title: Expanding the base for teaching of percutaneous coronary interventions: the explicit approach.
abstract: OBJECTIVE
  Accelerate and improve the training and learning process of operators performing percutaneous coronary interventions (PCI).
  
  
  BACKGROUND
  Operator cognitive, in particular decision-making skills and technical skills are a major factor for the success of coronary interventions. Currently, cognitive skills are commonly developed by three methods: (1) Cognitive learning of rules for which statistical evidence is available. This is very incomprehensive and isolates cognitive learning from skill acquisition. (2) Informal tutoring received from experienced operators, and (3) personal experience by trial-and-error are both very slow.
  
  
  METHODS
  We propose in this concept article a conceptual framework to elicit, capture, and transfer expert PCI skills to complement the current approach. This includes the development of an in-depth understanding of the nature of PCI skills, terminology, and nomenclature needed to streamline communication, propensity of reproducible performance assessment, and in particular an explication of intervention planning and intra-intervention decision-making. We illustrate the impact of improved decision-making by simulation results based on a stochastic model of intervention risk.
  
  
  RESULTS
  We identify several key concepts that form the basis of this conceptual framework, in particular different risk types and the notions of strategy, interventional module, and tactic.
  
  
  CONCLUSIONS
  The increasing complexity of cases have brought PCI to the point where the decision-making skills of master operators need to be made explicit to make them systematically learnable such that the skills of beginner and intermediate operators can be improved much faster than is currently possible.
authors.affiliation: Department of Cardiology, Hospitals and Clinics Bitterfeld/Wolfen, Bitterfeld, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Lanzer
authors.forename: Lutz
authors.initials: L
authors.lastname: Prechelt
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000193:education*; D002983:Clinical Competence; D003071:Cognition; D003142:Communication; D032882:Comprehension; D003198:Computer Simulation; D003479:Curriculum; D003661:Decision Support Techniques; D004503:Education, Medical, Graduate; D019317:Evidence-Based Medicine; D006801:Humans; D007858:Learning; D008611:Mentors; D018570:Risk Assessment; D012307:Risk Factors; D013269:Stochastic Processes; D013663:Teaching / Q000379:methods*; D009626:Terminology as Topic