EP10.01: Learning performance on radiofrequency ablation in a twin reversed arterial perfusion sequence model

To characterise the procedural learning curve of novice practitioners for mastering radiofrequency ablation (RFA) in a simulated twin reversed arterial perfusion (TRAP) sequence model. 12 novices participated in practicing RFA in a TRAP sequence model, which was evaluated for the validity evidence. Cumulative summation (CUSUM) scores were obtained through the binary outcomes (operation success or failure). Learning curve CUSUM analysis was used to define the number of procedures to achieve competency. The 10% and 25% thresholds were designated as acceptable and unacceptable failure rates, respectively. The overall model rating was 4.26 ##+ 0.58 with high performance as a learning tool. A success rate of 92.8% was attained across 767 procedures performed. The average number of procedures to achieve competency was 29, relative to years of experience doing invasive prenatal testing. After passing the competency level, the success rate significantly improved from 88.2% to 96.7% (P < 0.001) and the needle insertion time decreased from 33 seconds to 28 seconds (P = 0.027). The performance of RFA in this simulated TRAP sequence accumulated over time. Accomplishing the competency level enhances technical success and shortens needle insertion process. This simulation training initially imparts practical skills for inexperience surgeons.