What question did this study set out to answer?

The study aims to evaluate the effectiveness of mentored simulation-based training on coronary diagnostic skills among medical students.

March 16, 2026Open Access

Simulation training for invasive cardiovascular procedures: the Heart-SIMS-1 randomized trial

Key Points

The study aims to evaluate the effectiveness of mentored simulation-based training on coronary diagnostic skills among medical students.
Conducted a pilot randomized trial with final-year medical students.
Participants received a one-hour lecture followed by randomized training sessions.
Simulation training used 3D-printed coronary models for hands-on learning.
Efficacy and safety were assessed with a procedural checklist and identification of procedural red flags.
Theoretical knowledge was evaluated via a multiple-choice test.
Simulation training group achieved a higher efficacy score (91.5%) compared to conventional training (64.6%).
Safety scores showed simulation training group at 100% versus 62.5% for conventional.
Fewer procedural red flags were identified in simulation group (0) than in conventional group (median of 2).
Simulation group scored higher on the theoretical knowledge test (85.7%) compared to conventional group (76.8%).

Abstract

Interventional cardiology training has a long learning curve, with potential procedural risks to patients and clinicians. We aimed to assess whether mentored simulation-based training with 3D-printed models can improve the skills of beginners in coronary diagnostic procedures in a pilot randomized trial. Twenty-nine final-year medical students recruited from a single University were lectured on the fundamentals of invasive coronary angiography (ICA) for one-hour, and then randomized to conventional or simulation training. Conventional training (n = 15) consisted of watching a 20-minute video demonstrating ICA steps performed in a 3D-printed coronary simulator. The simulation training group (n = 14) were offered, in pairs, the same content in a 20-minute hands-on session using a 3D-printed simulator. The co-primary endpoint was efficacy and safety of performing a simulated ICA in the angiography suite. Efficacy and safety were graded using a 13-point procedural checklist (0-100%) and the identification of five procedural “red flags” items, respectively. The secondary endpoint was theoretical knowledge (multiple-choice test). All participants completed the protocol. In both components of the co-primary endpoint, the simulation group scored higher: efficacy score of 91.5 ± 3.8% vs. 64.6 ± 8.3% (mean difference 95% CI 20.8, 30.8) and safety score 100.0% (100.0-100.0%) vs. 62.5 (20.8–79.2%) (median difference 95% CI 20.8, 79.2), p < 0.001. The median number of “red flags” were 2 (1–4) in conventional and 0 (0–0) in simulation training (p < 0.001). Also, simulation group obtained a higher score in the theoretical knowledge test: 85.7 ± 9.0% vs. 76.8 ± 12.7%, p = 0.039. Mentored simulation-based training using 3D-printed simulators significantly improved theoretical knowledge and basic procedural skills of ICA. These results suggest that simulation-based training should be pursued for improving patient safety and technical proficiency. NCT06224101.

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