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Research Snapshot Theater: Professional Development and Education, Adult I

Simulation of TVP Troubleshooting Improves CCM Fellows’ Temporary Pacing Skills and Confidence

Sunday, March 22, 2026
9:45 AM - 10:45 AM Central Time
Location: Connections Central - RST 15
Introduction: Placement and management of temporary venous pacemakers (TVPs) is a technically difficult, but necessary skill for critical care medicine (CCM) fellows. Although well-established simulation modalities exist to teach TVP placement, including high and low-fidelity task-trainers, no literature currently exists on modalities to simulate management of TVP complications and emergencies. InterSim® III is a novel software that simulates different unstable arrhythmias amenable to pacing. An interactive TVP troubleshooting simulation was designed with the goal of improving CCM fellows’ knowledge of and confidence with TVP management and troubleshooting.


Methods: First-year CCM fellows participated in a 1.5-hour session, with a lecture followed by simulated TVP placement, and five pre-programmed simulated cases of TVP management and troubleshooting. For initial TVP placement, learners utilized the PacerMan® simulation system; learners utilized the InterSim® III software system for the cases. Pre- and post-intervention, learners completed five parallel pairs of expert-reviewed, validated questions based on the learning objectives, and subjective confidence questions.


Results: 13 first-year CCM fellows participated. 12 completed the pre-test; 11 completed the post-test. Fellows’ scores on the knowledge questions improved (p < 0.01). Fellows’ confidence improved in TVP placement (p < 0.01), recognizing TVP complications (p < 0.01), choosing initial pacing settings (p < 0.01), and troubleshooting TVP problems (p < 0.01). Fellows found the simulation to be relevant to their clinical practice and at an appropriate level of difficulty.


Conclusions: Realistic TVP troubleshooting with an interactive simulation platform improved CCM fellows’ knowledge and confidence. This simulation modality may benefit other trainees for whom TVP management is a necessary skill. Additional iterations of this simulation with trainees in other specialties are planned.