title: Introducing transapical aortic valve implantation (part 2): institutional structured training program.
abstract: OBJECTIVE
  Introduction of a new procedure has a typical learning curve with the "learning phase" at the beginning, characterized by an increased mortality or complication rate. We developed our institutional structured training program for transcatheter aortic valve implantation (TAVI) with the aim of eliminating these negative effects.
  
  
  METHODS
  The program regulated the introduction of TAVI and building and training of the team. It combines cumulative knowledge from the field with the institutional and individual background experience. It includes stepwise acquisition of the tools necessary for the preoperative strategic planning, perioperative team communication, technical aspects of the procedure, and postoperative management. The program establishes a basis for interaction and feedback between the members of the team ("teach and learn"; "be proctor and proctored").
  
  
  RESULTS
  The program consists of 4 main parts: general principles, team building, team education and training, and the institutional clinical and procedural policies. The program possesses several control mechanisms, eg, occasional external proctoring. Additionally, a chain of steps spontaneously generates further procedural improvements and optimizes the overall outcome. The program has also had a global positive effect on the local institutional environment, awaking awareness of existing latent conditions and active failures, identifying them and inducing their correction, which has led to general clinical improvement.
  
  
  CONCLUSIONS
  A structured educational training program enables implementation of a new procedure (TAVI) into clinical practice without increased morbidity and mortality rate during the learning curve. The program may also be used as a basis for any new device introduction into clinical practice.
authors: Deutsches Herzzentrum Berlin, Berlin, Germany. Electronic address: pasic@dhzb.de.
authors: Miralem
authors: M
authors: Pasic
authors: Deutsches Herzzentrum Berlin, Berlin, Germany.
authors: Axel
authors: A
authors: Unbehaun
authors: Deutsches Herzzentrum Berlin, Berlin, Germany.
authors: Stephan
authors: S
authors: Dreysse
authors: Deutsches Herzzentrum Berlin, Berlin, Germany.
authors: Semih
authors: S
authors: Buz
authors: Deutsches Herzzentrum Berlin, Berlin, Germany.
authors: Thorsten
authors: T
authors: Drews
authors: Deutsches Herzzentrum Berlin, Berlin, Germany.
authors: Marian
authors: M
authors: Kukucka
authors: Deutsches Herzzentrum Berlin, Berlin, Germany.
authors: Alexander
authors: A
authors: Mladenow
authors: Deutsches Herzzentrum Berlin, Berlin, Germany.
authors: Roland
authors: R
authors: Hetzer
authors: Deutsches Herzzentrum Berlin, Berlin, Germany.
authors: Giuseppe
authors: G
authors: D'Ancona
mesh_terms: D001021:Aortic Valve / Q000601:surgery*; D057189:Checklist; D003479:Curriculum; D019918:Heart Valve Prosthesis Implantation / Q000193:education* / Q000379:methods*; D006801:Humans