Simulator-based teaching for coronary angiography (CA) is a seductive tool for medical students to improve knowledge and skills. Its pedagogical impact has not been fully evaluated yet. The aim of this study was to compare traditional face-to-face teaching with a simulator-based teaching.

Hundred and eighteen students were prospectively randomized in two groups: a control teaching group (n=59, CONT group) and a simulator (Mentice AB, Sweden) group (n=59, SIM group). CONT group received a PowerPoint-based course (30min), consisting of 15 slides encompassing predefined learning objectives (coronary anatomy, different projections, film interpretation). SIM group received a simulator-based course including exactly the same information in an interactive, real 3D environment. After the course, students were evaluated by 40 multiple-choice questions (maximum of 100 points (pts)), including questions on coronary anatomy (part 1:50 pts), on angiographic projections (part 2:10 pts), and real case interpretations (part 3:40 pts).

Student characteristics were identical in both groups: 52.5% were female; age was 22.6±1.4 years. 35.6% were in their 4th year of medical school, 35.6% in 5th year and 28.8% in 6th year. SIM students scored higher than CONT students irrespective of age and year of medical school (59.5±10.8 pts vs. 43.7±11.3 pts, P<0.00001) for all parts of the evaluation (part 1: 36.9±6.6 pts vs. 29.6±6.9 pts, P<0.00001; part 2: 5.9±3.0 pts vs. 3.1±2.8 pts, P<0.00001; and part 3:16.8±6.9 pts vs. 10.9±6.5 pts, P<0.00001). Student satisfaction was also higher in SIM group than in CONT group (98% vs. 75%, P<0.0001) (Fig. 1).

This prospective, randomized trial suggests that simulator-based teaching in CA significantly improves students’ knowledge in coronary anatomy, angiography projections, but also clinical competence and decision making process. These results should encourage further evaluation of simulator-based teaching in other branches of medicine.