Background:
Legitimate concerns continue to mount with regard to having novice physicians learn and practice procedures on patients. It is incumbent on the education community to develop effective modalities for teaching proper procedure technique that do not place patients at undue risk. To that end, these authors previously published phase I of the Procedure Patient Safety Initiative (PPSI), wherein subjective criteria were used to demonstrate the worthiness of using a nonhuman tissue model (NHTM) to train practitioners on ultrasound‐guided central line placement and wide sterile barrier (WSB) technique. Further validation for the NHTM was required, however, to confirm that practitioners trained with this model will learn and retain the necessary procedural skills, and that this training will ultimately result in a safer experience for patients.
Purpose:
Phase II of the PPSI uses objective criteria to evaluate whether intensive 1:1 training sessions with the NHTM can be employed to teach novice practitioners proper procedural techniques and to assess whether those learned skills can be retained over time.
Description:
Twenty incoming interns were voluntarily recruited. Each participant was assessed at baseline using a 6‐point tool, with an initial average score of 1.02. Participants were then given a 1:1 tutorial by an experienced proceduralist on proper procedural technique, using the NHTM; they were given as much time as needed to achieve competency with each step before proceeding. Immediate repeat evaluation scores improved to an average of 4.37 (P < .0001). Follow‐up evaluation within 3 weeks demonstrated an insignificant drop in average score to 4.24 (P = .14). Of note, although only 1 participant could successfully place a central line during the initial evaluation, all 20 could successfully cannulate the vein in both the immediate and delayed follow‐up evaluations.
Figure 1. Our nonhuman tissue model.
Conclusions:
The goal of procedural training is to teach novice physicians how to perform proper, safe, and effective procedures. Our NHTM was proven in phase I to be a subjectively worthwhile modality for learning proper techniques. Phase II further validates the NHTM by using 1:1 sessions to teach proper central line placement skills. Scores improved significantly from baseline to posttraining, and trainees retained their skills over time. As a next step, PPSI phase III will go to the bedside and systematically compare performance scores and outcomes on actual patients after trainees undergo either our 1:1 training approach with the NHTM or the see‐one, do‐one, teach‐one approach still employed at many institutions.
Author Disclosure:
A. Harrington, none; P. Uddin, none; B. Rosen, none; B. Ault, none; M. Ault, none.