Simulation versus theoretical learning for the transradial approach: a randomized controlled trial in interventional cardiology.

Aymen Noamen, Ahmed Ben Amara, Mokhles Lajmi, Nadhem Hajlaoui, Wafa Fehri
Author Information
  1. Aymen Noamen: H��pital militaire principal d'instruction de Tunis / Universit�� Tunis El Manar / facult�� de m��decine de Tunis.
  2. Ahmed Ben Amara: H��pital militaire principal d'instruction de Tunis / Universit�� Tunis El Manar / facult�� de m��decine de Tunis.
  3. Mokhles Lajmi: H��pital militaire principal d'instruction de Tunis / Universit�� Tunis El Manar / facult�� de m��decine de Tunis.
  4. Nadhem Hajlaoui: H��pital militaire principal d'instruction de Tunis / Universit�� Tunis El Manar / facult�� de m��decine de Tunis.
  5. Wafa Fehri: H��pital militaire principal d'instruction de Tunis / Universit�� Tunis El Manar / facult�� de m��decine de Tunis.

Abstract

INTRODUCTION: Simulation-based education (SE) in interventional cardiology improves knowledge acquisition and mastery of procedures including the conventional radial access (CRA).
AIM: To evaluate the contribution of SE in CRA compared with theoretical learning alone.
METHODS: This is a prospective randomized controlled study including cardiology residents and patients with normal radial pulses. Experienced residents as well as patients with contraindications to CRA, requiring urgent intervention, or with hemodynamic instability were not included. Missing the teaching sessions was the exclusion criteria. Residents were randomized into two groups: simulation versus control. They attended a theory lecture explaining CRA and were evaluated Only the simulation group attended an SE session with measurement of heart rate (HR) and stress level. A real application was then performed with measurement of HR and stress level. The primary outcome was success puncture rate.
RESULTS: The success of the puncture was similar between the two groups (p=0.651). In the practical application, the stress level was significantly different before the procedure but similar after the end of the procedure. The stress level varied significantly within the same group before and after the procedure The simulation group was significantly less tachycardic both before and during the procedure with a significant difference between the two groups (p <10-3).
CONCLUSION: This study demonstrated the interest of SE in novice residents for CRA as a complement to theoretical learning upstream of the real-life procedure.

References

  1. PLoS One. 2020 Jun 11;15(6):e0234567 [PMID: 32525955]
  2. Tunis Med. 2018 Jul;96(7):401-404 [PMID: 30430482]
  3. Medicine (Baltimore). 2021 Sep 17;100(37):e27201 [PMID: 34664850]
  4. J Med Internet Res. 2018 Sep 24;20(9):e261 [PMID: 30249587]
  5. Am J Cardiol. 2019 Apr 15;123(8):1208-1213 [PMID: 30732853]
  6. Cureus. 2021 Aug 15;13(8):e17188 [PMID: 34414052]
  7. Catheter Cardiovasc Interv. 2018 May 1;91(6):1054-1059 [PMID: 28766876]
  8. Mt Sinai J Med. 2009 Aug;76(4):330-43 [PMID: 19642147]
  9. Nurse Educ Today. 2012 Apr;32(3):294-8 [PMID: 21862186]
  10. Tunis Med. 2022 mars;100(3):192-202 [PMID: 36005910]
  11. Pan Afr Med J. 2015 Aug 31;21:328 [PMID: 26587174]
  12. Tunis Med. 2020 Jun;98(6):466-474 [PMID: 33479963]
  13. Eur Heart J. 2015 Apr 1;36(13):777-83 [PMID: 25586121]
  14. Interv Cardiol. 2016 May;11(1):70-73 [PMID: 29588710]
  15. Cochrane Database Syst Rev. 2018 Apr 18;4:CD012318 [PMID: 29665617]
  16. Neurology. 2018 May 22;90(21):981-987 [PMID: 29784718]
  17. BMJ Open. 2021 Aug 16;11(8):e045600 [PMID: 34400443]
  18. Anaesth Crit Care Pain Med. 2016 Dec;35(6):407-416 [PMID: 27133235]
  19. Eur Heart J. 2021 Apr 7;42(14):1289-1367 [PMID: 32860058]
  20. Trends Cardiovasc Med. 2017 Apr;27(3):163-170 [PMID: 27986510]
  21. Tunis Med. 2020 May;98(5):363-369 [PMID: 32548839]
  22. Arch Cardiovasc Dis. 2021 Jan;114(1):73-84 [PMID: 33419690]
  23. Catheter Cardiovasc Interv. 2016 Feb 15;87(3):376-80 [PMID: 26489781]
  24. Anesthesiology. 2014 Jan;120(1):149-59 [PMID: 24398732]
  25. Medicine (Baltimore). 2019 Sep;98(36):e17072 [PMID: 31490407]
  26. BMJ Open. 2020 Sep 21;10(9):e037338 [PMID: 32958489]
  27. Arch Cardiovasc Dis. 2020 May;113(5):297-302 [PMID: 32291188]

MeSH Term

Humans
Prospective Studies
Learning
Educational Status
Contraindications
Cardiology

Word Cloud

Created with Highcharts 10.0.0CRAprocedureSEstresslevelcardiologytheoreticallearningrandomizedresidentstwosimulationgroupsignificantlyinterventionalincludingradialcontrolledstudypatientsversusattendedmeasurementrateHRapplicationsuccesspuncturesimilargroupsINTRODUCTION:Simulation-basededucationimprovesknowledgeacquisitionmasteryproceduresconventionalaccessAIM:evaluatecontributioncomparedaloneMETHODS:prospectivenormalpulsesExperiencedwellcontraindicationsrequiringurgentinterventionhemodynamicinstabilityincludedMissingteachingsessionsexclusioncriteriaResidentsgroups:controltheorylectureexplainingevaluatedsessionheartrealperformedprimaryoutcomeRESULTS:p=0651practicaldifferentendvariedwithinlesstachycardicsignificantdifferencep<10-3CONCLUSION:demonstratedinterestnovicecomplementupstreamreal-lifeSimulationtransradialapproach:trial

Similar Articles

Cited By (2)