Table 2 Qualitative user feedback for realism of the integrated simulation training framework

Scenarios

“Good flow to scenarios, starting with the procedure, then going on to the crisis” (P1, intermediate)

“Several challenges are thrown into the scenarios which work very well in learning how to react and how quickly” (P1, intermediate”)

“The scenarios are key to these simulations…talking through what you plan to do as you’re doing it…for training purposes it’s excellent” (P3, senior)

Technical procedure

“The feedback from the simulator didn’t feel very accurate…but the scenarios are designed around this issue which is really useful, and offers more benefits for training” (p5 junior)

“There were some technical issues with simulator…handling the guidewire felt odd…once you get into it its ok” (P3, senior)

“[The interventional VR simulator] feels different to the real procedure…different sensitivity…but the scenario allows adaption to this” (P4, intermediate)

Simulated patient

“Very realistic chatter, but how these interactions are handled by trainees will vary according to individual differences; I can’t always deal with talking to a patient and doing the procedure, so this is good practice” (P4, intermediate)

“Having a real patient instead of a mannequin makes it more realistic” (P2, senior)

“I got a lot of feedback from the patient… very realistic” (P3, senior)

Multidisciplinary team and behavioural component

“Having an actual nurse and radiographer…the actual team would make it even more realistic” (P5, junior)

“Having to manage team members is key to these simulations…I think clinical feedback from a real cath-lab team would add to the realism and makes it feel more immersive” (P4, intermediate)

“Having non-clinical stand-in team members is not realistic. Feedback from the team is very important…you need real cath-lab members in the team” (P3, senior)

“Having a fully operational team would make it more realistic, i.e. radiographer, runner nurse…” (P2, senior)

Case flow and crisis management

“The crisis scenarios worked very well. The traces were very realistic” (P4, intermediate)

“Having the crisis equipment, defibrilliator… makes it feel very realistic” (P1, intermediate)

“The crisis was very realistic and close to real life in real PCI’s” (P2, senior)

Simulated angio-suite

“In terms of simulating an angio-suite it’s quite realistic…I think actually being involved in the scenarios and experiencing that makes it realistic” (P5, junior)

“It’s quite realistic, relatively immersive…but there will always be a schism between reality and simulation….the patients’ torso is a bit too long so she was far too away while I was operating…I couldn’t always hear her” (P1, intermediate)

“Having a team and task is what makes it more immersive…it means you focus less on the little things like equipment which aren’t necessarily that accurate…” (P2, senior)

Overall experience

“Simulating everything together, the pressure…the team skills, communication and crisis…to know what to do when something is going wrong, to get the right decision making…I found it more challenging and useful than the technical part which didn’t feel that accurate” (P5, junior)

“Very realistic in terms of the whole experience: doing the procedure, talking to the patient, handling the team” (P1, intermediate)

“Very much the same as what actually happens, and the workload in the cath-lab” (P1, intermediate)

“I felt immersed…responding to traces, talking to the patient, interactions with team” (P4, intermediate)

“I felt immersed in the scenario. There’s a patient there speaking to you. It felt serious and I responded to it accordingly (P2, senior)