title: Retrospective study of the impact of fellowship training on two quality and safety measures in uterine artery embolization.
abstract: OBJECTIVE
  To measure the impact of 1-year interventional fellowship training on fluoroscopic time and contrast media utilization in uterine artery embolization (UAE).
  
  
  METHODS
  Retrospective single institution analysis of 323 consecutive UAEs performed by 12 interventional fellows using a standardized protocol. Fluoroscopy time and contrast media volume were recorded for each patient and correlated with stage of fellowship training. Preprocedure uterine volume (using MRI or ultrasound) was used as a measure of procedural complexity. Regression analysis was conducted per trainee factoring in duration of training, procedure number, supervising radiologist, uterine volume, and outcome variables of fluoroscopy time and contrast media volume.
  
  
  RESULTS
  Median number of patients treated per trainee was 27 (range, 16-43) with mean fluoroscopic time 24.5 minutes (range, 4-90 min) and mean contrast volume 190 mL (range, 50-320 mL). Increasing uterine volume had no significant effect (P > .05) on fluoroscopic time but significantly increased (P < .001) contrast media volume. Significant training effect was identified with decrease in fluoroscopic time (P < .001) and decrease in contrast volume (P = .02) over training. Over the course of a 1-year fellowship, these summed to a decrease of 12 minutes in UAE fluoroscopy time and 17 mL less contrast.
  
  
  CONCLUSIONS
  A significant (P < .05) training effect that is clinically relevant was demonstrated over the course of a yearlong interventional radiology fellowship program in performance of a standardized protocol for UAE. This data supports fellowship training as a basis for UAE credentialing and privileging.
authors: Department of Radiology, Vancouver General Hospital, Vancouver, Canada.
authors: Sam
authors: S
authors: Stuart
authors: Department of Radiology, Vancouver General Hospital, Vancouver, Canada.
authors: John R
authors: JR
authors: Mayo
authors: Department of Radiology, Vancouver General Hospital, Vancouver, Canada.
authors: Alden
authors: A
authors: Ling
authors: Department of Radiology, Vancouver General Hospital, Vancouver, Canada.
authors: Michael
authors: M
authors: Schulzer
authors: Department of Radiology, Vancouver General Hospital, Vancouver, Canada.
authors: Darren
authors: D
authors: Klass
authors: Department of Radiology, Vancouver General Hospital, Vancouver, Canada.
authors: Mark A
authors: MA
authors: Power
authors: Department of Radiology, Vancouver General Hospital, Vancouver, Canada.
authors: Benjamin J
authors: BJ
authors: Roberton
authors: Department of Radiology, Vancouver General Hospital, Vancouver, Canada.
authors: J M
authors: JM
authors: Wan
authors: Department of Radiology, Vancouver General Hospital, Vancouver, Canada. Electronic address: Dave.Liu@vch.ca.
authors: David M
authors: DM
authors: Liu
mesh_terms: D002983:Clinical Competence; D003287:Contrast Media / Q000008:administration & dosage; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement; D005257:Fellowships and Scholarships; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D015642:Radiology, Interventional / Q000193:education*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014283:Triiodobenzoic Acids; D018084:Ultrasonography, Interventional; D055357:Uterine Artery Embolization / Q000193:education* / Q000592:standards
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C054871:ioversol
keywords: Credentialing; interventional; radiation; training; uterine artery embolization