Outcomes of Simulation-Based Education for Vascular Access: A Systematic Review and Meta-Analysis

Okano, Hiromu; Mayumi, Takuya; Kataoka, Yuki; Banno, Masahiro; Tsujimoto, Yasushi; Shiroshita, Akihiro; Taito, Shunsuke; Tokumine, Joho

doi:10.7759/cureus.17188

Cited by 4 publications

(6 citation statements)

References 21 publications

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“…Besides the conventional bedside training, simulation training may be beneficial for common procedural skills (e.g., central venous catheter insertion) and particularly for less common skills (e.g., pericardiocentesis) [ 9 , 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of number of critical care procedural skill repetitions on supervision level and teaching style

Zante

2023

PLoS ONE

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Background During critical care procedural skills training (e.g., in intubation and pericardiocentesis) the appropriate supervision level is important to ensure correct use of techniques and guarantee patient safety. The appropriate teaching style should be selected to address residents’ learning behavior and foster their competence. The aim of this study was to explore the number of repetitions for given skills needed to achieve a specified supervision level and a specific teaching style. Methods This cross-sectional multicenter survey obtained data from residents and faculty of three multidisciplinary intensive care units (ICU) in Switzerland. Using a 4-point Likert scale, participants were asked to indicate the number of repetitions required to achieve the specified supervision level and teaching style. Results Among 91 physicians, the response rate was 64% (n = 59). Their median estimations of the numbers of skill repetitions needed to achieve the final fourth level of supervision and final fourth stage of teaching style were as follows: arterial catheter insertion: supervision level 32, teaching style 17.5; peritoneal paracentesis: supervision level 27, teaching style 17; central venous catheter insertion: supervision level 38, teaching style 28; lumbar puncture: supervision level 38, teaching style 21; endotracheal intubation: supervision level 100, teaching style 45; chest drain insertion: supervision level 27, teaching style 21.5; temporary pacemaker placement: supervision level 50, teaching style 19.5; percutaneous tracheostomy: supervision level 50, teaching style 29; pericardiocentesis: supervision level 50, teaching style 35. Comparison of repetitions between supervision level and teaching style revealed no difference at the first and second levels, except for endotracheal intubation at level 2 (p = 0.03). Differences were observed at the third and fourth levels of supervision level and teaching style (p≤0.04). Conclusions It appears that the supervision level and teaching style applied by faculty should change according to both the number of repetitions and the difficulty of critical care procedural skills.

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Section: Discussionmentioning

confidence: 99%

Impact of number of critical care procedural skill repetitions on supervision level and teaching style

Zante

2023

PLoS ONE

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“…Many studies have evaluated the teaching methods used for ultrasound guided venous access, but there is still no method accepted as the optimal approach. [ 26 ] In conclusion, near-infrared venous imaging may be a useful alternative to ultrasound guidance to obtain difficult peripheral venous access in obese patients, especially for novices.…”

Section: Discussionmentioning

confidence: 99%

Near-infrared venous imaging may be more useful than ultrasound guidance for novices to obtain difficult peripheral venous access: A crossover simulation study

et al. 2023

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Background: Difficult peripheral venous access, especially in obese people, is challenging for novices. We conducted a randomized cross-over study to examine whether near-infrared venous imaging or ultrasound guidance is more useful for novice operators to obtain difficult peripheral venous access. Methods: Medical students were recruited as participants. After receiving basic training using commercial simulators, participants were randomly assigned to obtain simulated venous access using a difficult venous access simulator with near-infrared venous imaging or ultrasound guidance in a randomized cross-over design. A difficult venous access simulator was newly developed with deep and narrow vessels to simulate an obese patient. The primary outcome measure of the study was the first-time success rate (%), and the secondary outcome measures included procedure time (seconds) and the number of 3 consecutive successful attempts, to represent proficiency with the procedure. Pearson chi-square test, the Wilcoxon signed-rank test, and generalized estimating equations were used for statistical analysis. Results: Forty-one medical students with no experience performing peripheral venous access were enrolled in this study. The rate of successful first attempts did not differ between the 2 groups (70% for near-infrared; 65% for ultrasound guidance; P = .64). The duration of the procedure for the first attempt was significantly shorter using near-infrared imaging (median: 14; interquartile range: 12–19) compared to ultrasound guidance (median 46; interquartile range: 26–52; P = .007). The number of attempts until 3 consecutive successes was not significantly different comparing the 2 approaches (near-infrared: 3 (3, 7.25), ultrasound guidance: 3 (3, 6.25), P = .63). Conclusion: There was no difference in success rate of first-time attempts or acquiring proficiency for the 2 methods. However, duration of the first attempt was significantly shorter with near-infrared imaging than with ultrasound guidance. Near-infrared imaging may require less training than ultrasound guidance. Near-infrared venous imaging may be useful for novices to obtain difficult peripheral venous access in obese patients.

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“…Okano et al reported in a meta-analysis that simulation education for vascular access was of questionable value to improve clinical practice. [ 23 ] This may be due to a lack of training in techniques to specifically avoid ultrasound pitfalls, which often occur while moving the interlocked probe and needle. The occurrence of these events also stems from the physical characteristics of a vein.…”

Section: Discussionmentioning

confidence: 99%

“…The need for simulation education for vascular access is clear, [ 24 , 25 ] but its effectiveness remains unclear. [ 23 ] Simulation education for vascular access is expected to continue to grow in educational content and method. [ 26 ] Self-learning through a web-based learning system is one of the leading candidates.…”

Section: Discussionmentioning

confidence: 99%

A web-based self-learning system for ultrasound-guided vascular access

et al. 2022

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Ultrasound-guided vascular access is practiced widely. Optimal educational methods have not yet been established. We hypothesized that a step-by-step web-based learning system is effective for self-learning. In this study, we examined the potential of this system as a self-learning tool. This was an observational study at a single institution. Participants included residents, who were self-educated through the web-based system. Skill proficiency was measured after self-learning. The primary outcome was the extent to which self-learning enabled residents to acquire proficiency in the basic skills of ultrasound-guided vascular access: needle visualization, hand-eye coordination, and avoiding posterior wall penetration. A secondary outcome was the time required to achieve proficiency. Thirty-nine residents were enrolled in this study. Eleven residents (28%) passed the first skill assessment test. There was no significant difference in the number of days that the web-based system was accessed, the total number of screen views, or the total learning time between participants who passed and those who failed the first test. Skill assessment scores between those who passed and those who failed the first test were different, especially the score for hand-eye coordination, and the number of posterior wall penetrations. Self-learning with a web-based system enabled 28% of residents to pass the first skill assessment test. The remaining 72% failed the first skill assessment test but continued to learn using the web-based system and eventually passed the test. Hence, the web-based system needed formative testing to function as a self-learning system. Simulation education for vascular access is expected to increase in educational content and methods. Self-learning through a web-based learning system is a leading candidate for this growth.

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Outcomes of Simulation-Based Education for Vascular Access: A Systematic Review and Meta-Analysis

Cited by 4 publications

References 21 publications

Impact of number of critical care procedural skill repetitions on supervision level and teaching style

Impact of number of critical care procedural skill repetitions on supervision level and teaching style

Near-infrared venous imaging may be more useful than ultrasound guidance for novices to obtain difficult peripheral venous access: A crossover simulation study

A web-based self-learning system for ultrasound-guided vascular access

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