New simulation training in the Cardiac Catheterization Laboratory at Mayo Clinic in Arizona

Samantha endovascular simulator in use

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With the support of generous benefactors, Mayo Clinic in Arizona has established a state-of-the-art simulation facility dedicated to multidisciplinary clinical training and research. Medical simulation creates realistic clinical scenarios in computerized, life-sized patients, where doctors in training can respond in real time to situations commonly encountered in clinical practice without any risk to actual patients.

Traditional training in cardiac catheterization procedures involves only real-life exposure to patients. In an effort to promote excellence and patient safety in physician training while reducing risk to patients, the interventional cardiologists at Mayo Clinic in Arizona have acquired the Samantha endovascular simulator.

"Fellows learn basic cardiac catheterization techniques and face common scenarios before ever touching an actual patient," says John P. Sweeney, MD, director of the Cardiac Catheterization Laboratory at Mayo Clinic in Arizona. Nurses and radiology technologists will update their skill sets and learn new techniques using this system. Orientation of new staff will start with simulation training instead of with patients.

The Samantha endovascular simulator allows fellows to perform routine diagnostic catheterizations, coronary interventions, and peripheral vascular interventions in a simulated environment. The trainee faces various situations and complications that might be encountered in a real-life case. The responses may range from a pharmacologic or mechanical solution to defibrillation for life-threatening arrhythmias.

A videotape of the simulated case can be captured and the case reviewed with experts in the field. Constructive criticism and suggestions regarding scenario management allow the trainee to learn in a more relaxed environment before encountering a similar situation in the catheterization laboratory.

This system builds on existing simulation training for emergency medical services personnel addressing cardiovascular conditions, especially ST-elevation myocardial infarction. Through this experience, instances when teamwork has not been optimal can be identified. Simulation training for emergency medical services, emergency department, and cardiac catheterization laboratory staff focusing on teamwork is used to optimize the care of such patients. From a research standpoint, the effects of simulation training on quality and safety metrics will be tracked and quantified.

This effort to optimize the care of patients undergoing invasive cardiac procedures is being led by Dr Sweeney, F. David Fortuin, MD, and Richard W. Lee, MD, all invasive cardiologists. Dr Fortuin, a codirector of the Multidisciplinary Simulation Center, notes that "simulation training is becoming part of the culture at Mayo Clinic. It is no longer considered an alternative educational technique, but rather an integral part of medical training."