PAN-CANADIAN INITIATIVE ON FUNDAMENTAL COMPETENCIES FOR TRANSCATHETER CARDIAC SURGERY: A MODIFIED DELPHI CONSENSUS STUDY

BACKGROUND Transcatheter cardiac procedures have generated increasing interest in trainees and training programs alike. Using the modified Delphi method, we sought to clarify the transcatheter competencies that cardiac surgery residents should be expected to attain by the completion of training. METHODS AND RESULTS Individuals with expertise in transcatheter structural heart and aortic procedures were recruited across Canada. A questionnaire was prepared using a 5-point Likert scale. During two rounds participants rated the competencies that they felt cardiac surgery residents should be required to achieve to perform transcatheter procedures. Data was analyzed and presented to participants between rounds. Competencies rated 4 or higher by at least 80% of respondents after the second round were considered fundamental to transcatheter cardiac surgical training. A total of 46 individuals participated in the study including 23 cardiac surgeons, 17 interventional cardiologists and 6 vascular surgeons. Participants with relevant experience performed a median of 75 (interquartile range 40 – 100) transcatheter aortic valve implantations in the prior year as primary or secondary operator and 15 (interquartile range 11 – 35) thoracic endovascular aortic repairs in the prior two years as primary operator. Median clinical and teaching experience consisted of 13 (interquartile range 7 – 19.5) years in practice and 8.5 (interquartile range 5- 15) residents taught per year, respectively. Of the included competencies, 53 were considered fundamental to transcatheter cardiac surgical training. CONCLUSION The identified fundamental competencies can be used to develop educational strategies during transcatheter cardiac surgery training. Future efforts should focus on collecting evidence for their validity.