Competency-Based Cardiac Imaging for Patient-Centered Care: Key Points

Westwood M, Almeida AG, Barbato E, et al.
Competency-Based Cardiac Imaging for Patient-Centered Care. A Statement of the European Society of Cardiology (ESC). With the Contribution of the European Association of Cardiovascular Imaging (EACVI), and the Support of the Association of Cardiovascular Nursing & Allied Professions (ACNAP), the Association for Acute CardioVascular Care (ACVC), the European Association of Preventive Cardiology (EAPC), the European Association of Percutaneous Cardiovascular Interventions (EAPCI), the European Heart Rhythm Association (EHRA), and the Heart Failure Association (HFA) of the ESC. Eur Heart J 2023;Sep 19:[Epub ahead of print].

The following are key points to remember from a European Society of Cardiology (ESC) and European Association of Cardiovascular Imaging (EACVI) statement on competency-based cardiac imaging for patient-centered care:

  1. The adequate delivery of cardiac imaging services depends upon expertise in both imaging methodology and clinical cardiovascular care. The ESC and EACVI have developed and implemented an education and certification program for all cardiac imaging modalities: echocardiography, cardiac computed tomography (CCT), cardiovascular magnetic resonance (CMR), and nuclear cardiology. This statement articulates the need for competency-based cardiac imaging delivery.
  2. The core principles of competency for all imaging modalities are effectiveness, efficiency, equity, patient-centeredness, safety, and timeliness. Key components of patient-centered cardiac imaging care include shared decision making, confidentiality, convenient access, and empathetic and clear communication.
  3. Certification in each of the four imaging modalities through EACVI requires passing a modality-specific examination and clinical training in image acquisition and interpretation. Similar to the Core Cardiology Training Symposium (COCATS) standards in the United States, EACVI level I certification requires basic knowledge of the modality, and levels II and III certification require more in-depth knowledge and larger case volumes.
  4. EACVI emphasizes a multimodality approach to training, and in 2023, it launched a multimodality imaging certification, which recognizes individuals certified in two complementary imaging modalities. EACVI also held its first multimodality imaging congress in 2023.
  5. A recent report by the European Society of Radiology and European Society of Cardiovascular Radiology emphasized the need to increase cardiac imaging expertise and capacity among radiologists. The authors of this ESC/EACVI statement disagree with the implication that radiologists are essential in all cardiac imaging care, pointing out that many high-level cardiac imaging departments are led entirely by cardiologists. The authors stress the importance of understanding pathophysiology and disease processes in determining optimal use of cardiac imaging.
  6. Clinical Topics: Noninvasive Imaging, Echocardiography/Ultrasound, Magnetic Resonance Imaging

    Keywords: Certification, Diagnostic Imaging, Echocardiography, Magnetic Resonance Imaging, Nuclear Medicine, Patient-Centered Care

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