Editor's Choice - Development and Testing of Step, Error, and Event Frameworks to Evaluate Technical Performance in...

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Cardiology
• Angiology

Background:

• Competency-based education requires effective tools for endovascular performance assessment.
• Peripheral endovascular interventions (PVI) demand precise evaluation methods.

Purpose of the Study:

• To develop and validate a comprehensive analysis tool for assessing procedural steps, errors, and events in PVI.
• To establish a standardized framework for evaluating endovascular procedural performance.

Main Methods:

• A modified Delphi consensus involving international experts in vascular surgery, interventional radiology, cardiology, and angiology.
• Iterative survey rounds and Likert scale ratings to achieve expert agreement (>70%) and reliability (Cronbach's alpha > 0.7).
• Application of the finalized frameworks to 10 video-recorded elective PVI cases by an experienced endovascular surgeon.

Main Results:

• A consensus panel of 28 experts (29% North America, 71% Europe) was established.
• Finalized frameworks included 15 steps, 26 errors, and 18 events with high expert agreement.
• Analysis of 10 PVI cases identified a median of 55 steps, 27 errors, and 2 events per case.

Conclusions:

• A validated tool for evaluating steps, errors, and events in iliac-femoral-popliteal endovascular procedures was successfully developed.
• The tool, applied to recorded data, can identify hazardous steps, common errors, and significant events.
• This framework offers detailed technical performance feedback to promote procedural mastery among endovascular specialists.