We had the opportunity to speak to Healthcare Systems key opinion leader Prof. Dr. med. Marcus Katoh, MBA, Chefarzt - Institut für Diagnostische...
We had the opportunity to speak to Healthcare Systems key opinion leader Prof. Dr. med. Marcus Katoh, MBA, Chefarzt - Institut für Diagnostische und Interventionelle Radiologie, Helios Klinikum Krefeld and Helios Klinik Hüls. Prof. Katoh was recently appointed as the new chairman of the board of The German Society for Interventional Radiology (DeGIR) and aims to represent all interventional radiologists and minimally invasive radiologists in the DRG, focusing on advanced training and quality assurance in interventional radiology practice.
The DeGIR now has around 1,500 members, and our aim is to provide them with information on new topics, techniques, and educational issues to help with quality improvement or documentation. At present, we have a national registry, where we try to collect all the information about interventional cases carried out in Germany. We also try to cover economic issues, such as coding. In short, we try to empower interventional radiologists in their daily work.
Every day we have something new in interventional radiology. But I think the most exciting thing right now, at least in Germany, is that intervention is getting a more prominent role within the much larger specialty of radiology. General radiology used to be only diagnostic, and now it is getting more and more therapeutic. And I think one of our most important tasks is to prepare these so-called modern radiologists to do the intervention. And for this reason, we need to educate them not only on techniques but also on clinical skills and clinical issues, which are very important to take control of the whole procedure and patient outcome.
It was by chance that I got introduced to the subject of simulation. I work in a hospital that belongs to the Helios group, one of Europe’s most prominent hospital groups. As part of the radiology team, we wrote an application for a simulator because we thought it would be good to have such a training possibility. I must admit, I was one of the people who said, well, is it worth it to buy a machine like that? But then, when we got one, I changed my mind completely. I realized that in intervention and other areas of medicine, education remains very old-style - standing with a mentor or teacher, as he whispers for a trainee to carry out specific procedure steps at the patient’s side. It is concerning that this is still the routine today, even within our hospital. However, not everyone is lucky enough to have a simulator in their hospital to train on.
Upon purchase, the simulator was shared by the hospitals in the Helios group and traveled to different hospitals for two or three months at a time. But when it got to my hospital the first time, it was not put to good use because the team did not know how it should be used or what to do. I realized that we needed a curriculum or program around it to educate our physicians effectively. So, we created a training program, and then the situation changed completely. The second time the simulator was in our hospital, we had many physicians using it, even senior physicians, and participating in very lively discussions, which was extremely interesting to see. As an expert or a senior physician, it is common that you carry out a lot of work alone, and after you have done this for several years, you establish your own best practices as a physician. But when two experts were sitting in front of the simulator, without a patient, they had time to think about why they do what they do, and they got into many interesting questions. Such as, why do you use this device in this situation? Or why should you use this technique in this way? Everybody does some things differently, and this is a great environment to exchange experience and information. So, I believe that simulation, together with a good curriculum, is a crucial part of education in interventional radiology.
“We have simulators at different sites for the hands-on part, and it’s combined with a web conference so you can run presentations and show training materials. We are still at the beginning of this, but it looks very good. We were surprised at how nicely the exchange of information works using different camera views to show the face or the hands of the experts while they are working on the simulator”
When we started working with the Mentice simulator through DeGIR, we knew how highly developed the simulators were, and we saw the potential to use them for education. So first, we developed and implemented a course where you had an expert working on a simulator, which was projected on a big screen for all the participants to watch. In parallel, the trainees sat with their dedicated simulator conducting the same case, mimicking the procedural steps as the expert. This was an excellent format of training. Our motto for this setup was “steal with your eyes,” meaning that the students could “steal” the techniques of the experts by copying exactly what they were doing.
It’s hard to say, but I don’t think that it will be enough to place catheters with the help of, say, an iPad or something. I believe tactile information and feedback are very, very important. Since COVID, we did not conduct any in-person workshops, so we have extended the original simulation course further. We have simulators at different sites for the hands-on part, and it’s combined with a web conference so you can run presentations and show training materials. We are still at the beginning of this, but it looks very good. We were surprised at how nicely the exchange of information works using different camera views to show the face or the hands of the experts while they are working on the simulator. And I think when you have your own simulator, and the possibility to implement a camera and a video conference, it will be possible to be at different sites and to do a course, where everyone follows what the other participants or the experts do. I mean, the simulators are advancing, and the quality is getting better. Going forward, I believe this format could be a natural alternative to live cases on humans in a congress when combined with questions and an expert panel.
In my eyes, these kinds of tools are getting more and more handy. Maybe there’s a slight barrier due to the cost. Still, I know they are also getting implemented directly together with the angiography units now, which is a significant step. And I think there is great potential for any certification and qualification of physicians to allow us to do standardized examinations. For these reasons, technology will be essential, and hopefully, we can get there in the next three to five years.
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