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SCAI: Medical simulation necessary in interventional cardiology
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The Society for Cardiovascular Angiography and Interventions is calling for expanding and standardizing the use of medical simulation for practicing cardiologists, as well as fellows-in-training.
The authors of the paper, who are part of SCAI’s Simulation Committee, said there is a need for simulation in interventional cardiology, especially for highly complex procedures.
In the paper, which was published recently in Catheterization and Cardiovascular Interventions, the authors outlined the available simulators and simulation-based companies, as well as the use of simulation across the spectrum of interventional cardiology procedures, from diagnostic cardiac catheterization and PCI (including transradial interventions) to structural heart and endovascular interventions.
“Interventional cardiology is particularly well-suited for simulation because the procedures are complex, learning curves can be steep and complications can be life-threatening,” Sandy M. Green, MD, FSCAI, the paper’s lead author and an interventional cardiologist at Geisinger Medical Center in Danville, Penn, said in a press release. “While simulation cannot replace real patient experience, it provides a safe arena to develop and refine skills that improves overall patient care.”
Although the cost of this technology, which can range from $90,000 to $250,000 per simulator, has been a major deterrent to its widespread adoption, Green and colleagues said institutions should pool together resources from several training programs so that simulators could be made available at a shared simulation center for residents. They also wrote that sending trainees to regional simulation centers has been shown to be cost-effective in one study and may be the most cost-effective approach.
Other deterrents cited in the paper include the “dearth of didactic curricula to accompany the psychomotor skill learned on a simulation, the wide variability and/or
lack of consistency that exists among the simulation platforms, and a complete absence of large-scale trials showing that this expensive technology actually improves operators’ skill in the angiography suite and presumably enhances patient outcomes.”
To tackle these hurdles and, ultimately, accelerate the adoption of this novel technology, the authors made the following four recommendations:
- SCAI, in conjunction with the American College of Cardiology and the American Board of Internal Medicine, should develop a set of standardized cases that embodies the essential psychomotor and knowledge base skill sets required to be an interventional cardiologist;
- The standardized cases should be developed and integrated with a standardized didactic curriculum that meets current evidence-based learning standards;
- Large-scale studies should be initiated to evaluate the effect of simulation in a number of key areas, including feasibility, efficacy and reliability; and
- Formal simulation training programs should be included in the annual scientific sessions and integrated into the program for fellows and practicing physicians.
“Simulation is a very helpful tool for physicians who work in an ever-changing technological and procedural environment, like interventional cardiology,” John C. Messenger, MD, FSCAI, associate professor of medicine in the division of cardiology at the University of Colorado, Denver, chair of SCAI’s Simulation Committee and co-author of the paper, said in the release. “Our hope is that these recommendations will encourage the expansion of simulation training programs for fellows and experienced clinicians alike and, as a result, enhance the quality of care we provide patients.”
Disclosure: The researchers report no relevant financial disclosures.
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