From simulator to patient: transfer of procedural skills to practice in cardiac device implantation.

Aims: Cardiac implantable electronic devices (CIED) training for novice implanters typically occurs Methods and results: Prospective observational cohort study following participants from a prior multinational randomized simulation trial to assess transfer of training to clinical practice. Early-career implanters (≥20 prior pacemaker/defibrillator cases; limited CRT first-operator experience) reported the implant technique they applied in their first two routine clinical cases within 30 days of training, using a validated standardized performance metrics form assessing surgical and lead implantation steps. The primary outcome was the mean percentage of deviations from optimal technique per participant.Of 30 randomized participants, 21 (70%) submitted 42 case reports (10 PBP, 11 SBT). Baseline characteristics were similar, and case complexity did not differ between groups ( Conclusion: Metrics-based PBP training was associated with significantly fewer procedural deviations from optimal CIED implant technique during early clinical practice compared with traditional simulation. These findings support benchmark-based simulation as a strategy to improve early clinical skill transfer in cardiac electrophysiology.