SESSION TYPE: Teaching of Procedures
PRESENTED ON: Tuesday, October 23, 2012 at 04:30 PM - 05:45 PM
PURPOSE: To study the effect of model fidelity on learning outcomes of a simulation-based education program for central venous catheter (CVC) insertion.
METHODS: We conducted a non-inferiority design, randomized controlled trial. Forty residents rotating through the medical intensive care unit of an academic medical center completed a simulation-based education program for CVC insertion. The curriculum was designed in accordance with the principles of deliberate practice and mastery learning. Each resident underwent baseline skills testing, and was then randomized to complete the educational intervention on either a commercially available, high fidelity CVC model (Simulab's CentraLineMan) or a low fidelity model. The low fidelity model was assembled by allowing a gelatin mix to set in a rectangular container with two embedded surgical drains serving as blood vessels. Residents received one-on-one instruction until they were able to insert the CVC on their respective model while achieving a previously determined minimum passing score on a 26-item checklist. Upon completion of their ICU rotation, residents returned for repeat skills testing on the high fidelity model. The mean post-training checklist scores on the 26-item checklist were compared between low and high fidelity model groups.
RESULTS: Post-graduate year, residency program and pre-training checklist scores were similar between low and high fidelity model groups. Mean post-training score on the 26-item checklist for the low fidelity model group was 23.8 ± 2.2 (91.5%), and was not inferior to the mean score of the high fidelity model group of 22.5 ± 2.6 (86.5%) (p<0.0001). Residents in both groups judged the training program to be highly useful despite perceiving a lesser degree of physical realism in the low fidelity model compared with the high fidelity model (p=0.05).
CONCLUSIONS: A simulation-based education program for CVC catheter insertion utilizing an inexpensive, low fidelity model achieved learning outcomes comparable to those accomplished with a commercially available, high fidelity model.
CLINICAL IMPLICATIONS: Desirable learning outcomes can be achieved for CVC insertion using low fidelity simulation equipment provided robust educational principles are applied to curricular design.
DISCLOSURE: The following authors have nothing to disclose: Emily Diederich, Sally Rigler, Jonathan Mahnken, Lei Dong, TImothy Williamson, Matthew Sharpe
No Product/Research Disclosure InformationUniversity of Kansas, Kansas City, KS