Evaluating Surgical Resident Needle Insertion Skill Gains in Central Venous Catheterization Training

Area of Science:

• Medical simulation
• Surgical training
• Medical device technology

Background:

• Ultrasound-guided central venous catheterization (CVC) training traditionally uses static manikins with observer feedback.
• Dynamic haptic robotic trainers (DHRTs) offer an alternative, simulating diverse anatomies and providing consistent, quantitative feedback.
• This study compares the efficacy of manikin-based versus DHRT-based training for CVC insertion skills.

Purpose of the Study:

• To evaluate and compare the effectiveness of Dynamic Haptic Robotic Trainers (DHRTs) against traditional manikins for ultrasound-guided central venous catheterization (CVC) needle insertion training.
• To assess skill acquisition and efficiency gains in surgical residents trained via DHRTs versus manikins.
• To determine if DHRTs lead to significant improvements in procedural completion time and technical skills.

Main Methods:

• Fifty-two first-year surgical residents were randomized into two training groups: manikin (n=26) or DHRT (n=26).
• Training involved internal jugular (IJ) CVC needle insertion, with manikin trainees receiving verbal feedback and DHRT trainees receiving quantitative feedback.
• All participants underwent pretesting and posttesting on manikins, with performance measured by timing, motion tracking, and a standardized checklist.

Main Results:

• All participants demonstrated significant skill improvements from pretest to posttest across the IJ CVC checklist items (P < 0.014).
• Key technical metrics including insertion angle, path length, and jerk showed significant improvements (P < 0.005).
• Average procedural completion time significantly decreased from pretest (3.52 min) to posttest (1.99 min) (P < 0.005).

Conclusions:

• No significant differences in overall skill gains were found between the manikin and DHRT training groups.
• Both training methods led to significant improvements in CVC insertion skills and efficiency.
• Results support the effectiveness of DHRTs as a viable method for training internal jugular CVC skills, offering consistent and quantitative feedback.