Canon Medical Systems recently sponsored a cardiology simulation training session at the Surgical Innovation Centre, located at St. Mary’s Hospital in Paddington. The Hammersmith MDT Immersive Team Simulation sessions utilised the simulation framework iCAST (Imperial Cardiology Simulation Training) programme. Developed by Imperial College London and Imperial College Healthcare NHS Trust, in conjunction with a team of behavioural psychologists and experts in simulation science, in close collaboration with strong clinical leads in cardiology and anaesthesia, it provides an inclusive and innovative approach to education, training and learning for consultants, trainees and cath-lab personnel.
Patient safety lies at the heart of the iCAST programme, which features a ‘live’ patient (actor), in a simulated setting with a state-of-the-art interventional simulator and trained clinical and technical faculty, housed in a high fidelity simulated cath lab (Orcamp) at the Surgical Innovation Centre at St. Mary’s. The pioneering iCAST framework fills crucial gaps in current cath-lab training by providing a safe, high-fidelity and immersive simulated setting for learning human factor skills (e.g. communication, leadership, decision-making, team co-operation and crisis management), combined with technical and procedural skills.
The simulations and subsequent structured team debriefs and group discussions aimed to provide a safe, simulated environment and multi-professional platform for learning for consultants and multi-disciplinary teams (MDTs), participating in the simulations. In addition, as an educational group learning tool, the aim was to generate discussions and solutions for Hammersmith cath-lab personnel viewing the simulations to establish: (a) what went wrong in the scenarios and why? (b) How can MDT communication and teamwork related issues be improved in real cath labs and (c) what are the current barriers and solutions for improvement?
Three entire cath-lab teams participated in three simulations, each led by a consultant cardiologist. Each team comprised one radiographer, one cath-lab nurse, one physiologist, and an anaesthetist, who was called when needed in the case. All consultants and cath-lab team members were blind to the scenarios and were presented with a case history only, leading on to the interventional procedure and onset of complications requiring external input. Consultant anaesthetists were paged to arrive to the simulated cath-lab as in real emergency cases. Using the iCAST methodology, scenarios were expertly manipulated, haemodynamically and procedurally, in a separate control room by the highly experienced simulation faculty.
Findings, based on fifty iCAST participants, reflected the high realism of the training format, its utility and potential. The simulation experience was positively rated in terms of replicating the workplace, pathway and interactions with the team. It was rated positively for team training and as a format to assess workplace performance.
From a cath-lab personnel perspective, a radiographer from Hammersmith Hospital, participating in the training said, “Thank you very much for giving me an opportunity for the simulation based training course. It was a very useful, challenging and effective way to enhance and improve technical skills, clinical knowledge and also inter-professional skills. I would say it is part of clinical governance to delivery quality service and quality care to the patients and I would like to recommend to all my multi-professional colleagues to participate in this simulation training course.”
Dr. Jonathan Cousins, Consultant Anaesthetist at Imperial College Healthcare NHS Trust summed up the day, commenting, “I have used and been trained inside anaesthetic-only simulators for many years, mainly to train crisis management and acute skill updates. iCAST is different and refreshingly so, the focus clearly on the MDT and getting a ‘pick and mix’ on call team to act in unison and without conflict between rank and specialty. Cardiac cath labs are the epitome of modern day hospital crisis environments. The specialty has rapidly out grown its historical construction and supports with the advent of HAC’s and chest pain centres – iCAST is clearly striving to repair this growth gap.”
Dr. Cousins continues, “It was clear how stressful the scenarios appeared to senior consultants (wanting to appear faultless and in sole charge) but the junior doctors with less knowledge, but more belief in teams and support relished the challenges. iCAST let them show the seniors how to engage (by example) and both groups were impressively changed by the end of the course. This course should be standard for all trainees entering the cardiac catheter labs and for consultant revalidation on a regular basis – a 100% must for those on a PCI rota. With more than fifteen years experience of my own, I learnt a great deal and can see improvements in my own practice.”
Shown here, students participating in a simulation-based training session
Canon Medical Systems has a carbon-zero project in place. We have calculated the carbon footprint for each of our products to include manufacturing, shipping, delivery and average hospital energy used for the standard lifetime of the equipment as follows:
X-ray equates to 13 stoves and 50,781 litres of water