International expert consensus on a scientific approach to training novice cardiac resynchronization therapy implanters using performance quality metrics

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dc.contributor.author Mascheroni, Jorio
dc.contributor.author Mont, Lluís
dc.contributor.author Stockburger, Martin
dc.contributor.author Patwala, Ashish
dc.contributor.author Retzlaff, Hartwig
dc.contributor.author Gallagher, Anthony G.
dc.contributor.author Alonso, Christine
dc.contributor.author Binner, Ludwig
dc.contributor.author Bongiorni, Maria Grazia
dc.contributor.author Infante, Ernesto Diaz
dc.contributor.author Gadler, Fredrik
dc.contributor.author Gras, Daniel
dc.contributor.author Margitfalvi, Peter
dc.contributor.author Moreno, Javier
dc.contributor.author Paratsii, Oleksii
dc.contributor.author Rao, Archana
dc.contributor.author Schäfer, Harald
dc.contributor.author van Kraaij, Dave
dc.date.accessioned 2019-05-08T10:16:22Z
dc.date.available 2019-05-08T10:16:22Z
dc.date.issued 2019-04-12
dc.identifier.citation Mascheroni, J., et al. (2019) 'International expert consensus on a scientific approach to training novice cardiac resynchronization therapy implanters using performance quality metrics', International Journal of Cardiology. doi: 10.1016/j.ijcard.2019.04.036 en
dc.identifier.issn 0167-5273
dc.identifier.uri http://hdl.handle.net/10468/7863
dc.identifier.doi 10.1016/j.ijcard.2019.04.036 en
dc.description.abstract Aims: Pacing and Cardiac Resynchronization Therapy (CRT) procedural training for novice operators usually takes place in-vivo and methods vary across countries/institutions. No common system exists to objectively assess trainee ability to perform required tasks at predetermined performance levels prior to in-vivo practice. We sought to characterize and validate with experts a reference approach to pacing/CRT implants based on objective and explicit performance quality metrics, for the development of a reproducible, simulation-based, training curriculum aiming to operator proficiency. Methods: Three experienced CRT implanters, a behavioural scientist and two engineers performed a detailed task deconstruction of the pacing/CRT procedure and identified the performance metrics (phases, steps, errors, critical errors) that constitute an optimal CRT implant for training purposes. The metrics were stress tested to determine reliability and score-ability and then subjected to detailed systematic review by an international panel of 15 expert implanters in a modified Delphi process. Results: Thirteen procedure phases were identified, consisting of 196 steps, 122 errors, 50 critical errors. The expert panel deliberation added 16 metrics, deleted 12, and modified 43. Unanimous panel consensus on the resulting CRT procedure metrics was obtained, which verified face and content validity. Conclusion: A reference pacing/CRT procedure and metrics created by a core group of experts accurately characterize the essential components of performance and were endorsed by an international panel of experienced peers. The metrics will underpin quality-assured novice implanter training. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Elsevier B.V. en
dc.relation.uri http://www.sciencedirect.com/science/article/pii/S016752731930703X
dc.rights © 2019, Elsevier B.V. All rights reserved. This manuscript version is made available under the CC BY-NC-ND 4.0 license. en
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/ en
dc.subject Pacing en
dc.subject Implant en
dc.subject Metrics en
dc.subject Training en
dc.subject Proficiency-based progression en
dc.subject CRT en
dc.subject Cardiac resynchronization therapy en
dc.title International expert consensus on a scientific approach to training novice cardiac resynchronization therapy implanters using performance quality metrics en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Anthony Gallagher, Medical School Office, University College Cork, Cork, Ireland. +353-21-490-3000 Email: ag.gallagher@ucc.ie en
dc.internal.availability Full text available en
dc.check.info Access to this article is restricted until 12 months after publication by request of the publisher. en
dc.check.date 2020-04-12
dc.date.updated 2019-04-17T09:07:32Z
dc.description.version Accepted Version en
dc.internal.rssid 481883332
dc.contributor.funder Medtronic PLC, Ireland en
dc.description.status Peer reviewed en
dc.identifier.journaltitle International Journal of Cardiology en
dc.internal.copyrightchecked Yes
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress ag.gallagher@ucc.ie en
dc.internal.bibliocheck In press. Check vol / issue / page range. Amend citation as necessary. en
dc.identifier.eissn 1874-1754


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© 2019, Elsevier B.V. All rights reserved. This manuscript version is made available under the CC BY-NC-ND 4.0 license. Except where otherwise noted, this item's license is described as © 2019, Elsevier B.V. All rights reserved. This manuscript version is made available under the CC BY-NC-ND 4.0 license.
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