Mentored simulation training improves procedural skills in cardiac catheterization: A randomized, controlled pilot study

Background: Despite valuable supplemental training resources for surgical skill acquisition, utility of virtual reality simulators to improve skills relevant to performing cardiac catheterization has not been evaluated. Methods and Results: Post baseline cardiac catheterization performance assessment, 27 cardiology trainees were randomized to either mentored training on a virtual reality simulator (n=12) or no simulator training (control; n=15). Cardiac catheterization performance was reassessed 1 week post baseline assessment. Performance scores at 1 week were compared with baseline within each group, and change in score from baseline to 1 week was compared between groups. Linear regression modeling was performed to assess the effect of simulator training as a function of baseline performance. Technical performance improved postintervention in the simulator group (24 versus 18; P=0.008) and changed marginally in the control group (20 versus 18; P=0.054). Improvement in technical performance was greater in the simulator group (6 versus 1; P=0.04). Global performance improved postintervention in both groups (simulator, 24 versus 17, P=0.01; control, 20 versus 18, P=0.02), with a trend toward greater improvement in the simulator group (5 versus 2; P=0.11). Lower scores at baseline were associated with larger differences in postintervention scores between the simulator and control groups (technical performance, P=0.0006; global performance, P<0.0001). Conclusions: Skills required to perform cardiac catheterization can be learned via mentored simulation training and are transferable to actual procedures in the catheterization laboratory. Less proficient operators derive greater benefit from simulator training than more proficient operators.