The hidden procedural curriculum
Some skills are formally taught. Others are passively learnt
Cardiology training provides extensive exposure to angiography and coronary intervention.
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However, many practical skills are acquired through individual mentorship or chance clinical exposure.
The experience and confidence of trainees by CCT can therefore vary considerably.
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Cath Talks focuses on this hidden procedural curriculum — the practical knowledge, judgement and behaviours that become essential when procedures become difficult.
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Practical knowledge
How do you respond when:
• the radial artery goes into severe spasm?
• the coronary will not engage safely?
• the pressure waveform damps?
• support is inadequate?
• equipment will not cross?
• equipment becomes trapped?
Crisis management
How do you respond when:
• coronary flow suddenly disappears?
• a perforation occurs?
• the patient becomes hypotensive?
• tamponade develops?
• ventricular arrhythmia occurs?
• cardiac arrest occurs in the cath lab?
Leadership
And while that is happening:
• Who leads?
• Who calls for help?
• Who manages haemodynamics?
• Who prepares bailout equipment?
• How is the team kept aware of the evolving situation?
