Effect of Simulation‐Based Cerebral Angiography Training on Navigational Error in Novices

Endovascular surgical procedures require visual‐spatial coordination in workspaces with restricted motions and temporally limited imaging. The development of the skills needed for these procedures can be facilitated by 3D simulator‐based training. Simulation‐based medical education has recently started focusing on personalized training in reducing errors, enhancing trans‐situational competence and promoting professional transparency. Cerebral angiography (CA) has lagged behind in this training approach due to the lack of validated, realistic training models, relying strictly on clinical case exposure frequency as a means of assessing proficiency. The ANGIO Mentor visual‐haptic simulator has been regarded as an effective training tool, increasing performance in diagnostic CA, however, this simulator has not been tested thoroughly in error reduction in CA. In our study, residents and graduate students were given practice diagnostic angiography and were subsequently tested on a right middle cerebral artery aneurysm case, repeating over 8 sessions. Participants were also administered a mental rotations test (MRT) and grouped into MRT groups to identify performance differences. We have identified a significant self‐guided reduction in spatial errors by the participants over 8 sessions. Further investigation revealed a negative change in error frequency for major trajectory deviations. This allowed us to categorize vessels that, although less frequent in erroneous access, were creating the most difficulty for the trainee and most potential harm to patients. Assessing MRTs, we found that high MRT individuals performed much better than low MRT individuals at the start of the study, however, both groups plateaued at a similar performance level by the 8th session. These results are significant in the adoption of personalized medical training in this field and identify vascular areas of difficulty that can be addressed by the curriculum. Although it is well understood that simulation training under expert supervision is most effective, we have shown that self‐guided training can build appropriate technical and spatial ability in procedural skill development. Support or Funding Information NSERC