Certification of Basic Skills in Endovascular Aortic Repair Through a Modular Simulation Course With Real Time Performance Assessment

Rebecca A. C. Skov*, Jonathan Lawaetz, Michael Stroem, Isabelle Van Herzeele, Timothy A. Resch, Jonas P. Eiberg

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

3 Citationer (Scopus)
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Abstract

Objective
Endovascular aortic repair (EVAR) is being used increasingly for the treatment of infrarenal abdominal aortic aneurysms. Improvement in educational strategies is required to teach future vascular surgeons EVAR skills, but a comprehensive, pre-defined e-learning and simulation curriculum remains to be developed and tested. EndoVascular Aortic Repair Assessment of Technical Expertise (EVARATE), an assessment tool for simulation based education (SBE) in EVAR, has previously been designed to assess EVAR skills, and a pass limit defining mastery level has been set. However, EVARATE was developed for anonymous video ratings in a research setting, and its feasibility for real time ratings in a standardised SBE programme in EVAR is unproven. This study aimed to test the effect of a newly developed simulation based modular course in EVAR. In addition, the applicability of EVARATE for real time performance assessments was investigated.

Methods
The European Society of Vascular Surgery (ESVS) and Copenhagen Certification Programme in EVAR (ENHANCE-EVAR) was tested in a prospective cohort study. ENHANCE-EVAR is a modular SBE programme in EVAR consisting of e-learning and hands-on SBE. Participants were rated with the EVARATE tool by experienced EVAR surgeons.

Results
Twenty-four physicians completed the study. The mean improvement in EVARATE score during the course was +11.8 (95% confidence interval 9.8 – 13.7) points (p < .001). Twenty-two participants (92%) passed with a mean number of 2.8 ± 0.7 test attempts to reach the pass limit. Cronbach’s alpha coefficient was 0.91, corresponding to excellent reliability of the EVARATE scale. Differences between instructors' EVARATE ratings were insignificant (p = .16), with a maximum variation between instructors of ± 1.3 points.

Conclusion
ENHANCE-EVAR, a comprehensive certifying EVAR course, was proven to be effective. EndoVascular Aortic Repair Assessment of Technical Expertise (EVARATE) is a trustworthy tool for assessing performance within an authentic educational setting, enabling real time feedback.

Keywords
AssessmentCertificationEndovascular aortic repairFeedbackSimulation based education
OriginalsprogEngelsk
TidsskriftEuropean Journal of Vascular and Endovascular Surgery
Vol/bind67
Udgave nummer4
Antal sider9
ISSN1078-5884
DOI
StatusUdgivet - 2024

Bibliografisk note

Funding Information:
This study was supported by an unrestricted general research grant from Medtronic ( A1731784 ), by the University of Copenhagen , and supplementary funding from the Department of Vascular Surgery, Copenhagen (Copenhagen Vascular Research Unit). None of the funders had any role in design, data collection, statistical analysis, interpretation, manuscript preparation, or decision to publish the study.

Funding Information:
Authors RS, JL, MS, and JE report no relevant conflicts of interests. TR reports consultant at COOK, Bentley; grants from COOK, GORE, Bentley; advisory board Artivion. IvH is supported by a Senior Clinical Fellowship (802314N) of the Fund for Scientific Research – Flanders, Belgium; honoraria for consulting and training, Medtronic, Tolochenaz, Switzerland.

Publisher Copyright:
© 2023 The Author(s)

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