Evaluation of a scoring system to assess proficiency in cerebral angiography for neuroendovascular surgery education

OBJECTIVE: Cerebral angiography is indispensable for endovascular neurosurgeons. However, there is no established system to evaluate the competency of trainees. We established a scoring system and statistically analyzed its characteristics. METHODS: Endovascular neurosurgeons scored the operators of 177 cerebral angiography based on ten evaluation items. Preoperative explanation, device selection, and device assembly were classified as “preparation,” communication with the patient, radiation protection and angiography system as “attention,” and catheter operation, blood loss, procedure completion, and sheath insertion as “skill”. The sum of the scores were compared using the Mann-Whitney test according to the status of the operator (trainee (TR), neurosurgeon (NS), or endovascular neurosurgeon (EVNS)). RESULTS: The highest average for each item was 0.89 for communication, and the lowest was 0.68 for catheter operation. The mean ± standard deviation of the total score was 7.82 ± 2.02, and scores by status were 7.08 ± 2.12 for TR, 8.32 ± 1.35 for NS, and 9.33 ± 1.20 for EVNS with significant differences among each status (p < 0.05). The sum scores of the preparation, attention, and skill sections also showed significant differences between each status except between NS and EVNS in the preparation section and TR and NS in the skill section (p < 0.05). CONCLUSIONS: There were significant differences in the total score between statuses, suggesting that the scoring system may be an indicator of proficiency in cerebral angiography. It was suggested that dividing each item into preparation, attention, and skill sections may indicate the characteristics of proficiency.