The Development of a Validated Checklist for Paracentesis

Riesenberg, Lee Ann; Berg, Katherine; Berg, Dale; Mealey, Kathleen; Weber, Danielle; King, Daniel; Justice, Ellen; Geffe, Kevin; Tinkoff, Glen

doi:10.1177/1062860612460399

Cited by 15 publications

(9 citation statements)

References 16 publications

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“…The first component of the PCAT is a skills checklist adapted, collated, and edited from other published paracentesis checklists. 5,9,14 The checklist was evaluated by local experts (two gastroenterologists, one gastroenterology nurse practitioner, and five hospitalists) using a modified Delphi method 15 and further edited to reflect best practices at our institution. The PCAT also includes two global measures: a global skill assessment scale and an entrustment scale.…”

Section: Methodsmentioning

confidence: 99%

Paracentesis Simulation: A Comprehensive Approach to Procedural Education

et al. 2018

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IntroductionStructured procedural education and assessment of competency are growing needs for residency and fellowship programs. Simulation is a useful way to learn, experience, and practice procedural skills with competence. Paracentesis is a common procedure encountered in internal medicine. This educational resource for paracentesis education includes didactics, cases, and assessments to address cognitive skills, a simulation experience to address psychomotor procedural skills, and an entrustment-based assessment tool.MethodsPrior to the simulation, learners completed preprocedural didactics and self-assessments. Utilizing a paracentesis trainer, ultrasound, and paracentesis kit, the case of a 46-year-old male with ascites in need of a paracentesis was presented. During the simulation, learners initially performed a paracentesis step by step, with assistance and feedback from the case instructor. This was immediately followed by paracentesis without assistance, where the instructor evaluated the learners with an assessment tool encompassing a procedural checklist, global skill assessment scale, and entrustment scale. Afterwards, learners completed case-based reviews and returned to the simulation lab several months later to repeat an unassisted paracentesis.ResultsThe curriculum was used with internal medicine and medicine-pediatric residents of all training levels. To date, over 120 residents have completed the curriculum. Residents reported an increase in self-confidence and competence using ultrasound to identify ascites and performing a paracentesis. Learners provided positive feedback.DiscussionThis curriculum offers the opportunity for both cognitive and psychomotor paracentesis education in a low-risk simulation environment. The comprehensive strategy with didactics, cases, and multiple simulations is designed to promote knowledge and skill retention.

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Section: Methodsmentioning

confidence: 99%

Paracentesis Simulation: A Comprehensive Approach to Procedural Education

et al. 2018

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“…Faculty at the Veterans Affairs Pittsburgh Healthcare System (VAPHS) and the University of Pittsburgh School of Medicine designed the "Mastering Paracentesis for Medical Residents" (MPMR) course based on current guidelines on the management of ascites 7 (chronic peritoneal effusion) and on published procedural guides. 8,9 The course is offered to all postgraduate year one (PGY-1) internal medicine residents during the first week of their Ambulatory 1 rotation (a required, four-week outpatient experience) and consists of two hours of didactic and simulation-based training with an ultrasound-compatible paracentesis mannequin (Figure 1). Before and immediately after each session, participants complete a 13-item multiple-choice knowledge test based on the American Association for the Study of Liver Diseases' practice guideline Management of Adult Patients With Ascites Due to Cirrhosis.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Simulation-Only vs. Simulation + Live Training in Paracentesis

2021

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Background Several studies have examined the effects of simulation and live training experiences on abdominal paracentesis skills, but no study has examined the durability of such training or compared skills retention between the simulation-only and hybrid training approaches. Methods A subset of internal medicine residents who participated in simulation-based training in abdominal paracentesis were assigned to an additional, live training experience. Procedural knowledge and skill were assessed following initial training and at six months, and compared between groups. Results Complete data was available for 29 out of 37 residents who received simulation-only training and 18 out of 23 who received simulation plus live training. There were no statistical differences in procedural skills scores at either point in time. The simulation plus live training group achieved a higher mean score on the knowledge test at six months (p=0.006). Conclusions Simulation-based training is sufficient for achieving initial mastery in abdominal paracentesis, but not for maintaining paracentesis skills at six months in the absence of structured, maintenance training. The addition of a live training experience to complement the simulation training was not sufficient to prevent skills decline.

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“…Therefore, checklists should be paired with overall scores. [58][59][60][61] Both checklists and overall scores ought to be obtained from reliable and valid instruments.…”

Section: Certification Assessments Of Manual Competence Should Combinmentioning

confidence: 99%

Credentialing of Hospitalists in Ultrasound‐Guided Bedside Procedures: A Position Statement of the Society of Hospital Medicine

Lucas

Tierney

Jensen

et al. 2018

Journal of Hospital Medicine

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Ultrasound guidance is used increasingly to perform the following 6 bedside procedures that are core competencies of hospitalists: abdominal paracentesis, arterial catheter placement, arthrocentesis, central venous catheter placement, lumbar puncture, and thoracentesis. Yet most hospitalists have not been certified to perform these procedures, whether using ultrasound guidance or not, by specialty boards or other institutions extramural to their own hospitals. Instead, hospital privileging committees often ask hospitalist group leaders to make ad hoc intramural certification assessments as part of credentialing. Given variation in training and experience, such assessments are not straightforward "sign offs." We thus convened a panel of experts to conduct a systematic review to provide recommendations for credentialing hospitalist physicians in ultrasound guidance of these 6 bedside procedures. Pathways for initial and ongoing credentialing are proposed. A guiding principle of both is that certification assessments for basic competence are best made through direct observation of performance on actual patients.

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The Development of a Validated Checklist for Paracentesis

Cited by 15 publications

References 16 publications

Paracentesis Simulation: A Comprehensive Approach to Procedural Education

Paracentesis Simulation: A Comprehensive Approach to Procedural Education

Comparison of Simulation-Only vs. Simulation + Live Training in Paracentesis

Credentialing of Hospitalists in Ultrasound‐Guided Bedside Procedures: A Position Statement of the Society of Hospital Medicine

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