Simulation center training as a means to improve resident performance in percutaneous noncontinuous CT-guided fluoroscopic procedures with dose reduction
Mendiratta-Lala M, Williams TR, Mendiratta V, Ahmed H, and Bonnett JW. Simulation center training as a means to improve resident performance in percutaneous noncontinuous ct-guided fluoroscopic procedures with dose reduction. AJR Am J Roentgenol 2015; 204(4):W376-383.
AJR. American journal of roentgenology
OBJECTIVE: The purpose of this study was to evaluate the effectiveness of a multifaceted simulation-based resident training for CT-guided fluoroscopic procedures by measuring procedural and technical skills, radiation dose, and procedure times before and after simulation training.
SUBJECTS AND METHODS: A prospective analysis included 40 radiology residents and eight staff radiologists. Residents took an online pretest to assess baseline procedural knowledge. Second-through fourth-year residents' baseline technical skills with a procedural phantom were evaluated. First-through third-year residents then underwent formal didactic and simulation-based procedural and technical training with one of two interventional radiologists and followed the training with 1 month of supervised phantom-based practice. Thereafter, residents underwent final written and practical examinations. The practical examination included essential items from a 20-point checklist, including site and side marking, consent, time-out, and sterile technique along with a technical skills portion assessing pedal steps, radiation dose, needle redirects, and procedure time.
RESULTS: The results indicated statistically significant improvement in procedural and technical skills after simulation training. For residents, the median number of pedal steps decreased by three (p=0.001), median dose decreased by 15.4 mGy (p
CONCLUSION: CT simulation training decreases procedural time, decreases radiation dose, and improves resident efficiency and confidence, which may transfer to clinical practice with improved patient care and safety.
Medical Subject Headings
Algorithms; Clinical Competence; Cross-Sectional Studies; Education, Medical, Graduate; Educational Measurement; Fluoroscopy; Humans; Internship and Residency; Phantoms, Imaging; Prospective Studies; Quality Improvement; Radiation Dosage; Radiography, Interventional; Radiology; Tomography, X-Ray Computed