A proposed program for revising training in diagnostic and interventional cardiac catheterization using a didactic lecture series and virtual reality simulation

Dear Sir

Cardiac catheterization is an invasive cardiology procedure learned during cardiology fellowship. The current paradigm of training cardiology fellows in the skills required for cardiac catheterization involves direct patient contact/care, i.e., learning on patients in an “apprenticeship” model (Gallagher & Cates 2004). In most cardiology programs, there is no formalized curriculum, despite the existence of knowledge and competency standards. At the University of Pittsburgh we have endeavored to develop a more complete training process for cardiology fellows in the adult learner model, which will enable them to meet the Accreditation Council for Graduate Medical Education's (ACGME) six core competencies while achieving a higher level of learner satisfaction. To accomplish this, we first performed a task analysis of training components in cardiac catheterization. We then performed a targeted needs assessment of our graduating fellows (N = 11), which showed poor learner satisfaction with current teaching and a need for simulation training, averaging a 2.2 and a 4.0, respectively, on a 5-point Likert scale. We then used the content of the task analysis, the data from the needs assessment, and the guidelines created by ACGME and Core Cardiology Training Symposium to create a comprehensive invasive cardiology curriculum using the latest in modern technology. Identified learner needs were molded into a workable and deliverable curriculum in invasive cardiology using an active, adult learner format addressing all three major learner domains (knowledge, psychomotor, and affective). The final curriculum involved: (1) delivery of didactic lectures via a web portal to improve fellow knowledge in core areas of cardiology, (2) virtual reality cardiac catheterization simulation to improve psychomotor skills, and (3) formative feedback from cardiology attendings on performance of cardiac catheterization with real patients. This curriculum was initiated at the University of Pittsburgh in July 2011 and will end its pilot phase in July 2012. We anticipate the data generated will show that innovative use of technology utilized in an adult learner format can improve the abilities and satisfaction of interventional cardiology trainees. This curriculum can serve as a model for other institutions to improve interventional cardiology training and experience.