Remote Training of Neurointerventions by Audiovisual Streaming Experiences from the European ESMINT-EYMINT E-Fellowship Program

• Published in: Clinical neuroradiology (Munich) Vol. 33; no. 1; pp. 137 - 145
• Main Authors: Hanning, Uta, Bechstein, Matthias, Kaesmacher, Johannes, Boulouis, Grégoire, Chapot, René, Andersson, Tommy, Boccardi, Edoardo, Psychogios, Marios, Cognard, Christophe, de Dios Lascuevas, Marta, Rodrigues, Marta, Rodriguez Caamaño, Isabel, Gargalas, Sergios, Simonato, Davide, Zupancic, Vedran, Daller, Cornelia, Meyer, Lukas, Broocks, Gabriel, Guerreiro, Helena, Fiehler, Jens, Martínez-Galdamez, Mario, Kalousek, Vladimir
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-03-2023; Springer
• Subjects: Aneurysms; Europe; Fellowships and Scholarships; Germany; Humans; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Neurology; Neuroradiology; Neurosurgery; Original; Original Article; Streaming media; Stroke (Disease); Europe; Germany; Teleobservership; Stroke; Telemedicine; Teleproctoring; Neuroendovascular training
• ISSN: 1869-1439; 1869-1447; 1869-1447
• DOI: 10.1007/s00062-022-01192-9

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.