Educational Problems
Conditions
Brief summary
Cardiac Device implantation includes implantation of pacemakers, implantable defibrillators and Cardiac resynchronisation Therapy (CRT) devices. These are well-established treatments for selected with heart rhythm abnormalities and heart failure. In the past, trainee doctors had the opportunity to perform many procedures and learn on the patient. This is no longer the case due to a change in training schedules and working times as well as patient safety mandates. Progression based training with the use of simulators has been proven to be effective in training and in order to use this methodology, the procedure needs to be well defined. Despite its worldwide adoption, a standardized procedure has never been defined in detail and agreed upon and the cardiac device implant technique varies with the operator. The purpose of the research is to establish the metrics (operational definitions) necessary to characterize a reference Cardiac Device implant procedure.
Detailed description
The purpose of the research is to establish the metrics (operational definitions) necessary to characterize a reference Cardiac Device implant procedure, to seek consensus from experienced device implanters on the appropriateness of the steps as well as errors identified, and to determine if such validated performance metrics are a valid assessment tool with the ability to discriminate between the performances of experienced and novice implanters. These validated metrics will potentially serve as an educational and training tool to improve and quality assure Cardiac device implant training. The steps involved in characterising a reference procedure are as follows: 1. Define the implant procedure in quantifiable steps (already performed) 2. Seek consensus and agreement by an independent panel on the steps (already done). 3. Video record routinely performed device implants by experienced and novice physicians. 4. Reviewing and scoring the video recorded procedures to verify that the metrics distinguish between a novice and an expert cardiac device performance.
Interventions
OTHERimplant of cardiac device as per guidelines
Observation of performance to validate matrix
Sponsors
Medtronic
Liverpool Heart and Chest Hospital NHS Foundation Trust
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients eligible for a cardiac device implant as per current European Society of Cardiology guidelines.
Exclusion criteria
Patient\< 18 y of age. Patients unable to provide informed written consent for the study. \-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The primary outcome measure is the comparison of the intra-operative performance of novices versus experts | 6 months | The primary analysis will compare the intra-operative performance of novices versus experts. The three experienced cardiac device implanters will test the consented metrics by reviewing and scoring the video recorded procedures to verify that the metrics distinguish between a novice and an expert cardiac device performance. IRR will be considered to be acceptable if it is ≥ 0.8 The primary analysis will compare the intra-operative performance of novices versus experts. The three experienced cardiac device implanters will test the consented metrics by reviewing and scoring the video recorded procedures to verify that the metrics distinguish between a novice and an expert cardiac device performance. IRR will be considered to be acceptable if it is ≥ 0.8 |
Outcome results
None listed