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Educational Impact of a Pulsatile Human Cadaver Circulation Model for Endovascular Training

Lookup NU author(s): Dr Craig Nesbitt, Dr Sam Tingle, Dr Roger Searle, Sebastian Mafeld, Professor Gerard Stansby


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© 2019 European Society for Vascular Surgery. Objectives: The face and construct validity of a novel pulsatile human cadaver model (PHCM) was recently demonstrated for endovascular training. This study aimed to assess the model's educational impact. Methods: Twenty-four endovascular novices were recruited and split into two equal training groups: PHCM and virtual reality simulator (VRS). Each candidate performed eight consecutive training attempts of endovascular renal artery catheterisation on their designated model, and a final crossover attempt on the alternate model. Performances were video recorded and scored using a validated scoring tool by two independent endovascular experts, blinded to the candidate's identity and attempt number. Each participant was given a task specific checklist score (TSC), global rating score (GRS), and overall procedure score (OPS). Results: In the PHCM group average OPS improved gradually from 19.42 (TSC 8.58, GRS 10.83) to 39.50 (TSC 15.00, GRS 24.5) over eight attempts (p < .0005). In the VRS group OPS improved from 20.54 (TSC 10.29, GRS 10.25) to 36.04 (TSC 14.21, GRS 21.88) between the first and eighth attempts (p < .0005), with limited improvement after the second attempt. PHCM training significantly improved OPS on their VRS crossover attempt (p ≤ .0001), achieving a similar OPS to candidates who had completed VRS training (p = .398). VRS training significantly improved OPS on PHCM (p < 0.05); however, OPS was significantly worse than candidates who had completed PHCM training (p ≤ .001). Conclusions: PHCM training has a longer learning curve, with gradual improvement, reflecting the enhanced difficulty of a more realistic model. These results support the use of PHCM preceded by VRS training, prior to performing endovascular surgery on patients.

Publication metadata

Author(s): Nesbitt CI, Tingle SJ, Williams R, McCaslin JE, Searle R, Mafeld S, Stansby GP

Publication type: Article

Publication status: Published

Journal: European Journal of Vascular and Endovascular Surgery

Year: 2019

Volume: 58

Issue: 4

Pages: 602-608

Print publication date: 01/10/2019

Online publication date: 05/09/2019

Acceptance date: 23/03/2019

ISSN (print): 1078-5884

ISSN (electronic): 1532-2165

Publisher: W.B. Saunders Ltd


DOI: 10.1016/j.ejvs.2019.03.026


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