Simulation-based training program with deliberate practice for ultrasound-guided jugular central venous catheter...

Area of Science:

• Medical Education
• Surgical Simulation
• Procedural Skills Training

Background:

• Simulation training is effective for bedside procedures like ultrasound-guided central venous catheter (CVC) insertion.
• A standardized methodology for teaching procedural skills remains undetermined.
• This study evaluated a simulation-based program to enhance novice performance in ultrasound-guided internal jugular CVC placement.

Purpose of the Study:

• To assess the effectiveness of a simulation-based training program for ultrasound-guided internal jugular CVC insertion.
• To improve technical performance of novice residents in a critical bedside procedure.
• To validate assessment tools for procedural skill acquisition.

Main Methods:

• Postgraduate year 1 residents participated in four deliberate practice sessions covering ultrasound principles, preparation, and CVC insertion techniques.
• Technical proficiency was evaluated pre- and post-training using the Imperial College Surgical Assessment Device (ICSAD) for hand-motion analysis and a global rating scale (GRS).

Main Results:

• Thirty-five residents completed the program, showing significant improvement in GRS scores (P < 0.001) post-training.
• Hand-motion analysis revealed a significant decrease in total path length (P = 0.008) using ICSAD.
• Procedural time was significantly reduced from a median of 387 seconds to 200 seconds (P = 0.029).

Conclusions:

• The simulation-training program using deliberate practice significantly enhanced residents' technical skills in ultrasound-guided internal jugular CVC placement.
• The findings support the validity of the ICSAD as an effective assessment tool for learning ultrasound-guided CVC insertion.