents participated, with one to three per training session. Each completed an average of 9.5 simulated endovascular cases. Performance on a standardized TASC B iliac angioplasty/stenting case was used to assess endovascular skills and knowledge at the beginning of the training program and this was repeated at completion of the training. Performance metrics were measured by the simulator, faculty observed trainees’ performance of simulated cases, and trainees provided their evaluations of the usefulness of the simulation experiences.
RESULTS: Endovascular procedural skills on the standardized iliac intervention case improved after completion of the training program. Compared to performance early on Day 1, key measures were improved. Expressed as percent change from each individual’s initial performance value (mean change from baseline), the following all improved (p less than or equal to 0.05, paired t-tests): total procedure time -53.7%, volume of contrast -43.5%, and fluoroscopy time -48.1%. Selection of angioplasty balloon catheters and stents was improved, the average number of catheters used and stents deployed decreased, though not reaching statistical significance. Faculty observation allowed identification of shortcomings of knowledge and skills, including common problems with selection of catheter, balloon, and stent sizes; correct positioning of the sheath; and intra-procedural monitoring.
CONCLUSIONS: Training with a simulator, incorporated into an individual or small group learning session, offers a risk-free means to realistically practice endovascular procedures. Essential procedural skills can be learned and practiced. Both objective metrics and subjective assessments suggest a substantial improvement in physician performance. Post-course evaluations indicated support for the use of simulation in vascular surgery residents’ endovascular training.
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Training with Simulation Improves Residents’ Endovascular Procedure Skills
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David L. Dawson, MD1, Jennifer Meyer2, Eugene S. Lee, MD, PhD1, William C. Pevec, MD1.
1University of California, Davis, Sacramento, CA, USA, 2Medical Simulation Corporation, Sacramento, CA, USA.
OBJECTIVES: Endovascular procedure simulators have been accepted as useful for training. The purpose of this study was to evaluate the role of simulation-based training in vascular surgery residencies.
METHODS: Residents from vascular surgery programs in a five-state area were invited to participate in a series of two-day endovascular training programs that utilized a high-fidelity endovascular procedure simulator (SimSuite®, Medical Simulation Corp, Denver, CO), didactic instruction, computer-based training, and tabletop procedure demonstrations. The curriculum covered arteriography and intervention for treatment of aortoiliac, renal, and carotid artery disease. Nine residents participated, with one to three per training session. Each completed an average of 9.5 simulated endovascular cases. Performance on a standardized TASC B iliac angioplasty/stenting case was used to assess endovascular skills and knowledge at the beginning of the training program and this was repeated at completion of the training. Performance metrics were measured by the simulator, faculty observed trainees’ performance of simulated cases, and trainees provided their evaluations of the usefulness of the simulation experiences.
RESULTS: Endovascular procedural skills on the standardized iliac intervention case improved after completion of the training program. Compared to performance early on Day 1, key measures were improved. Expressed as percent change from each individual’s initial performance value (mean change from baseline), the following all improved (p less than or equal to 0.05, paired t-tests): total procedure time -53.7%, volume of contrast -43.5%, and fluoroscopy time -48.1%. Selection of angioplasty balloon catheters and stents was improved, the average number of catheters used and stents deployed decreased, though not reaching statistical significance. Faculty observation allowed identification of shortcomings of knowledge and skills, including common problems with selection of catheter, balloon, and stent sizes; correct positioning of the sheath; and intra-procedural monitoring.
CONCLUSIONS: Training with a simulator, incorporated into an individual or small group learning session, offers a risk-free means to realistically practice endovascular procedures. Essential procedural skills can be learned and practiced. Both objective metrics and subjective assessments suggest a substantial improvement in physician performance. Post-course evaluations indicated support for the use of simulation in vascular surgery residents’ endovascular training.
Back to Annual Meeting
Back to Program
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