title: Simulation improves resident performance in catheter-based intervention: results of a randomized, controlled study.
abstract: OBJECTIVE
  Surgical simulation has been shown to enhance the training of general surgery residents. Since catheter-based techniques have become an important part of the vascular surgeon's armamentarium, we explored whether simulation might impact the acquisition of catheter skills by surgical residents.
  
  
  METHODS
  Twenty general surgery residents received didactic training in the techniques of catheter intervention. Residents were then randomized with 10 receiving additional training with the Procedicus, computer-based, haptic simulator. All 20 residents then participated in 2 consecutive mentored catheter-based interventions for lower extremity occlusive disease in an OR/angiography suite. Resident performance was graded by attending surgeons blinded to the resident's training status, using 18 procedural steps as well as a global rating scale.
  
  
  RESULTS
  There were no differences between the 2 resident groups with regard to demographics or scores on a visuospatial test administered at study outset. Overall, residents exposed to simulation scored higher than controls during the first angio/OR intervention: procedural steps (simulation/control) (50 +/- 6 vs. 33 +/- 9, P = 0.0015); global rating scale (30 +/- 7 vs. 19 +/- 5, P = 0.0052). The advantage provided by simulator training persisted with the second intervention (53 +/- 6 vs. 36 +/- 7, P = 0.0006); global rating scale (33 +/- 6 vs. 21 +/- 6, P = 0.0015). Moreover, simulation training, particularly for the second intervention, led to enhancement in almost all of the individual measures of performance.
  
  
  CONCLUSIONS
  Simulation is a valid tool for instructing surgical residents and fellows in basic endovascular techniques and should be incorporated into surgical training programs. Moreover, simulators may also benefit the large number of vascular surgeons who seek retraining in catheter-based intervention.
authors.affiliation: Columbia University, Weill Cornell Division of Vascular Surgery, New York Presbyterian Hospital, New York, NY 10021, USA.
authors.forename: Rabih A
authors.initials: RA
authors.lastname: Chaer
authors.forename: Brian G
authors.initials: BG
authors.lastname: Derubertis
authors.forename: Stephanie C
authors.initials: SC
authors.lastname: Lin
authors.forename: Harry L
authors.initials: HL
authors.lastname: Bush
authors.forename: John K
authors.initials: JK
authors.lastname: Karwowski
authors.forename: Daniel
authors.initials: D
authors.lastname: Birk
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Morrissey
authors.forename: Peter L
authors.initials: PL
authors.lastname: Faries
authors.forename: James F
authors.initials: JF
authors.lastname: McKinsey
authors.forename: K Craig
authors.initials: KC
authors.lastname: Kent
mesh_terms: D000792:Angiography; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000628:therapy*; D002406:Catheterization, Peripheral / Q000592:standards*; D003198:Computer Simulation; D006801:Humans; D007083:Iliac Artery; D007396:Internship and Residency / Q000592:standards*; D011795:Surveys and Questionnaires; D014656:Vascular Surgical Procedures / Q000193:education* / Q000379:methods