Cath Lab Digest - September 2007 - (Page 34)

34 YOUR PATH TO SUCCESS: CAREER ADVICE SEPTEMBER 2007 continued from previous page For those seeking a less formal means of advancing your knowledge, there are programs offered through national training companies, with classes usually lasting 2 to 5 days, which provide concentrated coursework in a short period of time. 1. Establishing Your Goals: Where do you want to be? Considering your goals is an important first step. Do you want to learn more about how to best perform in your current role? Or is your goal to advance your career to become a supervisor, manager, or director of your program? Whatever your answer, there is work to do to achieve these goals. Have you talked to your manager about your goals and how they fit into your department and organization’s goals for you? Are these goals aligned with yours? This is a good place to start if your goal is to move up the ladder where you currently work. Having this type of conversation is a good way to let your manager know you are taking charge of your career and are willing to work hard to advance and to take on more responsibility. Sharing your thoughts with your supervisor will help you take the beginning steps necessary to reach your goals. It will also ensure that your supervisor is aware of the motivation you have to perform at your highest level within your program. offered through national training companies, with classes usually lasting 2 to 5 days, which provide concentrated coursework in a short period of time. These are usually noncredit classes with information very specific to a focused area of interest. For example, Corazon offers the Corazon Academy, a program developed by our team of experts to impart executive-level knowledge and skills to cardiac and vascular leaders holding positions critical to the overall performance and direction of the specialty. This includes service line administrators, CVOR management, cath lab directors and managers, and other cardiovascular leaders. If you or your organization has goals for you to move into a management position, this course, and others with a similar focus, could be very beneficial. Professional development seminars can also provide detailed information or knowledge on a specific area of your specialty, and training luncheons or other informal classes offered in your area can be another option to help further your career (be sure to review Cath Lab Digest’s clinical meetings calendar to keep abreast of any upcoming options in your area). Also, the value of reading can never be discounted. There is a wealth of literature available in print and online related to the cardiovascular industry. Remaining abreast of the latest and greatest in your area of expertise will do much to keep you knowledgeable and informed, which in turn, will help with your professional development and career advancement. Figure 1. The Silber score: Evaluation of randomized controlled trials based on evidence. Q A What is the Silber score and why did you develop it? The Silber score (Figure 1) is my suggestion for a better evidence-based medicine scoring system. It’s not perfect, but it’s a very nice tool to stimulate discussion. I developed the Silber score because I feel that the traditional levels of evidence used by American College of Cardiology (ACC)/American Heart Association (AHA)/European Society of Cardiology (ESC) — A (evidence from two or more multiple randomized clinical trials or meta-analyses), B (evidence from a single trial or meta-analysis) and C (expert opinion) – are no longer sufficient, particularly for percutaneous cutaneous interventions (PCI). What are the major limitations of the ACC/AHA/ESC scoring system in assessing evidence? The major limitation of this traditional scoring system is that it does not differentiate between clinical and surrogate primary endpoints. It does not address whether the size of a trial is adequate for the hypothesis. The ACC/AHA/ESC scoring system states that two randomized clinical trials are sufficient as evidence, but it does not outline the number of patients and follow-up period. Furthermore, there is subjective influence possible in this scoring system, so it can be arbitrary. What are the major differences between the Silber and the ACC/AHA/ESC scoring systems? The Silber score takes into account the power of a trial, which should be a least 80 percent. My scoring system also requires a minimum number of patients to be followed, depending on the primary endpoint. In the Silber system, you should have a follow-up of at least 95 percent of patients for evidence to be sufficient for a primary clinical endpoint. Furthermore, it is very important that the Clinical Event Committee and Data Safety Monitoring Board is external and independent. The members of these boards should not enroll and treat patients. Finally, the Silber score is highly reproducible, so each investigator or group should result in the same level of evidence. In the Silber system, multi-center studies with at least three centers get one point, whereas studies with less than three centers get zero points. This is important because the more centers that participate, the better picture you get. Single-center studies are usually smaller so they are often not sufficient and underpowered. In other scoring systems, the number of centers is not reflected at all. Sponsored by Boston Scientific Corporation For more information on the Silber score, visit the Evidence Based Medicine Center (EBMC) on www.tctmd.com, which is made possible by support from Boston Scientific Corporation. EBMC was developed to help physicians evaluate the strength of evidence from the currently available clinical studies and initiate discussion about how to interpret such evidence. Q A 2. Achieving Your Goals: Define the ‘how’ Now that you’ve defined your goals, finding the programs, seminars, courses, and/or other resources to provide continuing education is the next step. Depending upon your personal or professional career aspirations, the education can take many forms. For instance, a traditional college or university with day, evening, and weekend classes might be a fit for formal, advanced education. Some even offer accelerated programs with weekend classes or online options, making it even easier to fit classes within your work schedule and home life. Don’t forget about your local community college. Many offer not only business programs, but nursing, cardiovascular technology, radiology and nuclear medicine technology courses for obtaining a certificate or license. For those of you seeking a less formal means of advancing your knowledge, there are programs Q A 3. Making Time for Your Goals: Now or never! There are never enough hours in a day, but making time for continuing education is a sound investment. Again, planning is indeed the most important aspect. Discuss your goals with your loved ones, your manager and whoever else may need to help http://www.tctmd.com

Table of Contents Feed for the Digital Edition of Cath Lab Digest - September 2007

St. Dominic Hospital The Genous Bio-engineered R Stent Percutaneous Treatment of Peripheral Arterial Chronic Total Occlusions: Device Options and Clinical Outcomes Contents Clinical Editor’s Corner Percutaneous Revascularization of Peripheral Chronic Total Occlusion — Which Patients, Why, and How? Myocardial Infarction and Syncope: A Manifestation of the “Raynaud-Prinzmetal Syndrome”? Essential Technical Components of the Transradial Approach If You Build It, Will They Come? Evidence-Based Medicine with Drug-Eluting Stents Back to School: The Value of Education in Cardiovascular Services The ACVP Standards and Competencies: Are You Using Them Effectively? What Do You Think? My Experience with Fibromuscular Dysplasia and Stroke A Brief Review of Fibromuscular Dysplasia Letter to the Editor A Look at On-the-Job Training: Perceptions, Reality and Our Profession Doing the Wave: Inventory Management with RFID The Ten-Minute Interview with… Paul Pinsker, RCIS CLD’s Annual Salary Survey Harrisburg Area Community College Volunteer Survey CEU Education Center SICP* Section Ask the Clinical Instructor: A Q&A Column for Those New to the Cath Lab Clinical & Industry News

Cath Lab Digest - September 2007

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