Effect of Metrics-Based Simulation Training to Proficiency on Procedure Quality and Errors Among Novice Cardiac...

Area of Science:

• Medical Education and Training
• Cardiovascular Interventions
• Surgical Simulation

Background:

• Current cardiac device implant training lacks objective assessment of trainee proficiency before patient procedures.
• This gap exposes patients to risks associated with the early learning curve of operators.
• There is a need for standardized, performance-based evaluation in surgical training.

Purpose of the Study:

• To evaluate the impact of a novel metrics-based simulation training (proficiency-based progression [PBP]) on cardiac implant performance quality.
• To compare PBP training against traditional simulation-based training (SBT).

Main Methods:

• A prospective randomized trial involving novice cardiac device implanters.
• Participants were randomized to either PBP (requiring proficiency demonstration at each stage) or SBT (standard simulation training).
• Performance was assessed via virtual reality simulation of a cardiac resynchronization therapy (CRT) implant, with video recordings scored using validated metrics.

Main Results:

• The PBP group demonstrated significantly better performance, completing 27% more procedural steps and making 73% fewer errors compared to the SBT group.
• Critical errors were reduced by 84% and combined errors by 77% in the PBP group.
• 93% of PBP trainees achieved the predefined performance level, versus 0% in the SBT group.

Conclusions:

• Proficiency-based progression (PBP) training leads to superior objectively assessed performance in novice cardiac device implanters compared to traditional simulation-based training (SBT).
• Systematic implementation of PBP training can establish safe and effective performance standards prior to supervised in vivo practice.
• Further research is warranted to confirm the impact of PBP on reducing procedure-related patient complications.