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Feature


Bridging the gaps


The role of simulation in interventional radiology training By Andrew Kesselman, MD, and Ronald Winokur, MD, FSIR


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major challenge at many academic teaching hospitals is providing a balance of trainee hands-on experience and education while maintaining patient safety and confidence in their providers. In addition to procedural education challenges, the evolution of new interventional procedures or techniques requires a learning curve for experienced practitioners to gain skill and confidence. A similar challenge exists in low- to middle-income countries where a lack of skilled practitioners and resources can limit the widespread availability of interventional radiology services.


Incorporating simulation into education can bridge the gaps in trainee


12 IRQ | SUMMER 2020


procedural training, reduce the learning curve for new procedures and allow access to hands-on training in areas of the world where it is otherwise difficult to gain technical skills. Many of these challenges have been highlighted during the recent COVID-19 pandemic, which may open the door to broader inclusion of simulation in IR training programs.


Benefits of simulated education Simulated education first became popular as a part of flight training and has since been utilized in both procedure-based and surgical training for skill acquisition in laparoscopic surgery, colonoscopy, bronchoscopy, endovascular aortic repair (EVAR) and ultrasound-guided needle placement.


The effect of simulation in these procedural areas includes decreased procedure time, increased accuracy, decreased errors in laparoscopic surgery, decreased senior assistance, improved ability to identify endoscopic landmarks, improved technical skill acquisition in ultrasound guidance, decreased procedure time in EVAR and fewer endoleaks.


Simulation-based training reinforces real world experiences with mock experiences that can lead to improved technical performance through repetition, identification of skills and behavior, and objective feedback that may not be available in the clinical environment. Educational programming can be modified to teach specific skills or to perform entire procedures for assessment of knowledge and proficiency. Additionally, the simulator can provide guidance on procedural steps, anatomy and catheter selection to help junior trainees overcome the initial barriers required for performance in live patient procedures. In order to advance the apprenticeship model of medicine, research demonstrating the added value of simulation to bolster the safety,


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