Article Text
Abstract
Background Training by the use of simulators and flow models is increasingly integrated into training of young interventionalists and into the launch of new materials in Neurointerventions. There seems general agreement that such an artificial environment is useful but not all aspects of a given intervention can be trained there. We aimed at comparing the practical experience of a given interventionalist and the performance in the skills lab. We hypothesized that there is a strong positive correlation.
Methods We enrolled 26 volunteers with different training background and 2–14 years of experience in Neurointerventions. The subjects were subdivided regarding experiences in thrombectomy, aneurysm coiling, flow diverter and flow disruptor placement as first operator as well as their overall years of practical experience in Neurointerventions. The maximum experience score was 28. We evaluated the skills of the volunteers with a set of four tasks (aneurysm coiling and thrombectomy in a virtual simulator, placement of an intra-aneurysmal flow disruptor and aneurysm coiling in a flow model). The respective procedural times and fluoroscopy times were subdivided in quartiles. The maximum score (procedural times within the lowest quartile in all four procedures) was 100.
Results The median of the practical results was 75% (range 33–100) while the median score of practical experience was 18 (range 7–28). There was no correlation between practical experience and practical results in the simulator/flow model scores (R = 0.03, p > 0.1). Six out of the ten participants with the minimal practical experience had had scores in practical skills better than the median of the entire group. Three of them had perfect practical skill scores (100%). There was no equal score in the more experienced participants.
Discussion This preliminary analysis of our training data reveals surprising insight into the relation between the measured performance in an artificial training environment and actual experience in neurointerventions. The missing correlation between the real-world-practical experience of a given interventionalist and the performance in the skills lab might suggest either a subchallenge or an excessive challenge by the training technologies. The high scores in the less experienced (younger) participants may be explained by influence of genuine computer skills on procedure duration. A subgroup analysis comparing the different procedures and their relation to the required practical experience is currently ongoing and will be presented during the meeting.
Disclosures M. Ernst: None. J. Buhk: 2; C; Codman, Acandis, Sequent. 3; C; Codman, Acandis. A. Froelich: None. J. Fiehler: 1; C; Microvention. 2; C; Acandis, Microvention, Stryker, Codman, Sequent. 3; C; Covidien, Penumbra, Philips.