Texas Cardiac Arrhythmia Institute's New Electrophysiology Technology Training Program

Maha Rinaudo, PhD, President, and TCAI Clinical Coordinator Sharon Collier, RN, NASPExAM Testamur in EP TCA Institute

Maha Rinaudo, PhD, President, and TCAI Clinical Coordinator Sharon Collier, RN, NASPExAM Testamur in EP TCA Institute

As Cardiology has evolved during the last ten years, it has developed into many subspecialties: Preventive Cardiology, Coronary Interventional, Vascular Interventional, Heart Failure Specialists and Electrophysiology (EP). In particular, EP has taken on a much larger role than just a subspecialty. This field is growing at a high rate; EP lab staff has less and less time to complete on the job training. The technologists and nurses in the EP lab are viewed as an extension of the physician performing the procedure, and they are all an integral part of the care and treatment of the patients. There have been no formal educational programs or training, except for courses offered by the Heart Rhythm Society (HRS; previously known as the North American Society of Pacing and Electrophysiology), in-services offered by medical device companies, and hospital-based educational seminars offered by senior EP techs and nurses. Nevertheless, the complexity of the 3D advanced mapping recording, ablation equipment and device troubleshooting continues to increase, all of which requires highly trained electrophysiology lab staff to run equipment and facilitate the everyday, stressful EP job. Another challenge is recruiting and maintaining a trained electrophysiology staff, which is extremely difficult due to the lack of formal educational programs. Texas Cardiac Arrhythmia Institute (TCAI) was founded to fulfill the need of a well-rounded training program for nurses, technicians, fellows, local physicians, and physicians from other states as well as other countries. The Institute was founded in January 2006 by six electrophysiologists (R. Horton, MD, R. Canby, MD, J. Sanchez, MD, J. Gallinghouse, MD, L. Price, DO and J. Zagrodzky, MD) and Maha Rinaudo, PhD, following the lead of Dr. Horton and Dr. Sanchez, who for the last 10 years have been training EP lab staff during their spare time. TCAI goes over every aspect of an EP study (EPS), including basic intervals to ablation electrograms, and covers the types of changes one would expect during the ablation of specific tachycardias. After attending our classes, the student should be able to go back to their respective hospitals and be able to understand a basic EPS, know what the doctor is looking for, and be able to function on the GE Prucka system at an improved level, whether the student is new to the system or has experience. TCAI also utilizes a Registered Nurse from non-invasive cardiology and a variety of highly qualified device company speakers. TCAI is the only institute dedicated to the teaching of all aspects of Electrophysiology. Our audience includes: Nurses, physicians, cardiac therapists, and technicians, as well as other healthcare professionals who are interested in EP and Cardiology to further their education and training; Domestic and international practicing clinicians and residents who receive training from TCAI clinical experts; and Fellowship graduates with in vivo training under the supervision of cardiologists and EPs. A large selection of programs have been created, which we will describe in the next section. TCAI Programs: EP Specialized Training Classes TCA Institute offers specialized EP and pacing training to develop patient care skills, learn the proper use of diagnostic equipment, and provide an extensive hands-on clinical practice. This kind of diversified training helps nurses and technicians nationwide assist on all procedures in their labs, proficiently use all lab equipment, and understand the physician's instructions during procedures. We offer both lectures and hands-on lab training. This extensive course enables the attendee to return to his or her lab with knowledge and skills that can be directly and immediately applied; in addition, the course also helps the attendee realize an increased productivity. St. David's Institute for Learning, a CEU provider, provides CE credits for TCAI. Nurses and technicians who attended our latest classes have expressed great satisfaction with this training. In fact, lab personnel are reserving in advance their spots for the next course. Some of our class topics include CardioLab (also known as Prucka); Mechanics of the EP Study; Fundamentals of Cardiac EP; Intermediate and Advanced EP; Pacemakers, ICDs and Heart Failures Devices; 3D Advanced Mapping System; and Ultrasound/X-Ray. Specialized training is also available for new hires at medical companies (device sales reps, clinical specialists, TFEs). It is intended to boost the training of new hires who have direct responsibilities related to patient care. This program has been designed to maximize their performance and technical knowledge. TCA Institute programs may be used as a preparation for further training or as a refresher for CRM professionals. The curriculum and course lengths can be customized to meet the needs of the participants. We are always updating our schedule to include additional topics. Accelerated Eight-Month Program In order to maintain an EP lab's continuous operations, it became evident that a new educational process was needed. Opportunities including advancing to supervisory or management positions, leaving the direct patient care arena to enter the industry, or providing sales or clinical applications support, etc. were not available to those EP staff interested in such employment possibilities. Therefore, the EP accelerated eight-month program was born. In place of the traditional on the job training, new EP staff members undergo eight months of intense didactic education in combination with clinical rotations in EP labs. The didactic portion of the program is highly specific to EP, and is a combination of lectures and case studies provided by several instructors. The TCA Institute's accelerated eight-month program enables the graduate to earn a Certificate of Completion in Electrophysiology Education. Classes begin each year in January and September. The program will start in January 2007. This program, the first of its kind, gives the interns a well-rounded clinical experience. It will be focusing on basic and advanced EP, cardiac pacing, ECG interpretation, anatomy & physiology, cardiovascular, invasive, and non-invasive and ICD technology, etc. Students will learn patient care skills required during EP studies, scrubbing for EPS and implants, sterile techniques, and radiation safety. Extensive clinical experience will be the largest portion of this eight-month program. All EP lab equipment and tools will be taught; therefore, the graduate will become proficient in the electrophysiology service line and find a job as an Allied Health Professional, either in medical centers or at medical device companies. We are still currently accepting applications for this program. Domestic and International Physicians & Associated Professionals Continuing Education TCAI is pioneering a customized educational training for visiting clinicians; we provide a unique program based on observational and in vivo training in hospitals. There is a huge need for trained fellows worldwide on complicated cases; in addition, it is important to stay up-to-date on the evolution of technology, and to allow domestic and international electrophysiologists and cardiologists to learn the latest techniques. TCAI physicians will share their experience with these visiting clinicians, enabling them to return home with knowledge and skills that can be directly applied to their practice. Customizable learning formats are available for the visiting physicians or clinical scientists. Each experience is tailored to the individual's continuing education and career goals. TCAI offers an intensive clinical training in which fellows are exposed to a large number of procedures in the course of the training. The visiting clinician will work closely with a TCAI physician host, who will help with specific educational goals, and each attendee will receive assistance from TCAI with visa applications and information on housing and accommodations. Individuals participating in our Board-approved postgraduate subspecialty training programs are eligible to obtain a Temporary Physicians in Training Permit from the Texas Medical Board. The TCA Institute is also setting up, along with St. David's Hospital, Biosense Webster, Stereotaxis and St. Jude Medical, the first Center of Excellence in the United States where trainees can observe live cases and benefit from physician lectures. With the growth of invasive cardiology in the emerging economies of Latin America, this Center has the potential to attract a large number of cath and EP professionals, including physicians and nurses. NASPExAM Preparation Course for Physicians and Allied Health Professionals This course will begin on March 2007 to prepare for the next NASPExAM. Our expert staff will work with a small group on recent questions from previous exams. The course will improve the participants' level of preparation by providing a refresher on key elements of the exam. Fees TCA Institute is a non-profit organization; all of our fees are based on participant requirements. To request a class topic, please contact us atadmin@tcainstitute.com. Texas Cardiac Arrhythmia Institute accepts applications to any of the above programs. They can be contacted at 866-892-3408. You can also visit their website at: www.tcainstitute.com