| Simulation training in central venous catheter insertion: improved performance in clinical practice. | |
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MedLine Citation:
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PMID: 20736674 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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 second-year residents occurred at a tertiary care teaching hospital from January 2007 to September 2008. The intervention group (n = 90) received a didactic and hands-on, competency-based simulation training course in US-guided CVC insertion, whereas the control group (n = 95) received training through a traditional, bedside apprenticeship model. Success at first cannulation and successful CVC insertion served as the primary outcomes. Secondary outcomes included reduction in technical errors and decreased mechanical complications. RESULTS: Blinded independent raters observed 495 CVC insertions by 115 residents over a 21-month period. Successful first cannulation occurred in 51% of the intervention group versus 37% of the control group (P = .03). CVC insertion success occurred for 78% of the intervention group versus 67% of the control group (P = .02). Simulation training was independently and significantly associated with success at first cannulation (odds ratio: 1.7; 95% confidence interval: 1.1-2.8) and with successful CVC insertion (odds ratio: 1.7; 95% confidence interval: 1.1-2.8)--both independent of US use, patient comorbidities, or resident specialty. No significant differences related to technical errors or mechanical complications existed between the two groups. CONCLUSIONS: Simulation training was associated with improved in-hospital performance of CVC insertion. Procedural simulation was associated with improved residents' skills and was more effective than traditional training. |
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Authors:
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Leigh V Evans; Kelly L Dodge; Tanya D Shah; Lewis J Kaplan; Mark D Siegel; Christopher L Moore; Cara J Hamann; Zhenqiu Lin; Gail D'Onofrio |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Academic medicine : journal of the Association of American Medical Colleges Volume: 85 ISSN: 1938-808X ISO Abbreviation: Acad Med Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-25 Completed Date: 2010-09-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8904605 Medline TA: Acad Med Country: United States |
Other Details:
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Languages: eng Pagination: 1462-9 Citation Subset: AIM; IM |
Affiliation:
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Yale University School of Medicine, Department of Emergency Medicine, New Haven, Connecticut 06519, USA. leigh.evans@yale.edu |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00919308 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Catheterization, Central Venous
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standards* Chi-Square Distribution Clinical Competence* Competency-Based Education / methods* Education, Medical, Graduate / methods* Educational Measurement Humans Intensive Care Units Internship and Residency Patient Simulation* Prospective Studies Regression Analysis Single-Blind Method Statistics, Nonparametric Ultrasonography, Interventional |
| Grant Support | |
ID/Acronym/Agency:
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U18 HS16725/HS/AHRQ HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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