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Effectiveness of a novel training program for emergency medicine residents in ultrasound-guided insertion of central venous catheters

Published online by Cambridge University Press:  21 May 2015

Michael Y. Woo ,
Jason Frank ,
A. Curtis Lee ,
Calvin Thompson ,
Pierre Cardinal ,
Marianne Yeung  and
Jennifer Beecker
Michael Y. Woo*
Affiliation:
Department of Emergency Medicine, University of Ottawa, Ottawa, Ont.
Jason Frank
Affiliation:
Department of Emergency Medicine, University of Ottawa, Ottawa, Ont.
A. Curtis Lee
Affiliation:
Department of Emergency Medicine, University of Ottawa, Ottawa, Ont.
Calvin Thompson
Affiliation:
Department of Anesthesia, University of Ottawa, Ottawa, Ont.
Pierre Cardinal
Affiliation:
Division of Critical Care, University of Ottawa, Ottawa, Ont.
Marianne Yeung
Affiliation:
Department of Emergency Medicine, University of Ottawa, Ottawa, Ont.
Jennifer Beecker
Affiliation:
Department of Emergency Medicine, University of Ottawa, Ottawa, Ont.
*
Department of Emergency Medicine, Ottawa Hospital, 1053 Carling Ave., Ottawa ON K1Y 4E9; [email protected]

Abstract

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Objective:

Insertion of central venous catheters (CVCs) is an essential competency for emergency physicians. Ultrasound-guided (USG) insertion of CVCs has been shown to be safer than the traditional landmark technique. There is no clear consensus on effective methods for training physicians in USG insertion of CVCs. We developed and evaluated a novel educational training program in the USG technique for insertion of CVCs.

Methods:

Sixteen emergency medicine residents volunteered for a pre- and postprogram evaluation study, which was approved by our research ethics board. After their previous experience was determined, each participant was videotaped inserting a USG CVC in the right internal jugular vein on models. Participants then reviewed a Web-based instructional module and had a practical session. Participants were again videotaped inserting a USG CVC. The primary outcome was the change in score before and after the training program, using an expert-validated performance evaluation tool used to review the videotaped performances in a blinded fashion. Participants also completed a questionnaire to measure their satisfaction with the training program and any change in their perceived competence.

Results:

Participants ranged from residency year 1 to 5. Thirteen of 16 (81%) had never attempted USG insertion of a CVC. Participants reported that the models were realistic. Performance scores (12/19 to 13.2/19) and global ratings assessments (3.5/7 to 5.5/7) improved significantly (p < 0.01; the effect size, Cohen d = 1.12 before and 1.28 after) after the instruction. There was good interrater reliability between evaluators of the videotaped performances regarding performance scores (r = 0.68) and global rating scores (r = 0.75). All participants felt their confidence and technical skills were improved (p < 0.01) and all felt satisfied with the training program.

Conclusion:

This brief innovative multimethod training program was effective in enhancing emergency medicine resident competence in USG insertion of CVCs.

Keywords

central venous catheterultrasonographytrainingeducation
Type
Education • Enseignement
Information
Canadian Journal of Emergency Medicine , Volume 11 , Issue 4 , July 2009 , pp. 343 - 348
Copyright
Copyright © Canadian Association of Emergency Physicians 2009

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