Simulation‐based training program with deliberate practice for ultrasound‐guided jugular central venous catheter placement

Background Current evidence supports the utility of simulation training for bedside procedures such as ultrasound‐guided jugular central venous catheter (CVC) insertion. However, a standardized methodology to teach procedural skills has not been determined yet. The aim of this study was to evaluate the effectiveness of a simulation‐based training program for improving novice technical performance during ultrasound‐guided internal jugular CVC placement. Methods Postgraduate year 1 (PGY‐1) residents from anesthesiology, emergency medicine, cardiology, ICU, and nephrology specialties were trained in four deliberate practice sessions. Learning objectives included principles of ultrasound (US), preparation (gown, glove, draping), procedural skills I (US scanning and puncture), and procedural skills II (catheter insertion). CVC technical proficiency was tested pre‐ and post‐training using hand‐motion analysis with the Imperial College Surgical Assessment Device (ICSAD) and a global rating scale (GRS). Results Thirty‐five PGY‐1 residents successfully completed the program. These novices' GRS scores improved significantly after the training (P < 0.001). Total path length measured with the ICSAD decreased significantly after the training (P = 0.008). Procedural time decreased significantly after training from 387 (310–501) seconds to 200 (157–261) seconds (median and interquartile range) (P = 0.029). Conclusion This simulation‐training program based on deliberate practice significantly increased the technical skills of residents in US‐guided short‐axis, out‐of‐plane internal jugular CVC placement. Data also confirm the validity of the ICSAD as an assessment tool for ultrasound‐guided internal jugular CVC placement learning.