Measuring competence in central venous catheterization: a systematic-review

Abstract

ObjectivesCentral venous catheterization is a complex procedural skill. This study evaluates existing published tools on this procedure and systematically summarizes key competencies for the assessment of this technical skill.MethodsUsing a previously published meta-analysis search strategy, we conducted a systematic review of published assessment tools using the electronic databases PubMed, MEDLINE, Education Resource Information Center (ERIC), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica, and Cochrane Central Register of Controlled Trials. Two independent investigators abstracted information on tool content and characteristics.ResultsTwenty-five studies were identified assessing a total of 147 items. Tools used for assessment at the bedside (clinical tools) had a higher % of items representing “preparation” and “infection control” than tools used for assessment using simulation (67 ± 26% vs. 32 ± 26%; p = 0.003 for “preparation” and 60 ± 41% vs. 11 ± 17%; p = 0.002 for “infection control”, respectively). Simulation tools had a higher % of items on “procedural competence” than clinical tools (60 ± 36% vs. 17 ± 15%; p = 0.002). Items in the domains of “Team working” and “Communication and working with the patient” were frequently under-represented.ConclusionThis study presents a comprehensive review of existing checklist items for the assessment of central venous catheterization. Although many key competencies are currently assessed by existing published tools, some domains may be under-represented by select tools.Electronic supplementary materialThe online version of this article (doi:10.1186/2193-1801-3-33) contains supplementary material, which is available to authorized users.

Assessment of central venous catheterization in a simulated model using a motion-tracking device: an experimental validation study

“…Central venous catheterization (CVC) is an essential competency required for many medical specialties [ 1 , 2 ]. Annually, 5 million CVC are performed only in the United States [ 3 ], with serious and life-threatening complications occurring in up to 5–26 % [ 4 ] of the cases.…”

“…Nowadays, simulated training for acquiring technical skills is becoming widespread for many medical specialties [ 2 , 6 , 7 ], from simple procedures like a venous puncture to more complex surgical procedures like a laparoscopic jejuno-jejunostomy [ 8 – 10 ], shortening the learning curves of residents while doing so in a safe and controlled environment [ 11 ]. Few studies have evaluated the acquisition of CVC proficiency through simulated models and their educational effectiveness [ 11 – 15 ].…”

Use of an error‐focused checklist to identify incompetence in lumbar puncture performances

“…In the case of central venous catheterisation, the number of checklists in use in the literature far outnumbers that of global rating scales. 8 , 9 The reason why checklists are used more commonly than global ratings for some procedural skills is not entirely clear. As procedural steps are typically executed in a predictable stepwise fashion, it is conceivable that checklists are felt to be better suited to the assessment task.…”

Using the Entrustable Professional Activities Framework in the Assessment of Procedural Skills

“…9 Studies of assessment methods for procedural skills have largely focused on technical ability, and have not considered nontechnical skills that are equally critical for successful procedural performance. [10][11][12][13] These skills include the ability to communicate effectively (eg, obtaining informed consent); to collaborate with other professionals; to act in a professional manner; and to exercise clinical reasoning and judgment. 14 There have been attempts to assess procedural skills in context, [15][16][17] but it remains unclear which nontechnical skills are most important to assess.…”