As the population continues to age, the demand for healthcare services is rising, including areas that depend on advanced simulation-based training, particularly electrophysiology, which is a rapidly expanding specialty focused on diagnosing and treating heart rhythm disorders. However, training in Europe remains fragmented and inconsistent.

A new EU-funded project, “ERIS,” aims to create and validate the first-ever European Research Institute on Simulation (ERIS), an educational institution at the European level, based on a collaborative academic network for healthcare professionals training in interventional electrophysiology.

The primary objective of ERIS is to develop an independent accredited European educational framework that ensures high-quality training in cardiac electrophysiology.

The project is funded by the Horizon Europe programme and seeks to coordinate simulation-based training for healthcare professionals in the EU.

The project is coordinated by the Fundació de Gestió Sanitària del Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, and involves a partnership with Clinique Pasteur Toulouse, Toulouse, France; Vrije Universiteit Brussel, Brussels, Belgium; the European Society of Cardiology (ESC); the European Heart Rhythm Association (EHRA); and VALDE SL, a consulting company dealing with the administration of the project.

According to José M. Guerra, MD, PhD, cardiologist in the Arrhythmia Unit at Hospital de la Santa Creu i Sant Pau, the project integrates theoretical education, advanced simulation, and clinical practice within a shared curriculum supported by European standards and objective metrics to assess competence.

Speaking with El Médico Interactivo, part of the Medscape Professional Network, Guerra said, “The importance of this institute lies in the fact that arrhythmias are increasingly common in an aging population and require complex procedures and innovative technologies. Without standardised training, patients do not have equitable access to optimal treatments. ERIS seeks to reduce complications, improve patient safety, and accelerate the safe adoption of new technologies across Europe.”

Hybrid Program

As Guerra explained, training is delivered through a hybrid program that combines classroom-based teaching with instruction via an interactive digital platform. This is complemented by advanced simulations using high-fidelity simulators, augmented reality, and anatomical models, allowing clinicians to safely practice complex procedures on patients.

Participants also completed supervised clinical placements at reference hospitals in Barcelona, Brussels, and Toulouse, all of which had access to advanced electrophysiologic technologies.

The program also applies the proficiency-based progression (PBP) method, in which advancement depends on demonstrated objective competence rather than the time spent in training. This approach aims to reduce errors and ensure that clinicians are adequately prepared before performing the procedures on patients.

“The program is designed primarily for cardiology specialists who wish to train in electrophysiology,” Guerra said. “It can also benefit practicing electrophysiologists who need to update their skills in new techniques and technologies.” In later phases, ERIS plans to include physicians in advanced training after completion of the MIR program in Spain’s standardised medical residency system, as well as other professionals involved in interventional procedures. The long-term goal is to create a European network of experts with shared certification and professional mobility.

Common standards will be established across EU member states through a Europe-wide accredited academic curriculum developed in collaboration with the ESC, EHRA, and participating universities, namely Universitat Autònoma de Barcelona, Barcelona, Spain, and Vrije Universiteit Brussel. The curriculum follows quality standards and objective competence metrics based on PBP; integrates theory, simulation, and clinical practice across all modules; and provides certification valid throughout the EU, supporting professional mobility and consistency in care delivery.

Common Competencies

According to Guerra, these shared standards ensure that a specialist trained in Spain, Belgium, or France has the same competencies and professional recognition as a specialist trained in any other European country.

Currently, cardiac electrophysiologic training in Europe is fragmented and unequal. Educational pathways vary by country and are often industry-led. In many cases, programs lack the integration of theory, simulation, and clinical practice, and there is no common accreditation system or objective framework for assessing competence in this field.

In response, ERIS introduced academic neutrality through independent governance without commercial bias, objective evaluation using PBP based on demonstrated competence, and equitable access to training programs adapted for less-developed countries, including scholarships to support participation in these programs.

Flexibility and Equity

Guerra noted that the program considers the differences between national healthcare systems. “The curriculum is designed to align with European standards while remaining flexible enough to adapt to the specific characteristics of each national healthcare system. ERIS works with scientific societies, hospitals, and universities across multiple countries to ensure that training is applicable and recognised in all settings.”

The initiative also seeks to address existing inequalities in access to advanced technologies and specialised training, particularly in countries with fewer resources or those distant from reference centres. “This generates differences in quality of care and clinical outcomes,” Guerra said.

To mitigate these disparities, ERIS has proposed several measures, including the creation of training hubs in strategic locations in Barcelona, Brussels, and Toulouse to facilitate regional access. The program also offers accredited pathways and scholarships for professionals from less privileged regions, as well as a mobility network to promote knowledge exchange and reduce gaps in expertise.

Public-private collaboration is also central to financing equipment and simulators at no cost to participants and disseminating common standards to ensure that innovation reaches healthcare systems across Europe.

This story was translated from El Medico Interactivo.