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Metric-based Simulation improves training for interventional neuroradiologists

A research paper in the journal “Stroke” based on the use of Mentice’s VIST ® physics-based, high-fidelity simulator, found metric-based simulation helps improve how interventional neuroradiologists (INRs) learn mechanical thrombectomy.

The paper, Metric-Based Virtual Reality Simulation for Mechanical Thrombectomy—A Paradigm Shift in Training for Mechanical Thrombectomy in Acute Stroke, researched the use of high-end virtual reality simulation to aquire skills for this minimally invasive procedure.

Mechanical thrombectomy is a life-saving procedure in which a clinical device is introduced into the affected brain’s vasculature to mechanically remove a blood clot. Several significant studies published in 2015 helped establish mechanical thrombectomy as the most effective and preferable solution for ischemic stroke. Despite this, initial acquisition of skills for new operators and maintenance of skills for lower volume operators and centers are factors that limit access for patients to safely receive this treatment.

Funded by a grant from the Swedish innovation agency VINNOVA, Mentice worked with a group of senior INRs and the ASSERT Center at University College Cork to develop and validate a simulation-based training system that can objectively, consistently and reliably quantify the performance levels of physicians wishing to become proficient in mechanical thrombectomy.

The system uses metrics derived from experienced INRs to establish a level of proficiency, i.e. a performance benchmark, that physicians must reach before performing on real patients. This offers a standardized and quality-assured approach to acquire, maintain and assess the endovascular skills needed for this procedure.

“Providing timely and high-quality treatment for ischemic stroke,” says Mentice CEO Göran Malmberg, “is one of today’s largest healthcare opportunities. High-fidelity simulation combined with proficiency-based progression is a disruptive solution that can help this transformation of healthcare.”

This solution is created with the purpose of assisting in a safe and effective roll-out and expansion of the treatment of ischemic stroke using mechanical thrombectomy. The paper concludes that metric-based simulation training can supplant a significant part of the learning curve on real patients and serves as a powerful tool to augment the practical skills of endovascular procedures.

“Mechanical Thrombectomy for acute stroke,” says Professor Tony Gallagher of ASSERT, “is a life-changing treatment for many acutely ill patients. The success of the treatment is determined in no small part by the skills of the physician performing the procedure. The VR simulation that we describe, and the training methodology will be used to enhance, and quality assure the learning experience and training of doctors. Conceptually and intellectually appealing, it represents a paradigm shift in how doctors are prepared for the treatment of acute stroke.”

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