학술논문
Remote Training of Neurointerventions by Audiovisual Streaming: Experiences from the European ESMINT-EYMINT E-Fellowship Program
ORIGINAL ARTICLE
ORIGINAL ARTICLE
Document Type
Academic Journal
Author
Hanning, Uta; Bechstein, Matthias; Kaesmacher, Johannes; Boulouis, Gregoire; Chapot, Rene; Andersson, Tommy; Boccardi, Edoardo; Psychogios, Marios; Cognard, Christophe; Lascuevas, Marta de Dios; Rodrigues, Marta; Caamano, Isabel Rodriguez; Gargalas, Sergios; Simonato, Davide; Zupancic, Vedran; Daller, Cornelia; Meyer, Lukas; Broocks, Gabriel; Guerreiro, Helena; Fiehler, Jens; Martinez-Galdamez, Mario; Kalousek, Vladimir
Source
Clinical Neuroradiology. March 2023, Vol. 33 Issue 1, p137, 9 p.
Subject
Language
English
ISSN
1869-1439
Abstract
Introduction Continuous live observation of various interventional procedures is a key element of neurointerventional training and a prerequisite for safely performing stand-alone interventions on patients in a clinical environment. A [...]
Background Remote access of trainees to training centers via video streaming (tele-observership, e-fellowship) emerges as an alternative to acquire knowledge in endovascular interventions. Situational awareness is a summary term that is also used in surgical procedures for perceiving and understanding the situation and projecting what will happen next. A high situational awareness would serve as prerequisite for meaningful learning success during tele-observerships. We hypothesized that live perception of the angiographical procedures using streaming technology is feasible and sufficient to gain useful situational awareness of the procedure. Methods During a European tele-observership organized by the European Society of Minimally Invasive Neurological Therapy (ESMINT) and its trainee association (EYMINT), a total of six neurointerventional fellows in five countries observed live cases performed by experienced neurointerventionalists (mentors) in six different high-volume neurovascular centers across Europe equipped with live-streaming technology (Tegus Medical, Hamburg, Germany). Cases were prospectively evaluated during a 12-month period, followed by a final questionnaire after completion of the course. Results A total of 102/161 (63%) cases with a 1:1 allocation of fellow and mentor were evaluated during a 12-month period. Most frequent conditions were ischemic stroke (27.5%), followed by embolization of unruptured aneurysms (25.5%) and arteriovenous malformations (AVMs) (15.7%). A high level of situational awareness was reported by fellows in 75.5% of all cases. After finishing the program, the general improvement of neurointerventional knowledge was evaluated to be extensive (1/6 fellows), substantial (3/6), and moderate (2/6). The specific fields of improvement were procedural knowledge (6/6 fellows), technical knowledge (3/6) and complication management (2/6). Conclusion Online streaming technology facilitates location-independent training of complex neurointerventional procedures through high levels of situational awareness and can therefore supplement live hands-on-training. In addition, it leads to a training effect for fellows with a perceived improvement of their neurointerventional knowledge. Keywords Telemedicine * Teleproctoring * Teleobservership * Neuroendovascular training * Stroke
Background Remote access of trainees to training centers via video streaming (tele-observership, e-fellowship) emerges as an alternative to acquire knowledge in endovascular interventions. Situational awareness is a summary term that is also used in surgical procedures for perceiving and understanding the situation and projecting what will happen next. A high situational awareness would serve as prerequisite for meaningful learning success during tele-observerships. We hypothesized that live perception of the angiographical procedures using streaming technology is feasible and sufficient to gain useful situational awareness of the procedure. Methods During a European tele-observership organized by the European Society of Minimally Invasive Neurological Therapy (ESMINT) and its trainee association (EYMINT), a total of six neurointerventional fellows in five countries observed live cases performed by experienced neurointerventionalists (mentors) in six different high-volume neurovascular centers across Europe equipped with live-streaming technology (Tegus Medical, Hamburg, Germany). Cases were prospectively evaluated during a 12-month period, followed by a final questionnaire after completion of the course. Results A total of 102/161 (63%) cases with a 1:1 allocation of fellow and mentor were evaluated during a 12-month period. Most frequent conditions were ischemic stroke (27.5%), followed by embolization of unruptured aneurysms (25.5%) and arteriovenous malformations (AVMs) (15.7%). A high level of situational awareness was reported by fellows in 75.5% of all cases. After finishing the program, the general improvement of neurointerventional knowledge was evaluated to be extensive (1/6 fellows), substantial (3/6), and moderate (2/6). The specific fields of improvement were procedural knowledge (6/6 fellows), technical knowledge (3/6) and complication management (2/6). Conclusion Online streaming technology facilitates location-independent training of complex neurointerventional procedures through high levels of situational awareness and can therefore supplement live hands-on-training. In addition, it leads to a training effect for fellows with a perceived improvement of their neurointerventional knowledge. Keywords Telemedicine * Teleproctoring * Teleobservership * Neuroendovascular training * Stroke