SESSION TITLE: Education and Teaching in Critical Care
SESSION TYPE: Original Investigation Slide
PRESENTED ON: Wednesday, October 29, 2014 at 07:30 AM - 08:30 AM
PURPOSE: To evaluate the long term retention of central venous catheter (CVC) insertion skills after simulation-based training.
METHODS: Forty residents rotating through the medical intensive care unit of an academic medical center completed a simulation-based training 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, then received one-on-one instruction until they were able to insert the CVC on the model while achieving the previously determined minimum passing score on a 26-item checklist. Upon completion of their 1-month ICU rotation, residents returned for repeat skills testing. One year later, the residents who were available returned to the lab again to repeat the same skills testing. Mean score on the 26-item checklist one year after simulation-based training was compared with resident performance prior to training and one month after training in order to assess skill retention.
RESULTS: A total of 27 of the original 40 residents (67.5%) participated in long-term follow-up testing. The mean checklist score one year after simulation-based training was over five points higher than pre-training (average difference 5.3; 95% confidence interval: 3.2, 7.5; p<0.01). The mean checklist score at one year did, however, significantly decline compared with the performance one month after training (average difference -3.7; 95% confidence interval: -5.9, -1.6; p<0.01).
CONCLUSIONS: Although resident performance after simulation-based training for CVC insertion declined over time, the performance on skills testing remained significantly improved over pre-training levels even into the following academic year.
CLINICAL IMPLICATIONS: Simulation-based education for CVC insertion provides a lasting impact on resident performance, although refresher instruction may be needed to maintain skills at a mastery level.
DISCLOSURE: The following authors have nothing to disclose: Laura Thomas, Jonathan Mahnken, Sally Rigler, Matthew Sharpe, Emily Diederich
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