Patrick Hoier, BS, RCIS, FSICP, is the Director of the Invasive Cardiovascular Technology program at Southeast Technical Institute in Sioux Falls, South Dakota. As director, Patrick assists with oversight and implementation of all cardiovascular core courses for invasive and non-invasive tracts, as well as developing and implanting curriculum for the invasive, electrophysiology, and special procedure courses associated with the invasive program. Patrick is also President Elect of the Society of Cardiovascular Invasive Professionals (SICP).
Patrick began his career in cardiovascular technology as a graduate from the invasive cardiovascular program at Southeast Technical Institute. The majority of his professional career in the laboratory environment was spent at Bryan Medical Center in Lincoln, Nebraska. During his time at Bryan, Patrick served as team leader in the cardiovascular catheterization department and was a member of the cardiac electrophysiology team. In 2001, Patrick designed and implemented an accredited invasive cardiovascular educational program through BryanLGH College of Health Science. In 2006, he returned to Southeast Technical Institute to become the director of the program he had originally graduated from.
Why did you choose to work in the invasive cardiology field?
In actuality, I stumbled upon the invasive cardiology field by accident. After high school, my ambition was to enroll in college and eventually progress into medical school. However, being a practical person, I continued to investigate other options in the medical field just in case my plans did not progress as I had wished. A close friend of mine suggested that I visit the local technical institute and explore a field I had never heard of: Invasive Cardiovascular Technology. After a tour of Southeast Technical Institute, a discussion with the program director, and a quick shadowing experience at a regional medical center, I enrolled and was excited to learn more about this profession. Ever since this “accidental” encounter with the profession, I have found myself excited and passionate about the field.
Invasive cardiology continues to fascinate me on many levels. There is the investigative part of the profession: hemodynamic interpretations, coronary analysis, and patient assessments. I love procedures that make me evaluate the presented data and, by putting this information together, arrive at a logical diagnosis. The more complicated the procedure, the more excited I am to be involved.
I also find the therapeutic component of the profession very rewarding. We all have been involved in cases where the patient’s health is deteriorating rapidly. Through teamwork, critical thinking, and application of skill, we are often able to stabilize and save the individual’s life. To have such an effect on the life of another person, and to be able to give that person more time with their family and loved ones, is amazing.
Finally, there is the humanistic part of this profession. Procedural care is no less important than prolonged care on the medical floors. Often our patients are scared, and potentially facing very serious consequences of their cardiac or vascular disease. The connection we make with these patients, gaining their trust so that they cooperate and allow us to perform the necessary procedures, is vital to our success. Though our time is limited with each patient, that connection we form with them is very rewarding.
When you began working in the cath lab, what were the devices, technology and procedures like at the time?
I am proud to say that I entered into the profession at a moment of great change. When I started cardiac stents were just beginning to enter the market, glycoprotein IIb/IIIa inhibitors were just being developed, manifolds were the method of contrast and saline administration, and we were still developing cine films in dark rooms. (My students often refer to my early years as “the dark ages.”)
What are some of the challenges you face on a daily basis?
As an educational program director and instructor I find myself challenged on many different levels. In the instructor role, I am required to constantly study and review the latest research data to ensure my students are up to date on clinically significant information. As new procedural technology is developed and released, I must take the time to contact product representatives and visit local medical centers for training so that I can train my students. This is on top of the required assessments, evaluations, and lecturing responsibilities that are associated with my position. It is my responsibility to ensure that my students are exposed to the knowledge and skills they will require to become competent cardiovascular specialists, and to successfully challenge the registry exams.
In the director role, I must constantly evaluate the program and ensure it is meeting all criteria required for maintaining accreditation. I must also maintain regular contact with our affiliated clinical sites (which are located throughout the lower 48 states) to ensure that my students are performing at an acceptable level while interning in the hospital environments.
What are you proud of in your educational program?
Our invasive cardiovascular technology program has a full functioning x-ray lab for simulated procedure practice. This includes a c-arm x-ray system, hemodynamic monitoring systems, the ACIST contrast injection system, and required catheters, balloons, guidewires, sheaths, etc. Students are expected to spend several hours each week participating in simulated experiences within this lab.
Our program also utilizes a high-fidelity human patient simulator for the practice of patient care procedures and skills. The CAE HPS simulation system allows the students to perform advanced lifesaving skills (including advanced cardiac life support [ACLS] procedures) in a true-to-life environment.
Our Invasive Cardiovascular Program is also an iPad-based educational system. Students use the iPad technology, and specified applications, to enhance their learning. Our classroom structure has shifted to an interactive lecture environment where the students are actively engaging the instructor through their technology.
Are you involved in any research?
As an educator, I am actively performing research aimed at identifying best practice approaches for medical education and training. I am currently focused on identifying models to integrate technology for the purpose of improving student success.
Is there a particular case, patient, or student from whom you learned something valuable?
Identifying a single patient or case is difficult. There have been so many cases throughout my career that have taught me how to critically evaluate hemodynamic data, identify anomalous coronary artery anatomy, select appropriate therapies, and better interact with my patients. It would probably be more accurate to say that I have found each in each procedure an opportunity for learning.
As an educator, students are always a source of inspiration for me. These individuals have selected to learn about our profession, and to sacrifice so much in order to become medical professionals. The amount of didactic information and procedural skills they need to develop in such a limited time is significant, and the fact that the students willingly take on such a momentous task is admirable. Each student that I have had the opportunity to interact with has helped me become a better educator.
If you could send a message back to yourself at the beginning of your career, what advice would you give?
I would tell myself to never stop reading, studying, and researching about the profession. I would remind myself to take the opportunity and learn about each new piece of technology that is developed, and to train in each procedural skill that is made available. I would also remind myself of the same thing that I remind all my students of: “never forget the patient”.
Who is someone you have learned from in the field of invasive cardiology?
I have had the honor of being mentored by many great individuals over the years. As a cardiovascular professional, I owe a lot of my knowledge and skill to all of my former co-workers at Bryan Medical Center in Lincoln, Nebraska. I will never be able to thank these individuals enough for all they have taught me.
As an educator, I have had the opportunity to interact and share ideas with many other cardiovascular educators. One that I have to mention was my own instructor: Jay Lucas. Another program director that continues to inspire me to become a better educator is Sally Elliott, Director of the Cardiovascular School of Technology at Sentara College in Chesapeake, Virginia, and current SICP President.
You are the President Elect of the SICP. Why is the SICP important?
The role of a professional society is to oversee the scope of practice, to be the voice of advocacy, and to oversee the future development of the profession. In order for a vocation to be recognized as a profession, it must have a society overseeing the roles and practice of the individuals working within the field. Being active in the professional society is vital to the life and development of the profession. Without active members, and without individuals willing to step up and play a larger role, our profession will not be able to grow and develop. A lack of participation also places patients at risk, as there will be less advocacy to ensure properly trained individuals are assisting with invasive cardiovascular procedures.
What developments in cardiology do you find most interesting?
I am very excited about the developments in transcatheter structural heart repair, and the therapeutic possibilities that are being investigated. The endovascular field is exploding right now, and I have been amazed at the amount of progress that has been made in treating chronic total occlusions in such a short period of time. Finally, increased study in best practice for medical therapy versus elective angioplasty will better define the care we should provide for our patients.
Patrick Hoier can be contacted at email@example.com.