Longitudinal trends using a point-of-care gelatin-based model for ultrasound-guided central venous catheter insertion

ABSTRACT

Ultrasound (US)-guided central venous catheter (CVC) insertion is a procedure that carries the risk of significant complications. Simulation provides a safe learning atmosphere, but most CVC simulators are not available outside of simulation centers. To explore longitudinal trends in US-guided CVC insertion competency in internal medicine (IM) interns, we studied the use of a low-fidelity, gelatin-based, US-guided CVC insertion simulation model combined with a simulation curriculum. This prospective observational study of IM interns was performed over the course of one academic year. Interns (n = 56) underwent model-based, US-guided procedure simulation training program and a repeated training course prior to their intensive care unit (ICU) rotation. CVC insertion competency at different timepoints was recorded. Survey data about intern experience and attitudes were also collected. Out of the 56 interns initially trained, 40 were included in the final analysis. Across all outcomes, interns experienced skill atrophy between initial training and the beginning of their ICU month. However, by the end of the month, there was a significant improvement in competency as compared to initial procedural training, which then waned by the end of the intern year. Attitudes toward the model were generally positive and self-reported confidence improved throughout the course of the year and correlated with objective measures of competency. Over the course of their intern year, which included simulation training using a gelatin-based model, interns demonstrated consistent competency trends. The use of a gelatin-based CVC insertion simulation model warrants further study as an adjunctive aid to existing simulation training.

KEYWORDS:

• Simulation training
• medical education
• gelatin
• central venous catheters
• point-of-care ultrasound
• internal medicine

Acknowledgments

We would like to acknowledge the contributions of the Emory University School of Medicine IM residency Class of 2021 for their willingness to participate in our study and enthusiasm for simulation. We would also like to thank the faculty and staff of Grady Memorial Hospital for accommodating our research and Dr. Imran Iftikhar for his expertise.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

RPR, MS, MG, WSB, and LMD added substantial contributions to the conception, design, data acquisition, analysis, and interpretation of the work. CGC added substantial contributions to the analysis and interpretation of the work. All authors assisted with drafting the work, revising it for content, approved the final version to be published, and vouch for data accuracy and integrity of the work.

Supplementary material

Supplemental data for this article can be accessed here.