Ji Young Buethe MD, Presenter: Nothing to Disclose

Nicholas L. Fulton MD, Abstract Co-Author: Nothing to Disclose

Daniel B. Gans MD, Abstract Co-Author: Nothing to Disclose

Stephen E. Dreyer MD, Abstract Co-Author: Nothing to Disclose

Jon Davidson MD, Abstract Co-Author: Nothing to Disclose

Mark Richard Robbin MD, Abstract Co-Author: Nothing to Disclose

To assess whether high-fidelity simulation-based training is more effective than standard didactics to train radiology residents in IVC filter placement and the perceptive validity of simulation-based training.

This is an IRB approved prospective pilot study using a high-fidelity endovascular simulator. Between 9/1/13-3/1/14, 20 radiology residents (R1-R4) were randomized into a siulation group(SG, n=10) vs a control group (CG, n=10). All underwent a pretest including procedure simulation and written knwledge test. Both groups received didactic resources on IVC filter placement, but only SG underwent 3 simulation training sessions. Both groups underwent a posttest simulation, written test, and a subjective questionnaire. Simulation tests were evaluated by a blinded board certified interventional radiologist using a task-specific checklist and a 5 point Likert scale technical competence score. Total procedure time, fluoroscopy time, and written test scores were also recorded. Non-parametric tests and unpaired two-tailed t test were used to compare performance outcomes between two groups.      

The SG demonstrated significant improvement in all parameters including technical competence (mean +2.1 points; P<0.01), procedure time (-8.08 min; P<0.01); fluoroscopy time (-1.03 min ;P=0.04), and written test score (+26%; P<0.01). The CG demonstrated significant improvement in only the procedure time (-7.21min; P=0.02) and written test score(+18%;P<0.01). Only the difference in technical competence score between the groups reached a statistical significance (P<0.01). Mean survey scores (SG,CG) were as follows: simulation realism(4.7,3.6), confidence after study completion(4.8,3.5), overall utility of simulation-based IVC filter training (4.8,4.2), benefit of simulation training in IR procedures(4.9,4.7). Self-confidence in IVC filter placement significantly improved in SG compared to CG (P<0.01).

Simulation based IVC filter placement training can be more effective than conventional teaching in gaining technical proficiency and self-confidence among radiology residents. This pilot study provides evidence to support further investigation of simulation-based IR training in clinical practice.

Simulation-based IR training may improve procedural skills, physician confidence, decrease procedure time and fluoroscopic time without patient morbidity or trainee radiation exposure.

Buethe, J, Fulton, N, Gans, D, Dreyer, S, Davidson, J, Robbin, M, Effectiveness of Simulation-based IVC Filter Placement Training for Radiology Residents: A Pilot Study.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14004693.html