CX 31- Van Herzeele calls for simulation-based endovascular skills training first


Virtual reality simulation, one of the new courses at this year’s Charing Cross Symposium, is a valuable training tool which could lower errors and costs in real life.
After the opening plenary at the CX Symposium on the place and future of virtual reality in endovascular training, Van Herzeele, Gent University Hospital, Belgium, is set to speak as part of the CX Endovascular Simulation Course.

She believes that both novices and established physicians could benefit from simulation-based training to carry out endovascular procedures. “It is essential to modernise education and to move training outside the operating room or interventional suite,” she says.

Van Herzeele, lead author of “The place and future of virtual reality simulation”, set to appear in a book titled Vascular and Endovascular Controversies, edited by Professor Roger Greenhalgh, finds that operators in endovascular techniques must learn to deal with reduced tactile feedback and the increased need for hand-eye co-ordination.

In general, core endovascular skills are acquired by carrying out diagnostic angiograms. However, training opportunities are becoming harder to come by and it is seen that the apprenticeship model is being tested by the increasing complexity of endovascular interventions, concern for patients’ safety and also the diminishing work week of trainees.

While real-life experience cannot be discounted, virtual reality simulation provides a promising opportunity for training and assessment of endovascular skills prior to real life experiences.

Of course, there’s a condition. Van Herzeele points out that, “Simulation-based training will not replace real-life experience.” It can, however, be “an adjunct to teach and improve basic and advanced endovascular technical skills of both novices and experienced interventionalists with the hope of shortening and flattening the learning curve on our patients,” she says.

Also, further work is necessary to evaluate the transferability of the acquired endovascular skills from the virtual reality to the interventional suite, the cost-effectiveness of simulator-based training and how to implement this technology in current training programs.
The CX Endovascular simulation course will take place on Saturday, 4 April at Learning Centre 3.



TEVAR simulation training moves to more complicated cases


Medtronic CardioVascular and Medical Simulation Corporation (MSC) have designed and built a set of simulations to teach physicians the safe and effective use of the Talent Thoracic Stent Graft and practice on TEVAR. The nature of this high-risk, low-volume procedure demands more comprehensive education and simulation training works remarkably well in this case.

The companies say rising demand for its well-established endovascular training programmes that incorporate cutting edge simulation is driving the need to train in more complicated cases such as thoracic dissections and Endurant abdominal aortic aneurysm endograft cases.

The addition of simulation training since late last year has generated more demand than originally expected and both companies have ramped up the number of simulators and training events to meet this demand.

In fact, more than 250 physicians in the United States have currently been trained and checked off to use the Talent Thoracic Stent Graft in practice. Medtronic Europe is in the initial stages of incorporating simulation training into its well-established TEVAR training program.

Highlights of SimSuite

The MSC SimSuite System recreates the actual environment that physicians are accustomed to right down to all of the patient monitors and treatment options available to them in a real patient case.

The company says this environment allows physicians to focus on the educational points of products and procedures, in addition to the technology and potential learning curves of the simulation. In fact, education and training achieved in this set-up allows physicians to acquire and retain the skills and techniques needed for safe and effective treatment.

Other advantages

The Medtronic Talent Thoracic Stent Graft simulations include the following: incorporation of the actual delivery handle, so that trainees get a real hands-on feel of the device; realistic haptics, which create a feeling of delivering the real device; and deployment that mimics device delivery.

Over 100 real-time data points are tracked throughout the simulation on procedural steps achieved, placement of the device, treatment of adverse events, and the recognition and treatment of endoleaks.

This data can then be compiled to provide a quick look at areas in the procedure or device deployment that might be challenging or that might require more training. Simulation data can be looked at in many ways to ensure that educational points are being grasped and retained to protect optimal patient outcomes.

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