Performance of central venous catheterization by medical students: a retrospective study of students' logbooks

Medical students often learn the skills necessary to perform a central venous catheterization in the operating room after simulator training. We examined the performance of central venous catheterization by medical students from the logbooks during their rotation in department of anesthesiology.

From the logbooks of medical students rotating in our department between January 2011 and June 2012, we obtained the kind and the number of central venous catheterization students had done, the results of the procedures whether they were success or failed, the reasons of the failures, complications, and the student self-reported confidence and satisfaction of their performance.

There were 93 medical students performed 875 central venous catheterizations with landmark guidance on patients in the operating theater, and the mean number of catheterizations performed per student was 9.4 ± 2.0, with a success rate of 67.3%. Adjusted for age, sex, body mass index, surgical category, ASA score and insertion site, the odds of successful catherization improved with cumulative practice (odds ratio 1.10 per additional central venous catheterization performed; 95% confidence interval 1.05-1.15). The major challenge students encountered during the procedure was the difficulty of finding the central veins, which led to 185 catheterizations failed. The complication rate of central venous catheterization by the students was 7.8%, while the most common complication was puncture of artery. The satisfaction and confidence of students regarding their performance increased with each additional procedure and decreased significantly if failure or complications had occurred.

A student logbook is a useful tool for recording the actual procedural performance of students. From the logbooks, we could see the students' performance, challenges, satisfaction and confidence of central venous catheterization were improved through cumulative clinical practice of the procedure.