Simulation-Based Objective Assessment Discerns Clinical Proficiency in Central Line Placement: A Construct Validation

2011 ◽  
Vol 2011 ◽  
pp. 55-57
Author(s):  
G.P. Gravlee
CHEST Journal ◽  
2010 ◽  
Vol 137 (5) ◽  
pp. 1050-1056 ◽  
Author(s):  
Yue Dong ◽  
Harpreet S. Suri ◽  
David A. Cook ◽  
Kianoush B. Kashani ◽  
John J. Mullon ◽  
...  

2017 ◽  
Vol 83 (6) ◽  
pp. 536-540 ◽  
Author(s):  
Joanna Grudziak ◽  
Blair Herndon ◽  
Ria D. Dancel ◽  
Harendra Arora ◽  
Christopher J. Tignanelli ◽  
...  

Central line placement is a common procedure, routinely performed by junior residents in medical and surgical departments. Before this project, no standardized instructional course on the insertion of central lines existed at our institution, and few interns had received formal ultrasound training. Interns from five departments participated in a simulation-based central line insertion course. Intern familiarity with the procedure and with ultrasound, as well as their prior experience with line placement and their level of comfort, was assessed. Of the 99 interns in participating departments, 45 per cent had been trained as ofOctober 2015. Forty-one per cent were female. The majority (59.5%) had no prior formal ultrasound training, and 46.0 per cent had never placed a line as primary operator. Scores increased significantly, from a precourse score mean of 13.7 to a postcourse score mean of 16.1, P < 0.001. All three of the self-reported measures of comfort with ultrasound also improved significantly. All interns reported the course was “very much” helpful, and 100 per cent reported they felt “somewhat” or “much” more comfortable with the procedure after attendance. To our knowledge, this is the first hospital-wide, standardized, simulation-based central line insertion course in the United States. Preliminary results indicate overwhelming satisfaction with the course, better ultrasound preparedness, and improved comfort with central line insertion.


2017 ◽  
Vol 4 ◽  
pp. 238212051668482 ◽  
Author(s):  
Serkan Toy ◽  
Robert SF McKay ◽  
James L Walker ◽  
Scott Johnson ◽  
Jacob L Arnett

Purpose: To evaluate the effectiveness of a learner-centered, simulation-based training developed to help medical students improve their procedural skills in intubation, arterial line placement, lumbar puncture, and central line insertion. Method: The study participants were second and third year medical students. Anesthesiology residents provided the training and evaluated students’ procedural skills. Two residents were present at each station to train the medical students who rotated through all 4 stations. Pre/posttraining assessment of confidence, knowledge, and procedural skills was done using a survey, a multiple-choice test, and procedural checklists, respectively. Results: In total, 24 students were trained in six 4-hour sessions. Students reported feeling significantly more confident, after training, in performing all 4 procedures on a real patient ( P < .001). Paired-samples t tests indicated statistically significant improvement in knowledge scores for intubation, t(23) = −2.92, P < .001, and arterial line placement, t(23) = −2.75, P < .001. Procedural performance scores for intubation ( t(23) = −17.29, P < .001), arterial line placement ( t(23) = −19.75, P < .001), lumbar puncture ( t(23) = −16.27, P < .001), and central line placement ( t(23) = −17.25, P < .001) showed significant improvement. Intraclass correlation coefficients indicated high reliability in checklist scores for all procedures. Conclusions: The simulation sessions allowed each medical student to receive individual attention from 2 residents for each procedure. Students’ written comments indicated that this training modality was well received. Results showed that medical students improved their self-confidence, knowledge, and skills in the aforementioned procedures.


2021 ◽  
pp. 000313482110111
Author(s):  
Nicholas J. Iglesias ◽  
Taylor P. Williams ◽  
Clifford L. Snyder ◽  
Christian Sommerhalder ◽  
Alexander Perez

Background Central line-associated bloodstream infections (CLABSIs) are preventable complications that pose a significant health risk to patients and place a financial burden on hospitals. Central line simulation-based education (SBE) efforts vary widely in the literature. The aim of this study was to perform a value analysis of published central line SBE and develop a refined method of studying central line SBE. Methods A database search of PubMed Central and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was performed for articles mentioning “Cost and CLABSI,” “Cost and Central line Associated Bloodstream Infections,” and “Cost and Central Line” in their abstract and article body. Articles chosen for qualitative synthesis mentioned “simulation” in their abstract and article body and were analyzed based on the following criteria: infection rate before vs. after SBE, cost of simulation, SBE design including simulator model used, and learner analysis. Results Of 215 articles identified, 23 were analyzed, 10 (43.48%) discussed cost of central line simulation with varying criteria for cost reporting, 8 (34.8%) numerically discussed central line complication rates (7 CLABSIs and 1 pneumothorax), and only 3 (13%) discussed both (Figure). Only 1 addressed the true cost of simulation (including space rental, equipment startup costs, and faculty salary) and its longitudinal effect on CLABSIs. Conclusion Current literature on central line SBE efforts lacks value propositions. Due to the lack of value-based data in the area of central line SBE, the authors propose a cost reporting standard for use by future studies reporting central line SBE costs.


