Department of Anesthesiology, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, 046000, Shanxi, China.
Clinical Skills Center, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, 046000, Shanxi, China.
BMC Med Educ. 2023 Feb 11;23(1):106. doi: 10.1186/s12909-023-04080-z.
Central venous catheters (CVCs) are life-saving tools for fluid therapy during surgery. Ultrasound-guided CVC placement has been shown to be safe and highly efficient. However, it is difficult for medical workers with less experience in ultrasonography to acquire the necessary skill in a short time. Simulation-based training is a good way to enhance the skill of a beginner. Therefore, in this study, we introduced a new, inexpensive and easily implemented model for ultrasound-guided CVC placement training and assessed the feasibility of this model.
This was a quasi-experimental study. Thirty-three anaesthesiology postgraduate year 2 and 3 residents with strong CVC interest were included in a simulator-based training workshop in a department of anaesthesiology. The simulation model consisted of a piece of pork and two latex catheters filled with red and blue ink. The workshop comprised 3 parts: a 10-min introductory lecture, a 15-min orientation on performing ultrasound-guided CVC insertion based on the model, and a 30-min practice session. Participants completed relevant questionnaires before and after the training. Moreover, an examination was held to evaluate their skill with the novel model.
All participants indicated that the novel model increased their self-perceived confidence in ultrasound-guided catheterization. They also all reported that the model was adequate for training anaesthesiology residents in ultrasound-guided catheterization. A few individuals thought the model did not mimic the progress of CVC insertion (3 of 33). After training, participants did not show a significant difference in the acquisition of central venous catheterization theory. However, their competency with ultrasound-guided CVC placement was enhanced. This was demonstrated not only based on subjective answers to the following questions, namely, "how do you perform central venous catheterization with ultrasound guidance?" (p < 0.001), "can you perform ultrasound-guided central venous catheterization?" (p < 0.001), and "how much self-confidence do you have in performing ultrasound-guided central venous catheterization?" (p < 0.001), but also in objective performance (evaluation of the core step in ultrasound-guided placement (p < 0.001)).
The new simulator is a feasible, inexpensive and easily reproducible tool for training anaesthesiologists in ultrasound-guided central venous catheterization. After the simulation-based training workshop, the competency of residents in performing central venous catheterization with ultrasound guidance improved.
中心静脉导管（CVC）是手术期间液体治疗的救生工具。超声引导的 CVC 置管已被证明是安全且高效的。然而，对于超声成像经验较少的医务人员来说，要在短时间内掌握必要的技能是很困难的。基于模拟的培训是增强初学者技能的好方法。因此，在这项研究中，我们引入了一种新的、廉价且易于实施的超声引导 CVC 置管培训模型，并评估了该模型的可行性。
这是一项准实验研究。33 名对 CVC 感兴趣的麻醉学住院医师 2 年级和 3 年级参加了一个麻醉学系的基于模拟器的培训研讨会。模拟模型由一块猪肉和两个充满红色和蓝色墨水的乳胶导管组成。该研讨会包括 3 个部分：10 分钟的介绍讲座、15 分钟的基于模型的超声引导 CVC 插入指导和 30 分钟的练习。参与者在培训前后完成了相关的问卷。此外，还进行了一次考试，以评估他们使用新型模型的技能。
所有参与者都表示，新型模型增加了他们对超声引导置管的自我感知信心。他们还都表示，该模型足以培训麻醉学住院医师进行超声引导置管。少数人认为该模型不能模拟 CVC 插入的进展（33 人中的 3 人）。培训后，参与者在获取中心静脉导管插入理论方面没有显著差异。然而，他们的超声引导 CVC 放置能力得到了增强。这不仅体现在以下问题的主观回答上，即“您如何在超声引导下进行中心静脉导管插入？”（p<0.001）、“您能否进行超声引导下的中心静脉导管插入？”（p<0.001）和“您对进行超声引导下的中心静脉导管插入有多大信心？”（p<0.001），还体现在客观表现上（对超声引导放置的核心步骤的评估（p<0.001））。
新型模拟器是一种可行、廉价且易于复制的工具，可用于培训麻醉医师进行超声引导下的中心静脉导管插入。在基于模拟的培训研讨会之后，住院医师进行超声引导下的中心静脉导管插入的能力得到了提高。
