Technology-Assisted Training for Ultrasound-Guided Peripheral IV Access by Nurses: A Randomized Educational Study.

Abstract

Introduction: Ultrasound-guided peripheral venous catheter (PVC) placement is increasingly performed by nurses and requires the acquisition of complex visuomotor and cognitive skills. Technology-enhanced guidance tools have been developed to facilitate learning, yet their educational benefit when added to existing training curricula remains uncertain, particularly in paramedical populations.

Methods: We conducted a single-center, randomized educational study comparing standard training with technology-assisted training for ultrasound-guided PVC placement among nurses. Twenty nurses were randomized to a control group (standard training; n=11) or an intervention group (standard training plus use of an ultrasound guidance/visualization device; n=9). All participants received identical theoretical instruction and mannequin-based practice. Within 3 months, each nurse performed 10 consecutive ultrasound-guided PVC placements in clinical settings. In the intervention group, the first 5 procedures were performed with device support and the last 5 without to assess skill transfer. The primary outcome was procedural success rate. Secondary outcomes included procedure time, number of attempts among successful procedures, and self-perceived mastery. Analyses were conducted at the attempt level.

Results: A total of 200 clinical procedures were analyzed (110 control, 90 intervention). The overall success rate was 78.0%, with no statistically significant difference detected between the control and intervention groups (76.4% vs. 80.0%, P=0.656). Procedures in the intervention group were associated with longer completion times compared with the control group (12.64 vs. 11.25 min, P=0.009). Learning curve analyses showed numerical improvements in procedure time over successive attempts in both groups, but no statistically significant acceleration of learning was detected in the intervention group. Self-perceived mastery did not differ between groups and remained stable over time.

Conclusions: In this pragmatic exploratory educational setting, integrating an ultrasound guidance/visualization device into an existing nurse training curriculum was not associated with improved procedural success or faster learning and was associated with longer procedure times. These findings suggest that the educational impact of technology-enhanced training depends less on technology alone than on its curricular integration and support for skill transfer.