Superiority of Simulator-Based Training Compared With Conventional Training Methodologies in the Performance of Transseptal Catheterization

• Published in: Journal of the American College of Cardiology Vol. 58; no. 4; pp. 359 - 363
• Main Authors: De Ponti, Roberto, MD, Marazzi, Raffaella, MD, Ghiringhelli, Sergio, MD, Salerno-Uriarte, Jorge A., MD, Calkins, Hugh, MD, Cheng, Alan, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 19.07.2011; Elsevier; Elsevier Limited
• Subjects: Adult; atrial fibrillation ablation; Biological and medical sciences; Cardiac Catheterization - methods; Cardiac Electrophysiology - education; Cardiology; Cardiology. Vascular system; Cardiovascular; catheter ablation; Catheters; Computer Simulation; Electrophysiology; Female; Higher education; Humans; Internal Medicine; Internship and Residency; Intubation; Male; Medical sciences; Objectives; Patient safety; Patients; simulator training; Software; Statistical analysis; Supervision; Supervisors; transseptal catheterization; Ultrasonic imaging; Virtual reality; TSP-C; atrial fibrillation ablation; transseptal catheterization; catheter ablation; Sim-T; conventional training; simulator training; Conv-T; Performance evaluation; Catheterization; Methodology; Circulatory system; Cardiology; Performance; Simulator; Comparative study
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2011.02.063

Objectives This study aims to compare the performance of electrophysiology fellows in transseptal catheterization (TSP-C) after conventional (Conv-T) or simulator training (Sim-T). Background Current training for TSP-C, an increasingly used procedure, relies on performance on patients with supervision by an experienced operator. Virtual reality, a new training option, could improve post-training performance. Methods Fellows inexperienced in TSP-C were enrolled and randomly assigned to Conv-T or Sim-T. The post-training performance of each fellow was evaluated and scored in 3 consecutive patient-based procedures by an experienced operator blinded to the fellow's training assignment. Results Fourteen fellows were randomized to Conv-T (n = 7) or to Sim-T (n = 7) and, after training, performed 42 TSP-Cs independently. Training time was significantly longer for Conv-T than for Sim-T (median 30 days vs. 4 days; p = 0.0175). The Conv-T fellows had significantly lower post-training performance scores (median 68 vs. 95; p = 0.0001) and a higher number of recurrent errors (median 3 vs. 0; p = 0.0006) when compared with Sim-T fellows. Conclusions The TSP-C training with virtual reality results in shorter training times and superior post-training performance.