Impact of the simulation-based Airway and Catheter Cannulation Education-from Starters to Specialists (ACCESS) program for critical care procedures.

Abstract

Purpose: Central venous catheterization and endotracheal intubation are critical lifesaving procedures, yet structured training opportunities remain limited and often rely on informal apprenticeships. This study evaluates the effectiveness of the Airway and Catheter Cannulation Education-from Starters to Specialists (ACCESS) program in improving procedural knowledge, confidence, and ultrasound proficiency.

Methods: Data from 70 healthcare professionals (38 residents, 28 specialists, and 4 others) who completed the ACCESS program between 2022 and 2025 were analyzed. Participants were divided into two cohorts: a retrospective cohort (n=46) from 2022 to 2023, who completed the post-training questionnaire only, and a prospective cohort (n=24) from 2024 to 2025, who underwent pre- and post-training assessments. The questionnaire used a self-reported 10-point Likert scale.

Results: Overall, 67 valid post-training responses were analyzed, excluding 3 incomplete surveys from the prospective group. Participants reported exceptional satisfaction, with clinicians (>6 years of experience) reporting higher satisfaction with equipment (P=0.020). In the prospective cohort (pre-training, n=24; post-training, n=21), significant improvements were observed across all domains (P<0.001). Ultrasound proficiency showed the most dramatic increase (from 4.67 to 8.81), accompanied by marked improvements in procedural confidence.

Conclusions: The ACCESS program effectively enhanced procedural competence, especially ultrasound-guided skills. The significant improvement observed in the cohort with a high percentage of specialists underscores the limitations of traditional models and highlights the critical value of standardized high-fidelity simulation training programs for physicians at all career stages.