Simulation-based endovascular skills assessment: the future of credentialing?

Area of Science:

• Medical Education
• Surgical Simulation
• Vascular Surgery

Background:

• Simulator-based training enhances performance in image-guided interventions.
• Assessing trainee skill and experience is crucial for effective surgical education.

Purpose of the Study:

• To evaluate the correlation between structured global performance assessment during endovascular simulation and trainee-reported skill/experience.
• To determine if simulation-based assessment can differentiate between varying levels of endovascular experience.

Main Methods:

• General surgery residents were categorized into low (<20 cases) and moderate (20-100 cases) endovascular experience groups.
• Residents performed a renal angioplasty/stent procedure on the Procedicus Vascular Intervention System Trainer (VIST) simulator.
• Performance was evaluated by a blinded expert using a structured global assessment scale and objective simulator metrics.

Main Results:

• The intermediate experience group (median 42 cases) scored significantly higher (3.60/5.0) than the low experience group (median 8 cases, 2.68/5.0) on global assessment (P=.03).
• Target vessel catheterization and interventional procedure scores were key differentiators between groups (P=.02, P=.05).
• Objective simulator metrics like procedure time and fluoroscopy time did not differ significantly between groups.

Conclusions:

• Structured assessment in high-fidelity simulation correlates well with prior endovascular experience.
• Simulation offers a valuable tool for assessing procedural competency and setting credentialing standards for endovascular surgeons.