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Simulation Training in Central Venous Catheter Insertion: Improved Performance in Clinical Practice
Academic Medicine, 2010
Purpose To determine whether simulation training of ultrasound (US)-guided central venous catheter (CVC) insertion skills on a partial task trainer improves cannulation and insertion success rates in clinical practice. Method This prospective, randomized, controlled, single-blind study of first-and secondyear residents occurred at a tertiary care teaching hospital from January 2007 to September 2008. The intervention group (n ϭ 90) received a didactic and handson, competency-based simulation training course in US-guided CVC insertion, whereas the control group (n ϭ 95) received training through a Please see the end of this article for information about the authors.
Intravenous catheter training system: Computer-based education versus traditional learning methods
The American Journal of Surgery, 2003
Background: Virtual reality simulators allow trainees to practice techniques without consequences, reduce potential risk associated with training, minimize animal use, and help to develop standards and optimize procedures. Current intravenous (IV) catheter placement training methods utilize plastic arms, however, the lack of variability can diminish the educational stimulus for the student. This study compares the effectiveness of an interactive, multimedia, virtual reality computer IV catheter simulator with a traditional laboratory experience of teaching IV venipuncture skills to both nursing and medical students. Methods: A randomized, pretest-posttest experimental design was employed. A total of 163 participants, 70 baccalaureate nursing students and 93 third-year medical students beginning their fundamental skills training were recruited. The students ranged in age from 20 to 55 years (mean 25). Fifty-eight percent were female and 68% percent perceived themselves as having average computer skills (25% declaring excellence). The methods of IV catheter education compared included a traditional method of instruction involving a scripted self-study module which involved a 10-minute videotape, instructor demonstration, and hands-on-experience using plastic mannequin arms. The second method involved an interactive multimedia, commercially made computer catheter simulator program utilizing virtual reality (CathSim). Results: The pretest scores were similar between the computer and the traditional laboratory group. There was a significant improvement in cognitive gains, student satisfaction, and documentation of the procedure with the traditional laboratory group compared with the computer catheter simulator group. Both groups were similar in their ability to demonstrate the skill correctly. Conclusions: This evaluation and assessment was an initial effort to assess new teaching methodologies related to intravenous catheter placement and their effects on student learning outcomes and behaviors. Technology alone is not a solution for stand alone IV catheter placement education. A traditional learning method was preferred by students. The combination of these two methods of education may further enhance the trainee's satisfaction and skill acquisition level.
Medical Teacher, 2010
Background: Up to 6000 patients per year in England acquire a central venous catheter (CVC)-related bloodstream infection (Shapey et al. 2008). Implementation of Department of Health guidelines through educational interventions has resulted in significant and sustained reductions in CVC-related blood stream infections (Pronovost et al. 2002), and cost (Hu et al. 2004). Aim: This review aimed to determine the features of structured educational interventions that impact on competence in aseptic insertion technique and maintenance of CV catheters by healthcare workers. Methods: We looked at changes in infection control behaviour of healthcare workers, and considered changes in service delivery and the clinical welfare of patients involved, provided they were related directly to the delivery method of the educational intervention. Results: A total of 9968 articles were reviewed, of which 47 articles met the inclusion criteria. Conclusions: Findings suggest implications for practice: First, educational interventions appear to have the most prolonged and profound effect when used in conjunction with audit, feedback, and availability of new clinical supplies consistent with the content of the education provided. Second, educational interventions will have a greater impact if baseline compliance to best practice is low. Third, repeated sessions, fed into daily practice, using practical participation appear to have a small, additional effect on practice change when compared to education alone. Active involvement from healthcare staff, in conjunction with the provision of formal responsibilities and motivation for change, may change healthcare worker practice.
The Journal of Continuing Education in Nursing, 2017
Vice president clinical education Nurse researcher Research project oversight Research protocol development CE program modification CE implementation planning Research outcomes identification Research results dissemination Director clinical education Manager clinical education Director e-learning CE program development CE program modification Research protocol development CE implementation planning CE implementation execution Research outcomes identification CE assessment tools creation Research results dissemination Nurse researcher Research protocol development CE assessment tools creation Assessment tools validation and reliability testing Research outcomes identification Research results analysis Research results dissemination 2 CE unit educators CE educator CE program modification Research protocol development CE implementation planning CE implementation communication and logistics Research outcomes identification Research results dissemination 8 PACT nurses PIVC skills assessment tool observers and evaluators Biostatistician Research results analysis Note. PIVC = peripheral intravenous catheter; CE = continuing education; PACT = Professional Advancement Clinical Tracks.
Simulation in healthcare : journal of the Society for Simulation in Healthcare, 2016
Peripheral intravenous catheter (PIVC) insertion is one of the most common invasive procedures performed in a hospital, but most nurses receive little formal training in this area. Blended PIVC insertion training programs that incorporate deliberate simulated practice have the potential to improve clinical practice and patient care. The study was a randomized, wait-list control group with crossover using nurses on three medical/surgical units. Baseline PIVC knowledge, confidence, and skills assessments were completed for both groups. The intervention group then received a 2-hour PIVC online course, followed by an 8-hour live training course using a synergistic mix of three simulation tools. Both groups were then reassessed. After crossover, the wait-list group received the same intervention and both groups were reassessed. At baseline, both groups were similar for knowledge, confidence, and skills. Compared with the wait-list group, the intervention group had significantly higher sc...
Journal of Hospital Medicine, 2009
BACKGROUND: Central venous catheter (CVC) insertions are performed frequently by internal medicine residents. Complications, including arterial puncture and pneumothorax, decrease when operators use fewer needle passes to insert the CVC. In this study, we evaluated the effect of simulation-based mastery learning on CVC insertion skill. DESIGN: This was a cohort study of internal jugular (IJ) and subclavian (SC) CVC insertions by 41 internal medicine residents rotating through the medical intensive care unit (MICU) over a five-month period. Thirteen traditionallytrained residents were surveyed about the number of needle passes, complications, and procedural self-confidence on CVCs inserted in the MICU. Concurrently, 28 residents completed simulation-based training in IJ and SC CVC insertions. Simulator-trained residents were expected to perform CVC insertions to mastery standards on a central line simulator. Simulator-trained residents then rotated through the MICU and were surveyed regarding CVC placement. The impact of simulation training was assessed by comparing group survey results. RESULTS: No resident met the minimum passing score (MPS) (79.1%) for CVC insertion at baseline: mean (M) (IJ) ¼ 48.4%, standard deviation (SD) ¼ 23.1, M(SC) ¼ 45.2%, SD ¼ 26.3. All residents met or exceeded the MPS at testing after simulation training: M(IJ) ¼ 94.8%, SD ¼ 10.0, M(SC) ¼ 91.1%, SD ¼ 17.8 (p < 0.001). In the MICU, simulator-trained residents required fewer needle passes to insert a CVC than traditionally-trained residents: M ¼ 1.79, SD ¼ 1.0 versus M ¼ 2.78, SD ¼ 1.77 (p ¼ 0.04). Simulator-trained residents displayed more self-confidence about their procedural skills: (M ¼ 81, SD ¼ 11 versus M ¼ 68, SD ¼ 20, p ¼ 0.02). CONCLUSIONS: Simulation-based mastery learning increased residents' skills in simulated CVC insertion, decreased the number of needle passes when performing actual procedures, and increased resident self-confidence.