Author(s):  
Jessica M. Gonzalez-Vargas ◽  
Dailen C. Brown ◽  
Jason Z. Moore ◽  
David C. Han ◽  
Elizabeth H. Sinz ◽  
...  

The Dynamic Haptic Robotic Trainer (DHRT) was developed to minimize the up to 39% of adverse effects experienced by patients during Central Venous Catheterization (CVC) by standardizing CVC training, and provide automated assessments of performance. Specifically, this system was developed to replace manikin trainers that only simulate one patient anatomy and require a trained preceptor to evaluate the trainees’ performance. While the DHRT system provides automated feedback, the utility of this system with real-world scenarios and expertise has yet to be thoroughly investigated. Thus, the current study was developed to determine the validity of the current objective assessment metrics incorporated in the DHRT system through expert interviews. The main findings from this study are that experts do agree on perceptions of patient case difficulty, and that characterizations of patient case difficulty is based on anatomical characteristics, multiple needle insertions, and prior catheterization.


2007 ◽  
Vol 104 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Ralf E. Gebhard ◽  
Peter Szmuk ◽  
Evan G. Pivalizza ◽  
Vladimir Melnikov ◽  
Christianne Vogt ◽  
...  
Keyword(s):  

2016 ◽  
Vol 12 (1) ◽  
pp. e83-e87 ◽  
Author(s):  
Jenna Page ◽  
Maureen Tremblay ◽  
Cate Nicholas ◽  
Ted A. James

A targeted educational intervention using a simulated central line care model improved competence in central line care and resulted in decreased CLABSI rates for oncology inpatients.


Ultrasound Guided Procedures and Radiologic Imaging for Pediatric Anesthesiologists is intended as a ready resource for both experts and novices. It will be useful to those with extensive training and experience as well as beginners and those with distant experience or training. A wealth of knowledge in the human factors of procedure design and use has been applied throughout to ensure that desired information can be easily located, that steps are clearly identified and comprehensible, and that additional information of high relevance to procedure completion is co-located and salient. This book begins with the basics but quickly progresses to advanced skill sets. It is divided into four parts. Part I starts with a primer on ultrasound machine functionality as well as procedural chapters on lung ultrasound to detect a mainstem intubation or pneumothorax and gastric ultrasound to assess gastric contents in incompletely fasted patients. Part II covers ultrasound guided peripheral intravenous line placement through the incremental advancement method, ultrasound guided arterial line placement, and ultrasound guided central line placement. Part III details several ultrasound guided regional anesthesia techniques. Part IV covers radiology of the pediatric airway and mediastinum, lungs, gastrointestinal, genitourinary, musculoskeletal, and neurologic systems.


2021 ◽  
Vol 18 (3) ◽  
pp. 385-392
Author(s):  
Gennadiy M. GROSHEV ◽  
◽  
Alexey G. KOTENKO ◽  
Nadezhda V. KLIMOVA ◽  
Natalia B. FEDOROVA ◽  
...  

Objective: Assessment of the need to study the process of delivering a batch of containers from the rear terminal to the port to ensure uninterrupted communication between the rear terminal and the seaport and delivery a batch of containers exactly on time. As a primary task, the problem of analyzing the factors affecting the nature of the delivery process is solved. Methods: The methods of the theory of probability and mathematical statistics were applied in terms of determining the factors that affect the nature of the delivery process. The method of constructing process models was used to create a technological model for the delivery of containers by a block train to the port. Results: A technological model of container delivery by block train is presented. Diagrams were built showing the share of the main deviations from the schedule of container trains by types of operations for traffic, traction, corporate transport services. The main factors influencing the duration of individual operations with container block trains en route and the increase in the delivery time for a batch of containers from rear terminals to the seaport as a whole are identified. The random nature of the duration of the delivery of containers by block trains following the schedule has been established. Practical importance: The need to improve the methodology for choosing a method for delivering containers from the rear terminal to the port using simulation based on the identified factors influencing individual elements of the technological model of container delivery by a block train, deviations from the delivery time of containers, scheduled running of block trains is shown.


ICU Protocols ◽  
2020 ◽  
pp. 383-395
Author(s):  
Rajesh Chawla ◽  
Vishakh Varma ◽  
Sudha Kansal ◽  
Roseleen Kaur Bali
Keyword(s):  

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