title: Technical skills assessment in a coronary angiography simulator for construct validation.
abstract: BACKGROUND
  The aim of this study was to evaluate technical skills in a coronary angiography (CA) simulator to establish the performance level of trainees and experts in virtual CA.The traditional master-apprentice way of learning CA is by practicing on patients despite a known risk for complications during training. Safe CA training is warranted, and simulators might be one possibility. Simulators used must be validated regarding their ability to separate trainees from experts. Construct validation of a CA simulator, to our knowledge, has not yet been published.
  
  
  METHODS
  Ten cardiology residents without experience in CA, 4 intermediate, and 10 CA experts performed 5 CAs in the Mentice VIST (Vascular Intervention Simulation Trainer). Metrics reflecting proficiency skills such as total procedure time, fluoroscopy time, and contrast volume were extracted from the simulator computer and compared between the groups. All examinations were videotaped, and the number of handling errors was examined. The videos were evaluated by 2 experts blinded to the test object's performance level.
  
  
  RESULTS
  Experts outperformed trainees in all metrics measured by the simulator. Improvement was demonstrated in all metrics through all 5 CAs. Furthermore, beginners had more handling errors compared with experts.
  
  
  CONCLUSIONS
  Mentice VIST simulator can distinguish between trainees and experts in CA in the metrics extracted from the computer and therefore prove the concept of construct validity.
authors.affiliation: From the Cardiology Unit (U.J.J., P.T.), Department of Medicine, Karolinska University Hospital; Department of Medicine (J.J.), Sundsvall-Härnösand County Hospital; and Department of Molecular Medicine and Surgery (G.A.), Karolinska Institutet, Karolinska Institutet, Stockholm; and Department of Coronary Heart Disease (G.K.O.), Skåne University Hospital, Lund University, Lund, Sweden.
authors.forename: Ulf J
authors.initials: UJ
authors.lastname: Jensen
authors.forename: Jens
authors.initials: J
authors.lastname: Jensen
authors.forename: Göran K
authors.initials: GK
authors.lastname: Olivecrona
authors.forename: Gunnar
authors.initials: G
authors.lastname: Ahlberg
authors.forename: Per
authors.initials: P
authors.lastname: Tornvall
mesh_terms: D000328:Adult; D002309:Cardiology / Q000193:education*; D002983:Clinical Competence; D003198:Computer Simulation; D003194:Computer-Assisted Instruction / Q000379:methods; D017023:Coronary Angiography / Q000379:methods* / Q000592:standards; D004502:Education, Medical, Continuing / Q000379:methods; D004521:Educational Measurement / Q000379:methods; D006801:Humans; D007396:Internship and Residency / Q000379:methods; D008297:Male; D008348:Manikins; D008875:Middle Aged; D018709:Statistics, Nonparametric; D013548:Sweden