Development of a High-Fidelity Simulation Curriculum into Training of Medical Students, Residents, and Fellows: Creation of a First-Hand Operator Experience and Assessing Excellence Versus Competency

The traditional apprenticeship model of “see one, do one, teach one” for interventionalists in training carries significant limitations. In interventional radiology, where academic practices may cover arterial, venous, dialysis, oncology, hepatobiliary, gynecology, gastrointestinal, and genitourinary services, exposure to certain critical procedures may be limited for trainees in the particular hospital environment. In addition, emergency scenarios requiring complex problem solving but strong teaching opportunities permit only one trainee to have exposure and challenge the trainee to be competent without pre-existing exposure. Finally, with the transition from interventional radiology fellowship to residency, medical students must have first-hand experiences in the field to make proper decisions about applications, however, many interventional radiologists may have patient safety concerns about immediate direct participation.

In a single center institution, we have developed the initial construct of a high-fidelity simulation (HFS) training program. We have used the adage: "may or may not see one, simulate as many as needed, teach using simulation." The program has educational, clinical, and research arms. Initial focus has been on fellows to generate exposure to complex peripheral arterial disease and medical students to showcase procedural experience. The research arm is focused on assessing the impact of HFS on excellence versus competency, speed of adaptation, comfort level, and safety of all trainees, as well as impact on students who enter both interventional and non-interventional fields. Subsequent expansion of the program will assess patient specific opportunities for learning.