title: Porcine transfer study: virtual reality simulator training compared with porcine training in endovascular novices.
abstract: OBJECTIVE
  To compare the learning of endovascular interventional skills by training on pig models versus virtual reality simulators.
  
  
  METHODS
  Twelve endovascular novices participated in a study consisting of a pig laboratory (P-Lab) and a virtual reality laboratory (VR-Lab). Subjects were stratified by experience and randomized into four training groups. Following 1 hr of didactic instruction, all attempted an iliac artery stenosis (IAS) revascularization in both laboratories. Onsite proctors evaluated performances using task-specific checklists and global rating scales, yielding a Total Score. Participants completed two training sessions of 3 hr each, using their group's assigned method (P-Lab x 2, P-Lab + VR-Lab, VR-Lab + P-Lab, or VR-Lab x 2) and were re-evaluated in both laboratories. A panel of two highly experienced interventional radiologists performed assessments from video recordings. ANCOVA analysis of Total Score against years of surgical, interventional radiology (IR) experience and cumulative number of P-Lab or VR-Lab sessions was conducted. Inter-rater reliability (IRR) was determined by comparing proctored scores with the video assessors in only the VR-Lab.
  
  
  RESULTS
  VR-Lab sessions improved the VR-Lab Total Score (beta = 3.029, p = 0.0015) and P-Lab Total Score (beta = 1.814, p = 0.0452). P-Lab sessions increased the P-Lab Total Score (beta = 4.074, p < 0.0001) but had no effect on the VR-Lab Total Score. In the general statistical model, both P-Lab sessions (beta = 2.552, p = 0.0010) and VR-Lab sessions (beta = 2.435, p = 0.0032) significantly improved Total Score. Neither previous surgical experience nor IR experience predicted Total Score. VR-Lab scores were consistently higher than the P-Lab scores (Delta = 6.659, p < 0.0001). VR-Lab IRR was substantial (r = 0.649, p < 0.0008).
  
  
  CONCLUSIONS
  Endovascular skills learned in the virtual environment may be transferable to the real catheterization laboratory as modeled in the P-Lab.
authors.affiliation: Department of Interventional Radiology, Sahlgrenska Hospital, Gothenburg, Sweden. max_berry@hotmail.com
authors.forename: Max
authors.initials: M
authors.lastname: Berry
authors.forename: Ted
authors.initials: T
authors.lastname: Lystig
authors.forename: Jonathan
authors.initials: J
authors.lastname: Beard
authors.forename: Hans
authors.initials: H
authors.lastname: Klingestierna
authors.forename: Richard
authors.initials: R
authors.lastname: Reznick
authors.forename: Lars
authors.initials: L
authors.lastname: Lönn
mesh_terms: D000328:Adult; D000800:Angioplasty, Balloon / Q000193:education*; D000818:Animals; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D001291:Attitude of Health Personnel; D003198:Computer Simulation; D003479:Curriculum; D004195:Disease Models, Animal; D005260:Female; D006801:Humans; D007083:Iliac Artery; D008297:Male; D008875:Middle Aged; D015642:Radiology, Interventional / Q000193:education*; D015607:Stents; D013552:Swine; D014584:User-Computer Interface