Are simulation training sessions beneficial for rad residents learning CT-guided procedures?

Adding simulation-based training can help radiology residents learning CT-guided procedures improve their knowledge, confidence and overall tested performance, according to a recent study published by the Journal of the American College of Radiation. Simulation laboratories are already used when teaching ultrasound-guided biopsies and other procedures to radiology residents, but such methods had not previously been tested in relation to CT-guided procedures in interventional radiology.

Lead author Melissa Picard, MD, department of radiology and radiological sciences at the Medical University of South Carolina in Charleston, and colleagues explained in the study that residents may not always experience a strong enough variety of cases during their residency, and this is one way simulation-based training could prove to be beneficial.

“Simulation laboratories could serve as a way to better standardize resident education and minimize gaps in training,” the authors wrote. “Further, simulation-based training provides opportunities for residents to learn and refine their skills through purposeful practice in a safe environment, removed from patients. The addition of simulation laboratories to the residency curriculum also allows for assessment of proficiency of skills before performing the procedure on a patient.”

To test the validity of such training, Picard et al. surveyed 24 radiology residents before and after attending small-group simulation training sessions. The study focused on three CT-guided procedures: random liver biopsy, lung nodule biopsy and drain placement.

Overall, the residents’ mean overall knowledge scores improved from 87 percent ± 10 percent to 94 percent ± 7 percent. Also, residents were asked to rate their confidence on a five-point scale, with 1 being the least confident and 5 being the most confident. Overall confidence increased after the simulation training from 3.28 to 4.13.

Looking deeper at the data, confidence based on random liver biopsy improved from 3.33 to 4.24, confidence based on lung nodule biopsy increased from 3.29 to 4.08, and confidence based on drain placement increased from 3.23 to 4.09.

Performance also saw improvements after residents participated in the simulation training sessions. Mean performance scores improved from 78 to 100 for random liver biopsy, from 75 to 100 for lung nodule biopsy, and from 94 to 100 for drain placement.

There is still work to be done, Picard and colleagues said, but the results of their research are promising for the future.

“It remains to be seen how this type of simulation will translate to actual performance in the clinical setting, but these initial findings are encouraging,” the authors wrote. “Interventions with simple low-fidelity trainers in the pre-patient setting have the potential to improve resident knowledge, confidence, and performance of CT-guided procedures, which may ultimately have a positive impact on their education, as well as patient safety.”

The authors added that their study did have limitations. Their simulation, for instance, was “sufficient,” but did not “reproduce ‘real-life’ experiences and environment.” Also, the study was performed at a single institution as opposed to being spread out across multiple sites.