Improving Resident Comfort with Central Venous Catheter Supervision: Use of an Error Management Training Approach.

Abstract

Background: Simulation is a well-established component of central venous catheter (CVC) training. However, there is little published regarding how to train residents to supervise CVC insertion.

Purpose: We describe a curriculum designed to help trainees identify potential procedural errors and improve their comfort with supervising CVC insertion.

Patients and methods: We conducted a one-group, pre-post-posttest study. All participants completed a pre-simulation assessment (Time 1) that evaluated residents' ability to identify potential complications with CVC insertion and their procedural completion and procedural supervision comfort. Residents then participated in a simulation in which they supervised a mock proceduralist insert a CVC and commit five pre-specified errors. Participants completed the same comfort assessment immediately following the simulation (Time 2) and repeat knowledge and comfort assessments five months later (Time 3).

Results: Forty-seven interns participated in the study. Relative to Time 1 (M = 3.00, SD = 1.02), interns were significantly more comfortable supervising CVC insertion at Time 2 (M = 3.75, SD = 0.85) and at Time 3 (M = 4.08, SD = 0.58).

Conclusion: We describe a simulation designed to help residents identify errors when supervising CVC insertion. Due to a poor survey response rate, no comparisons between pre- and post-simulation error identification could be determined. However, following our CVC supervisor simulation, participants reported immediate and sustained increases in their comfort supervising CVC placement.