Simulator training to minimize ionizing radiation exposure in the catheterization laboratory

  • Aric Katz
  • Avraham Shtub
  • Amir Solomonica
  • Adva Poliakov
  • Ariel Roguin
Original Paper


To learn about radiation and how to lower it. Patients and operators are routinely exposed to high doses of ionizing radiation during catheterization procedures. This increased exposure to ionizing radiation is partially due to a lack of awareness to the effects of ionizing radiation, and lack of knowledge on the distribution and behavior of scattered radiation. A simulator, which incorporates data on scattered ionizing radiation, was built based on multiple phantom measurements and used for teaching radiation safety. The validity of the simulator was confirmed in three catheterization laboratories and tested by 20 interventional cardiologists. All evaluators were tested by an objective knowledge examination before, immediately following, and 12 weeks after simulator-based learning and training. A subjective Likert questionnaire on satisfaction with simulation-based learning and training was also completed. The 20 evaluators learned and retained the knowledge that they gained from using the simulator: the average scores of the knowledge examination pre-simulator training was 54 ± 15% (mean ± standard deviation), and this score significantly increased after training to 94 ± 10% (p < 0.001). The evaluators also reported high levels of satisfaction following simulation-based learning and training according to the results of the subjective Likert questionnaire. Simulators can be used to train cardiology staff and fellows and to further educate experienced personnel on radiation safety. As a result of simulator training, the operator gains knowledge, which can then be applied in the catheterization laboratory in order to reduce radiation doses to the patient and to the operator, thereby improving the safety of the intervention.


Cardiac catheterization Education Radiation exposure Training Safety Simulation 



The authors acknowledge Dr. Arieh Bomzon, ConsulWrite ( for his editorial assistance in preparing the manuscript.

Compliance with ethical standards

Conflict of interest

There are no relationships with industry and no conflict of interest.


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Copyright information

© Springer Science+Business Media Dordrecht 2016

Authors and Affiliations

  1. 1.Department of Industrial Engineering and ManagementTechnion - Israel Institute of TechnologyHaifaIsrael
  2. 2.Interventional Cardiology, Rambam Medical Center, Ruth and Bruce Rappaport Faculty of MedicineTechnion - Israel Institute of TechnologyHaifaIsrael

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