Objective

Transcatheter cardiac procedures have generated increasing interest in trainees and training programs alike. Using the modified Delphi method, we sought to clarify the transcatheter competencies that cardiac surgery residents should be expected to attain by the completion of training.

Methods

Individuals with expertise in transcatheter structural heart and aortic procedures were recruited across Canada. A questionnaire was prepared using a 5-point Likert scale. During 2 rounds, participants rated the competencies that they thought cardiac surgery residents should be required to achieve to perform transcatheter procedures. Data were analyzed and presented to participants between rounds. Competencies rated 4 or higher by at least 80% of respondents after the second round were considered fundamental to transcatheter cardiac surgical training.

Results

A total of 46 individuals participated in the study, including 23 cardiac surgeons, 17 interventional cardiologists, and 6 vascular surgeons. Participants with relevant experience performed a median of 75 (interquartile range, 40-100) transcatheter aortic valve implantations in the prior year as primary or secondary operator and 15 (interquartile range, 11-35) thoracic endovascular aortic repairs in the prior 2 years as primary operator. Median clinical and teaching experience consisted of 13 (interquartile range, 7-19.5) years in practice and 8.5 (interquartile range, 5-15) residents taught per year, respectively. Of the included competencies, 53 were considered fundamental to transcatheter cardiac surgical training.

Conclusions

The identified fundamental competencies can be used to develop educational strategies during transcatheter cardiac surgery training. Future efforts should focus on collecting evidence for their validity.

中文翻译：

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关于经导管心脏手术基本能力的泛加拿大倡议：修改后的 Delphi 共识研究

客观的

经导管心脏手术引起了越来越多的受训者和培训计划的兴趣。使用改进的德尔菲法，我们试图阐明心脏外科住院医师在完成培训后应具备的经导管能力。

方法

在加拿大各地招募了具有经导管结构性心脏和主动脉手术专业知识的个人。使用 5 点李克特量表准备问卷。在 2 轮中，参与者对他们认为心脏外科住院医师执行经导管手术应具备的能力进行评分。在两轮之间对数据进行分析并呈现给参与者。在第二轮之后，至少 80% 的受访者将能力评为 4 分或更高，这被认为是经导管心脏手术培训的基础。

结果

共有 46 人参与了这项研究，包括 23 名心脏外科医生、17 名介入心脏病专家和 6 名血管外科医生。具有相关经验的参与者在前一年作为主要或二级操作者进行了 75 次（四分位间距，40-100）经导管主动脉瓣植入术，在过去 2 年中作为主要或二级操作者进行了 15 次（四分位间距，11-35）胸腔内主动脉修复术初级操作员。中位临床和教学经验分别包括 13 年（四分位间距，7-19.5）年的实践和 8.5（四分位间距，5-15）年的住院医师教学。在包括的能力中，53 项被认为是经导管心脏手术培训的基础。

结论

确定的基本能力可用于在经导管心脏手术培训期间制定教育策略。未来的努力应侧重于收集其有效性的证据。