The assessment of technical skills in a cardiology training program: is the ITER sufficient?

Diagnostic coronary angiography is an important tool in the assessment of heart disease. No objective data are available regarding the best method of training or testing a cardiology trainee's skill in the performance of this procedure. Training guidelines are based on the consensus opinions of experts in the field, and the assessment of proficiency is relegated to a generalized in-training evaluation report (ITER). However, is an ITER sufficient? The current modes of assessment are examined, with the question of whether a more comprehensive and valid assessment process is needed.