{
  "abstract": "Introduction Pericardiocentesis is a life-saving but high-risk procedure associated with potential complications. Despite being a core competency for cardiology trainees, there are limited opportunities for hands-on practice due to heavy clinical responsibilities and the rarity of the procedure in training settings. In most cases, pericardiocentesis is performed by senior clinicians, meaning trainees have few supervised learning opportunities. When trainees do perform the procedure, it is usually under urgent conditions without structured feedback, preventing them from refining their skills and completing Direct Observation of Procedural Skills (DOPS) assessments. As a result, there is a clear need for structured simulation-based training to enhance procedural skill performance in a safe environment.Purpose To design, evaluate, and enhance a high-fidelity pericardiocentesis simulation programme for cardiology trainees. The programme aims to enhance trainee confidence and competence while advocating for its integration into the formal training curriculum.Method A high-fidelity ultrasound-guided pericardiocentesis simulation programme was developed and introduced for cardiology trainees from February 2023. The programme was delivered one-to-one by a consultant cardiologist. Each session included:Didactic teaching, including review of core concepts, case discussions, and trainee experience-sharing.Simulation training, involving echocardiographic assessment of pericardial effusion, followed by ultrasound-guided pericardiocentesis using a high-fidelity procedural model and real pericardiocentesis instruments. The simulation setup and ultrasound-guided procedural model are shown in figure 2.Immediate feedback, with expert-led debriefing and technical correction. To assess trainee experience and confidence levels, anonymous feedback was collected after completing the simulation teaching.Results Over the two-year period, 73 cardiology registrars participated in the programme. Among them, 86.4% reported limited opportunities to practise pericardiocentesis in clinical settings due to lack of exposure, competing clinical responsibilities, and the need for consultant involvement in emergencies.Confidence scores significantly improved following training (figure 1): Pre-training confidence mean: 3.16 out of 5; Post-training confidence mean: 4.41 out of 5. 38 trainees (52.1%) improved by 1 confidence level, while 25 trainees (34.2%) improved by 2 or more levels.Trainees identified the most valuable aspects of the programme as expert instruction from experienced clinicians, realistic high-fidelity simulation equipment, immediate feedback and structured learning to enhance procedural skills and decision-making, and a multi-modal teaching approach integrating theory, case discussions, and hands-on practice.Abstract 1-020 Figure 1Improvement in trainee confidence levels before and after simulation-based pericardiocentesis trainingAbstract 1-020 Figure 2High-fidelity ultrasound-guided pericardiocentesis simulation model setupConclusion Our two-year evaluation demonstrates significant improvements in trainee confidence and skill proficiency in performing pericardiocentesis using simulation-based training, highlighting its importance for high-risk cardiology procedures. Given the increasing demand for structured procedural training, we have recently secured approval from Health Education England (HEE) for study leave funding, ensuring financial support for trainees and the programme’s long-term sustainability. Furthermore, we are working towards expanding this initiative nationally and internationally, as demonstrated by our presentation at this congress. This study underscores the growing need for simulation-based training in cardiology, particularly for high-risk procedures. Future initiatives will focus on integrating simulation into training curricula, evaluating additional cardiology procedures, and tracking long-term trainee performance and ARCP outcomes to assess the impact of simulation-based education on career progression.",
  "authors": [
    {
      "affiliations": [
        "Guy’s and St Thomas' NHS Trust Hospitals, London, UK"
      ],
      "name": "E Haghighifard"
    },
    {
      "affiliations": [
        "Guy’s and St Thomas' NHS Trust Hospitals, London, UK"
      ],
      "name": "C Campbell"
    },
    {
      "affiliations": [
        "Guy’s and St Thomas' NHS Trust Hospitals, London, UK"
      ],
      "name": "S Sabu"
    },
    {
      "affiliations": [
        "Guy’s and St Thomas' NHS Trust Hospitals, London, UK"
      ],
      "name": "A Dennis"
    },
    {
      "affiliations": [
        "Guy’s and St Thomas' NHS Trust Hospitals, London, UK"
      ],
      "name": "R Kanyal"
    },
    {
      "affiliations": [
        "Guy’s and St Thomas' NHS Trust Hospitals, London, UK"
      ],
      "name": "C Byrne"
    },
    {
      "affiliations": [
        "Guy’s and St Thomas' NHS Trust Hospitals, London, UK"
      ],
      "name": "G Gibson"
    },
    {
      "affiliations": [
        "Guy’s and St Thomas' NHS Trust Hospitals, London, UK"
      ],
      "name": "L Leung"
    },
    {
      "affiliations": [
        "Guy’s and St Thomas' NHS Trust Hospitals, London, UK"
      ],
      "name": "JM Behar"
    }
  ],
  "title": "1-020 Advancing pericardiocentesis training: a two-year evaluation of a high-fidelity simulation programme",
  "uid": "0d624617-91ae-5f67-a348-1d3673f2109e"
}