Simulation: present and future roles.

m nterventional cardiology is a broad and expanding eld that requires cognitive elements, clinical exerience and judgment, and a strong technical omponent. In addition, because of technological dvances and application of this technology to a ariety of noncardiac vascular beds such as carotid, eripheral, or renal vessels as well as structural ardiac lesions such as patent foramen ovale, oprators are constantly challenged to adapt to new pproaches. Assessment of cognitive elements has been studed extensively, and the metrics have been tested nd validated. The establishment of the Intervenional Cardiology Board Examination in 1999 in he U.S. as an “added qualification” was founded, n large part, on assessing cognitive elements in the andidates. This and subsequent examinations also ested some aspects of judgment using case examles that required synthesis of data and judgment. A crucial component has been the teaching and hen testing of technical skills, which is the least tandardized component in the typical intervenional cardiology curriculum. In the typical training xperience, trainees in percutaneous coronary inervention develop knowledge and skills through tudying, observing, assisting a senior operator, and hen ultimately performing the procedures indeendently. This experience is dictated by the ranom admission of patients, rather than a timely onsistent exposure to the wide range of patient nd anatomic conditions. Simulation has the poential to be the platform technology for not only eaching, but also for evaluating and testing.