Surgical skill simulation training to proficiency reduces procedural errors among novice cardiac device implanters: a...

Area of Science:

• Cardiovascular Medicine
• Surgical Education
• Medical Simulation

Background:

• Cardiac device implantation requires both surgical expertise and catheter manipulation skills.
• Formal surgical training is often lacking for cardiologists, leading to on-the-job skill acquisition with variable techniques.
• Suboptimal surgical approaches in device implantation can increase complication rates.

Purpose of the Study:

• To investigate the impact of a novel proficiency-based progression (PBP) simulation training on the surgical quality of cardiac device implantations.
• To compare the effectiveness of PBP training against traditional simulation (SIM) training for novice implanters.

Main Methods:

• An international prospective study randomized novice implanters to either PBP or SIM training.
• Trainees performed simulated implantations on porcine tissue, with videos scored by blinded assessors using validated metrics.
• Primary outcomes included procedural steps completed, critical errors, non-critical errors, and total errors.

Main Results:

• The PBP group completed 11% more procedural steps and made significantly fewer critical errors (61.2% reduction) and total errors (60.7% reduction) compared to the SIM group.
• 73% of PBP trainees met predefined performance standards, versus only 20% of SIM trainees.
• Baseline experiences were similar between the two groups.

Conclusions:

• Proficiency-based progression (PBP) simulation training yields superior surgical performance in novice cardiac device implanters compared to traditional simulation (SIM) training.
• Systematic integration of PBP training into academic surgical skills curricula is recommended prior to in vivo practice.
• Further research is needed to assess PBP training's impact on device-related surgical complications.