Benefits of lower limb angioplasty training using a virtual reality simulator among vascular surgical residents

ObjectiveTo assess the skill acquisition, operative competency and confidence of vascular surgery residents during a limb angioplasty workshop and to evaluate their surgical volume and retention rate over a year.MethodsFor three years (2018–2020), all residents/fellows in their final year of vascular residency at a school hospital were enrolled. Five residents in 2018 were enrolled in the Control group (apprenticeship model). Twelve residents/fellows from 2019 (Training group) and 2020 (COVID group) were trained with the ANGIO Mentor in two workshops. Residents were evaluated using the Objective Structured Assessment of Technical Skills (OSATS), simulator metrics, and a confidence questionnaire. A p-value of <.05 was considered statistically significant.ResultsThe groups were similar regarding age, sex, and number of limb angioplasties performed (Control 25.00±5.52; Training 23.16±7.44; COVID 24.50±8.17, p=.91, Student’s t-test). The residents of the Training and COVID groups showed significantly improved OSATS scores with the first workshop (15.50 [interquartile range 12.62–19.13] to 37.00 [36.50–39.38], p=.01 and 14.50 [13.62–15.00] to 34.75 [30.75–38.75], p<.001, respectively) and reported confidence improvement (from a median 3 [3–3] to 4 [4–5], p=.01). After six months, the retention rate was good; during that semester, each resident performed 10.50 [7.00–13.25] limb angioplasties. The second workshop neither improved the residents’ scores nor their confidence. At the end of the year, residents from the Control group scored worse than those from the Training and Control groups (Control 23.50 [19.00–24.50], Training 37.0 [36.50–39.37], COVID 34.75 [30.75–38.75], p=.005, Kruskal–Wallis test). The simulation metrics did not show significant differences among groups.ConclusionA three-week limb angioplasty workshop can improve residents’ skills and confidence. Performing 10 angioplasties per semester is sufficient to ensure the retention rate is good after six months, and a second workshop is unnecessary.