**5.1 Training for imaging**

To take advantage of the multiple advanced imaging capabilities of state-of-the-art fixed angiography systems, extensive training for physicians, nurses and technicians is crucial. Most members of the OR team are not familiar with fixed angiography systems. Only if they are well versed in and comfortable using it, they can take full advantage of the imaging and workflow capabilities of a hybrid OR.

Training of the team can be achieved by different concepts. However, at least one member of the OR team should be trained in very detail in order to use the system to its full potential. This person should serve as a trainer for the other team members and should take responsibility for the imaging. A good possibility is to ask colleagues from the radiology department to take over the training of the OR team member, since they are very familiar with imaging. This specially trained team member should then train several super users, who are also very familiar with the system. By ensuring that multiple OR team members can operate the system very well, 24/7 coverage can be provided in the hybrid OR - also for emergency cases on weekends or during night shifts, if required.

The individual scope of training depends on the responsibility of the OR staff as well as on the workflow set-up. If for example the surgeon himself operates the angiography system, he will be among the ones undergoing training in system handling and operation. If, by contrast, the system is operated by a radiographer, the surgeon will not need to be trained in detail.

Training possibilities are multiple. Principle training may be achieved by training in the hospital's own hybrid OR by the provider of the imaging system (applications training), at other clinical sites by experienced physicians and technicians (mini fellowships), in other departments within the hospital, and at hands-on workshops, usually organized by the industry.
