Statement details key skills endovascular specialists need to treat CLTI
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The Society for Cardiovascular Angiography and Interventions published a position statement that details key skills needed by all endovascular specialists who care for patients with chronic limb-threatening ischemia.
Published in the Journal of the Society for Cardiovascular Angiography & Interventions, the document spotlights specific key skills categorized into six core competencies and provides examples of fundamental and advanced skill sets for the treatment of chronic limb-threatening ischemia (CLTI), also known as critical limb ischemia.
The position statement was endorsed by the American College of Radiology, the American Podiatric Medical Association, SCAI, the Society of Interventional Radiology, the Society for Vascular Medicine, the Society for Vascular Surgery, the Society for Clinical Vascular Surgery and the Vascular & Endovascular Surgical Society.
“Care for patients with CLTI is typically complex, multifaceted and multidisciplinary. Standardizing expected competencies for endovascular specialists is an important step to ensure that patient-centric and evidence-based therapy is delivered,” Beau M. Hawkins, MD, FSCAI, assistant professor of medicine at The University of Oklahoma Health Sciences Center and chair of the writing group for the document, said in a press release. “This new framework is a starting point to enable training programs, professional medical societies and other entities to develop curricula that address the needs of this unique patient population.”
The six core competencies
The key skills were categorized into six core competencies based on the framework set down by the Accreditation Council for Graduate Medical Education: medical knowledge patient care and procedural skills; systems-based practice; practice-based learning and improvement; interpersonal and communication skills; and professionalism.
Below are some of the key skills recommended in each of the six core competencies for endovascular specialists treating patients with CLTI.
Core medical knowledge recommended in the statement included, and was not limited to:
- knowledge of peripheral arterial anatomy;
- the causes, epidemiology and natural history of CLTI; and
- the indications for noninvasive testing for patients with suspected or established CLTI.
Some of the core patient care and procedural skills recommended in the statement included:
- the performance of a focused history and physical examination of patients with CLTI;
- interpreting of noninvasive vascular imaging, physiologic and perfusion testing before and after revascularization procedures in the setting of CLTI; and
- prescribing medical therapy before and after revascularization to mitigate CV risk and optimize limb outcomes.
In the context of system-based practice, the statement recommended physicians utilize an interdisciplinary and coordinated approach to management of CLTI as well as cost-awareness and risk-benefit analysis.
Instructions for practice-based learning and improvement included the following:
- Identifying and acting on performance gaps found through review of studies, registries and guidelines;
- participating in initiatives for quality improvement; and
- participating in endeavors aimed at improving the care of patients with CLTI.
Interpersonal and communication skills for endovascular specialists included improved communication and education of patients and families across from diverse populations and communication with various professionals on the CLTI team.
Recommendations for professionalism specified in the document instruct physicians to:
- only practice within the reach of expertise and technical skills;
- promote adherence to guidelines and appropriate use criteria; and
- interact with respect and integrity with patients, families and all members of the CLTI team.
‘Unprecedented collaborative effort’
“This unprecedented collaborative effort among these eight multidisciplinary medical societies is another step forward toward advancing care for patients with CLTI,” Mehdi Shishehbor, DO, MPH, PhD, FSCAI, president of the Harrington Heart & Vascular Institute, University Hospitals Cleveland, and co-chair of the writing group, said in the release. “I hope that these efforts will evolve and translate into better care for these high-risk patients at risk of limb loss.”
Please see the document for full details on the SCAI position statement.
Reference:
- SCAI releases multi-society position statement focused on core competencies for endovascular specialists providing care for CLTI. Published April 25, 2022. Accessed April 25, 2022.
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Hawkins BM, et al. J Soc Cardiovasc Angiography Interv. 2022;doi:10.1016/j.jscai.2021.100015.
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