Development and Videographic Evaluation of a Vascular Access Simulation-Based Curriculum for Surgical and Medical Trainees
Background:. There is a paucity of data evaluating femoral arterial access training, despite significant morbidity/mortality associated with incorrect femoral arterial access. The aim of this study was to develop and evaluate a novel 2-component simulation-based curriculum to address a lack of stand...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health
2024-09-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000464 |
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| author | Alaska Pendleton, MD, MPH Tiffany R. Bellomo, MD Srihari K. Lella, MD Kristen Jogerst, MD Ada Stefanescu, MD, MSc Douglas Drachman, MD Nikolaos Zacharias, MD Anahita Dua, MD, MBA, MSc |
| author_facet | Alaska Pendleton, MD, MPH Tiffany R. Bellomo, MD Srihari K. Lella, MD Kristen Jogerst, MD Ada Stefanescu, MD, MSc Douglas Drachman, MD Nikolaos Zacharias, MD Anahita Dua, MD, MBA, MSc |
| author_sort | Alaska Pendleton, MD, MPH |
| collection | DOAJ |
| description | Background:. There is a paucity of data evaluating femoral arterial access training, despite significant morbidity/mortality associated with incorrect femoral arterial access. The aim of this study was to develop and evaluate a novel 2-component simulation-based curriculum to address a lack of standardized access training and identify the most frequent errors in access.
Methods:. The femoral arterial access curriculum was developed through a multi-disciplinary collaboration and utilized in-person simulation sessions in conjunction with online and in-person didactic training. Access errors and curriculum efficacy were assessed using mixed-methodology evaluation of video recordings of trainee arterial access pre- and postcurriculum. All recordings were reviewed and scored by 2 blinded, independent investigators.
Results:. Twenty-six participants completed the curriculum with pre- and postcurriculum recordings. Sixteen participants (62%) were in their first year of residency training. Fifteen participants (58%) belonged to general surgery residency, 9 (35%) to emergency medicine, 1 to vascular surgery, and 1 to interventional radiology residency programs. The global rating for the overall ability to obtain femoral arterial access under ultrasound guidance (0 = fail, 4 = excellent) improved following the curriculum (0.87 ± 0.15, 2.79 ± 1.26, P < 0.0001). Fourteen participants (54%) were unable to independently complete the procedure before training, compared to only 2 participants (8%) following the curriculum. Procedural completion time decreased from 7.14 ± 4.26 to 3.81 ± 2.53 minutes (P < 0.001). Most frequent errors, determined through qualitative analysis, included difficulty using the ultrasound and unsafe maneuvers.
Conclusions:. Before the curriculum, there were significant frequent errors in junior resident femoral arterial access with major patient safety concerns. A novel simulation-based femoral arterial access curriculum resulted in improved procedural skills across all metrics. |
| format | Article |
| id | doaj-art-88d253c8e9e2462f91bcf89f848485a0 |
| institution | Kabale University |
| issn | 2691-3593 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj-art-88d253c8e9e2462f91bcf89f848485a02025-01-24T09:18:48ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932024-09-0153e46410.1097/AS9.0000000000000464202409000-00015Development and Videographic Evaluation of a Vascular Access Simulation-Based Curriculum for Surgical and Medical TraineesAlaska Pendleton, MD, MPH0Tiffany R. Bellomo, MD1Srihari K. Lella, MD2Kristen Jogerst, MD3Ada Stefanescu, MD, MSc4Douglas Drachman, MD5Nikolaos Zacharias, MD6Anahita Dua, MD, MBA, MSc7From the * Division of Vascular and Endovascular Surgery, Department of Surgery, University of Rochester, Rochester, NY† Division of Vascular and Endovascular Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA† Division of Vascular and Endovascular Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA‡ Department of Surgery, Massachusetts General Hospital, Boston, MA§ Interventional Cardiology, Massachusetts General Hospital, Boston, MA.§ Interventional Cardiology, Massachusetts General Hospital, Boston, MA.† Division of Vascular and Endovascular Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA† Division of Vascular and Endovascular Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MABackground:. There is a paucity of data evaluating femoral arterial access training, despite significant morbidity/mortality associated with incorrect femoral arterial access. The aim of this study was to develop and evaluate a novel 2-component simulation-based curriculum to address a lack of standardized access training and identify the most frequent errors in access. Methods:. The femoral arterial access curriculum was developed through a multi-disciplinary collaboration and utilized in-person simulation sessions in conjunction with online and in-person didactic training. Access errors and curriculum efficacy were assessed using mixed-methodology evaluation of video recordings of trainee arterial access pre- and postcurriculum. All recordings were reviewed and scored by 2 blinded, independent investigators. Results:. Twenty-six participants completed the curriculum with pre- and postcurriculum recordings. Sixteen participants (62%) were in their first year of residency training. Fifteen participants (58%) belonged to general surgery residency, 9 (35%) to emergency medicine, 1 to vascular surgery, and 1 to interventional radiology residency programs. The global rating for the overall ability to obtain femoral arterial access under ultrasound guidance (0 = fail, 4 = excellent) improved following the curriculum (0.87 ± 0.15, 2.79 ± 1.26, P < 0.0001). Fourteen participants (54%) were unable to independently complete the procedure before training, compared to only 2 participants (8%) following the curriculum. Procedural completion time decreased from 7.14 ± 4.26 to 3.81 ± 2.53 minutes (P < 0.001). Most frequent errors, determined through qualitative analysis, included difficulty using the ultrasound and unsafe maneuvers. Conclusions:. Before the curriculum, there were significant frequent errors in junior resident femoral arterial access with major patient safety concerns. A novel simulation-based femoral arterial access curriculum resulted in improved procedural skills across all metrics.http://journals.lww.com/10.1097/AS9.0000000000000464 |
| spellingShingle | Alaska Pendleton, MD, MPH Tiffany R. Bellomo, MD Srihari K. Lella, MD Kristen Jogerst, MD Ada Stefanescu, MD, MSc Douglas Drachman, MD Nikolaos Zacharias, MD Anahita Dua, MD, MBA, MSc Development and Videographic Evaluation of a Vascular Access Simulation-Based Curriculum for Surgical and Medical Trainees Annals of Surgery Open |
| title | Development and Videographic Evaluation of a Vascular Access Simulation-Based Curriculum for Surgical and Medical Trainees |
| title_full | Development and Videographic Evaluation of a Vascular Access Simulation-Based Curriculum for Surgical and Medical Trainees |
| title_fullStr | Development and Videographic Evaluation of a Vascular Access Simulation-Based Curriculum for Surgical and Medical Trainees |
| title_full_unstemmed | Development and Videographic Evaluation of a Vascular Access Simulation-Based Curriculum for Surgical and Medical Trainees |
| title_short | Development and Videographic Evaluation of a Vascular Access Simulation-Based Curriculum for Surgical and Medical Trainees |
| title_sort | development and videographic evaluation of a vascular access simulation based curriculum for surgical and medical trainees |
| url | http://journals.lww.com/10.1097/AS9.0000000000000464 |
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