Validation of a High-Fidelity Electrophysiology Simulator and Development of a Proficiency-Based Simulator Training Program.
BACKGROUND
Simulator training can potentially provide high-intensity training in electrophysiology (EP) without compromising patient safety. We assessed the construct validity of a novel EP simulator (ANGIO Mentor; Simbionix) and developed proficiency-based scores for clinical EP simulator training.


METHODS
Two European training centers participated. Participants were grouped on the basis of years of EP experience and (for a subset) subjectively scored clinical catheter manipulation skills. Each participant attempted the simulator's 5 modules 3 times. These modules focus on catheter manipulation in 3-dimensional models, ranging from geometric shapes to fluoroscopic contracting cardiac models, with performance scored by the system on the basis of attainment of preset targets. Using these scores, targets were formulated for basic EP training.


RESULTS
Twenty-eight participants were included (13 with subjectively scored catheter manipulation). Scores for participants with less than 1-year EP experience (group 1) were significantly lower for each of the attempts at the modules (P < 0.002). For group 1 only, scores improved with subsequent attempts (P < 0.005). In 4 of the 5 modules, scores of group 1 were significantly lower than the more experienced groups (P < 0.0005). Participants with subjectively scored above-average catheter manipulation skills also had higher scores in 4 of the 5 modules (P < 0.05). Target scores for a proficiency-based training program were generated from the median scores for each module for those with 1-year experience or more.


CONCLUSIONS
Scores attained in the simulator can distinguish those with less than 1-year EP experience and those with above-average catheter manipulation skills. Consequently, target scores have been generated for a proficiency-based training program.
From the Cardiovascular Biomedical Research Unit (W.U., R.J.H., M.F., M.J.E., A.M., R.J.S.), Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK; and Department of Heart and Vessels (R.M., R.D.P.), Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy.
Waqas
W
Ullah
Ross J
RJ
Hunter
Malcolm
M
Finlay
Mark J
MJ
Earley
Ailsa
A
McLean
Raffaella
R
Marazzi
Roberto
R
De Ponti
Richard J
RJ
Schilling
D002983:Clinical Competence / Q000592:standards*; D003198:Computer Simulation; D004594:Electrophysiology; D006801:Humans; D007396:Internship and Residency; D000066908:Simulation Training / Q000592:standards*