Virtual reality training in coronary angiography and its transfer effect to real-life catheterisation lab

The aim of this study was to explore if proficiency-based training in a coronary angiography (CA) simulator can transfer acquired skills from virtual reality (VR) to the real world in order to improve early performance.

Sixteen senior cardiology residents were randomised to proficiency-based VR training or control. Two consecutive CAs were performed on patients. Skills metrics and errors were compared between the groups. Thirty-two CAs were performed under the supervision of an experienced interventionalist. VR-trained residents practised for a mean of 10 hours in a CA simulator. In real life, the VR-trained group had shorter fluoroscopy and total procedure times than the controls (median 558 vs. 842 seconds, p=0.003 and 1,356 vs. 1,623 seconds, p=0.032, respectively). The controls had a higher error score (median 27 vs. 15, p=0.002) and a lower performance score (median 47 vs. 68, p=0.006) than the VR-trained residents.

Simulator-based training in CA improved skills and decreased errors compared to mentor-based training only. CA training in VR resulted in a superior performance, measured by fluoroscopy and total procedure times, and superior error and performance scores, thereby confirming transfer validity. Our recommendation is to incorporate VR training in the curriculum for the general cardiologist to improve safe learning in CA.