title: The use of virtual reality for training in carotid artery stenting: a construct validation study.
abstract: BACKGROUND
  Given that carotid artery stenosis (CAS) intervention is procedurally difficult, possesses an extensive learning curve, and involves a grave list of potential complications, construct validation of new non-clinical training devices is of increasing importance.
  
  
  OBJECTIVE
  To evaluate the construct validity of the Procedicus-Virtual Interventional Simulator Trainer (Procedicus-VIST) and its use as a training tool.
  
  
  METHODS
  Sixteen interventionalists (15 males, one female; mean interventional radiology [IR] experience >11 years) and 16 medical students (15 males, one female; no IR experience) received 1 hour of didactic instruction followed by an hour of familiarization training. Subjects then attempted to complete a carotid artery stenting procedure within 1 hour while their performance metrics were recorded. All participants completed a qualitative exit survey of subjective parameters using a visual analog scale.
  
  
  RESULTS
  Procedure and fluoroscopic time was 8.7 and 8.7 min greater in the novice group (P=0.0066 and P=0.0031), respectively. There were no significant differences in performances between the two groups in the remaining metrics of cine loops (number recorded), tool/vessel ratio, coverage percentage, and placement accuracy or residual stenosis. Contrast measurement metrics were found to be too imprecise for statistical analysis. Experienced and novice opinions differed significantly for six of 10 subjective parameters. No statistically significant difference in video-gaming habits was demonstrated.
  
  
  CONCLUSIONS
  With the exception of the metrics of performance time and fluoroscopic use, construct validity of the Procedicus-VIST carotid metrics were not confirmed. Virtual reality simulation as a training method was valued more by novices than by experienced interventionalists.
authors.affiliation: Department of Radiology, Sahlgrenska University Hospital, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden. max_berry@hotmail.com
authors.forename: M
authors.initials: M
authors.lastname: Berry
authors.forename: R
authors.initials: R
authors.lastname: Reznick
authors.forename: T
authors.initials: T
authors.lastname: Lystig
authors.forename: L
authors.initials: L
authors.lastname: Lönn
mesh_terms: D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D004501:Education, Medical / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D015642:Radiology, Interventional / Q000193:education*; D015607:Stents; D014584:User-Computer Interface