title: Experienced endovascular interventionalists objectively improve their skills by attending carotid artery stent training courses.
abstract: OBJECTIVE
  Carotid artery stenting (CAS) is an advanced endovascular intervention with a steep learning curve. Virtual reality (VR) simulation has been proposed as a means to train and objectively assess technical performance.
  
  
  OBJECTIVE
  To objectively assess psychomotor skills acquisition of experienced interventionalists attending a two-day CAS course, using a VR simulator.
  
  
  METHODS
  Both cognitive and technical skills of 11 interventionalists were trained in a two-day course using didactic sessions, case reviews, supervised VR simulation and live-cases. Pre- and post-course skills were assessed through performance on the same CAS procedure using metrics derived from the simulator.
  
  
  RESULTS
  Significant differences were noted between pre- and post-course performance for procedure (36 vs. 20min., p=0.005), X-ray (20 vs. 11min., p=0.016) and delivery-retrieval time of the embolic protection device (12 vs. 9min., p=0.007). Advancement of the guiding catheter without a leading wire occurred to a greater extent pre- versus post-course (199 vs. 152mm., p=0.050) as did spasm of the internal carotid artery (4 vs. 2, p=0.049).
  
  
  CONCLUSIONS
  This study has objectively proven a benefit for experienced interventionalists to attend CAS courses for skills acquisition measured by a VR simulator. These data can be used to offer participants an insight into their skills and objectively audit course efficacy.
authors.affiliation: Department of Biosurgery and Surgical Technology, Imperial College London, UK; Regional Vascular Unit, St. Mary's Hospital, London, UK. vhisabelle@gmail.com
authors.forename: I
authors.initials: I
authors.lastname: Van Herzeele
authors.forename: R
authors.initials: R
authors.lastname: Aggarwal
authors.forename: S
authors.initials: S
authors.lastname: Neequaye
authors.forename: M
authors.initials: M
authors.lastname: Hamady
authors.forename: T
authors.initials: T
authors.lastname: Cleveland
authors.forename: A
authors.initials: A
authors.lastname: Darzi
authors.forename: N
authors.initials: N
authors.lastname: Cheshire
authors.forename: P
authors.initials: P
authors.lastname: Gaines
mesh_terms: D000800:Angioplasty, Balloon / Q000193:education*; D016893:Carotid Stenosis / Q000628:therapy*; D002983:Clinical Competence; D003198:Computer Simulation; D003479:Curriculum; D004502:Education, Medical, Continuing; D004521:Educational Measurement; D006801:Humans; D008955:Models, Cardiovascular; D011597:Psychomotor Performance; D015607:Stents; D014584:User-Computer Interface