Enhancing cardiology trainee competence through simulation-based training in diagnostic coronary angiography: a pilot programme evaluation

Abstract Introduction Recent changes to the United Kingdom (UK) cardiology curriculum have increased clinical demands, reducing opportunities for procedural skill development, particularly for early-stage trainees with limited access to catheter lab exposure. The Joint Royal College of Physicians Training Board highlights the importance of simulation-based training in cardiology. Simulation provides a structured environment for continuous learning, skill refinement, and improved procedural safety. It has the potential to enhance confidence, reduce errors, optimise contrast and radiation use, and improve procedural efficiency, ultimately contributing to improvement in patient safety and outcomes. Aim To develop and evaluate a coronary angiography simulation training programme to improve trainee performance, confidence, and procedural efficiency. Additionally, the programme seeks to shorten the learning curve for new cardiology trainees and offer a platform for skill maintenance when catheter lab access is restricted. Method A pilot teaching programme was conducted from January 2025 to March 2025 using high-fidelity Simbionix simulation equipment. Participants were recruited from medical education departments. Each trainee received a one-on-one session with a senior interventional cardiologist, who provided real-time feedback. Trainees then independently performed two simulated cases. Procedural time, fluoroscopy time and contrast volume usage were recorded in real time. Trainee confidence levels were assessed through anonymised pre- and post-course feedback forms using the Likert scale model. Results Eight first-year cardiology registrars participated. Their catheter lab exposure ranged from 1 to 8 sessions per month. Confidence scores (out of 5): Pre-simulation mean = 2.5; Post-simulation mean = 3.75. 75% of trainees improved by 1 point, while 25% improved by 2 points. Procedural time: Mean first attempt = 26 min 38 sec; Mean second attempt = 22 min 24 sec (15.89% improvement). Fluoroscopy time: Mean first attempt = 15 min 4 sec; Mean second attempt = 10 min 30 sec (30.31% reduction). Contrast usage: Mean first attempt = 142.3 mL; Mean second attempt = 94.6 mL (33.5% reduction). Trainees highlighted key themes in post-course feedback, including the value of high-fidelity simulation, expert mentorship, real-time feedback, and the opportunity to practice complication management in a controlled environment. Conclusion This pilot simulation programme effectively enhanced trainee confidence and procedural efficiency in diagnostic coronary angiography. By expanding the programme to a larger cohort and tracking long-term skill retention in follow-up sessions and live catheter lab procedures, we aim to further optimise simulation-based cardiology training.