Does simulation training facilitate staff confidence to set up an endovascular carotid artery stenting service?

Question/Introduction: The aim of the study was to evaluate if simulation training of the stroke and cathlab team on a high-end virtual reality (VR) simulator facilitates collaborative development of a new carotid artery stent (CAS) service. Methods: An experienced Neuro-interventionalist gave a one day comprehensive demonstration of the carotid artery stenting (CAS) procedure to the relevant health care staff (n=22) using a high fidelity simulator. The following day protocols and pathways were drafted jointly by the team (radiology, stroke, anaesthesia, vascular surgery) and tested in the VR environment. This was followed by a survey on the simulation experience regarding realism, technical issues, teamwork and communication. Results: Mean participant age was 37.5 ± 7.9 ranging from 25 to 58 years. Only 7 participants (31.8%) had seen a CAS procedure before. All participants found that the rehearsal environment created a realistic understanding of the patients needs pre-, peri- and post intervention and enabled enhanced teamwork and communication. Conclusion: CAS simulation training increased team knowledge, collaboration and competence and enabled set-up of a new endovascular service within 1 month of completion of training.