Abstract
Background: Temporary hemodialysis catheter (THDC) insertion is a required skill for nephrology fellows. Traditional fellowship training may provide inadequate preparation to perform this procedure. Our aim was to use a central venous catheter (CVC) simulator to assess nephrology fellows' THDC insertion skills and evaluate the impact of an educational intervention on skill development to mastery standards. Study Design: Prospective observational cohort study. Setting & Participants: 18 nephrology fellows from 3 academic centers in Chicago from May to August 2008. Six graduating fellows (traditionally-trained) underwent assessment of internal jugular THDC insertion skill using a CVC simulator. Subsequently, 12 first-year fellows (simulator-trained) underwent baseline testing and received a 2-hour education session featuring deliberate practice with the CVC simulator. Simulator-trained fellows were retested after the intervention and expected to meet or exceed a minimum passing score. Predictor: Completion of CVC simulation education session. Outcomes: THDC insertion skill performance. Measurements: Skills examination was scored on a 27-item checklist. Minimum passing score was set by an expert panel. Results: Performance of traditionally-trained graduating fellows in THDC insertion was poor (mean, 53.1%), and only 17% met the minimum passing score. Performance of simulator-trained first-year fellows improved from a mean of 29.5% to a mean of 88.6% after simulator training (P = 0.002). Simulator-trained fellows showed significantly higher THDC insertion performance than traditionally-trained graduating fellows (P = 0.001). The education program was rated highly. Limitations: Although it represents fellows from 3 programs, sample size was small. Conclusions: A curriculum featuring deliberate practice dramatically increased the skill of nephrology fellows to mastery standards in THDC insertion. This program illustrates a feasible and reliable mechanism to achieve and document procedural competency.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 70-76 |
| Number of pages | 7 |
| Journal | American Journal of Kidney Diseases |
| Volume | 54 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jul 1 2009 |
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Keywords
- Central venous catheterization
- clinical competence
- mastery learning
- medical education
- nephrology
- simulation-based education
- temporary hemodialysis catheter
- ultrasound
ASJC Scopus subject areas
- Nephrology
Cite this
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Mastery Learning of Temporary Hemodialysis Catheter Insertion by Nephrology Fellows Using Simulation Technology and Deliberate Practice. / Barsuk, Jeffrey H.; Ahya, Shubhada N.; Cohen, Elaine R.; McGaghie, William C.; Wayne, Diane B.
In: American Journal of Kidney Diseases, Vol. 54, No. 1, 01.07.2009, p. 70-76.Research output: Contribution to journal › Article
TY - JOUR
T1 - Mastery Learning of Temporary Hemodialysis Catheter Insertion by Nephrology Fellows Using Simulation Technology and Deliberate Practice
AU - Barsuk, Jeffrey H.
AU - Ahya, Shubhada N.
AU - Cohen, Elaine R.
AU - McGaghie, William C.
AU - Wayne, Diane B.
PY - 2009/7/1
Y1 - 2009/7/1
N2 - Background: Temporary hemodialysis catheter (THDC) insertion is a required skill for nephrology fellows. Traditional fellowship training may provide inadequate preparation to perform this procedure. Our aim was to use a central venous catheter (CVC) simulator to assess nephrology fellows' THDC insertion skills and evaluate the impact of an educational intervention on skill development to mastery standards. Study Design: Prospective observational cohort study. Setting & Participants: 18 nephrology fellows from 3 academic centers in Chicago from May to August 2008. Six graduating fellows (traditionally-trained) underwent assessment of internal jugular THDC insertion skill using a CVC simulator. Subsequently, 12 first-year fellows (simulator-trained) underwent baseline testing and received a 2-hour education session featuring deliberate practice with the CVC simulator. Simulator-trained fellows were retested after the intervention and expected to meet or exceed a minimum passing score. Predictor: Completion of CVC simulation education session. Outcomes: THDC insertion skill performance. Measurements: Skills examination was scored on a 27-item checklist. Minimum passing score was set by an expert panel. Results: Performance of traditionally-trained graduating fellows in THDC insertion was poor (mean, 53.1%), and only 17% met the minimum passing score. Performance of simulator-trained first-year fellows improved from a mean of 29.5% to a mean of 88.6% after simulator training (P = 0.002). Simulator-trained fellows showed significantly higher THDC insertion performance than traditionally-trained graduating fellows (P = 0.001). The education program was rated highly. Limitations: Although it represents fellows from 3 programs, sample size was small. Conclusions: A curriculum featuring deliberate practice dramatically increased the skill of nephrology fellows to mastery standards in THDC insertion. This program illustrates a feasible and reliable mechanism to achieve and document procedural competency.
AB - Background: Temporary hemodialysis catheter (THDC) insertion is a required skill for nephrology fellows. Traditional fellowship training may provide inadequate preparation to perform this procedure. Our aim was to use a central venous catheter (CVC) simulator to assess nephrology fellows' THDC insertion skills and evaluate the impact of an educational intervention on skill development to mastery standards. Study Design: Prospective observational cohort study. Setting & Participants: 18 nephrology fellows from 3 academic centers in Chicago from May to August 2008. Six graduating fellows (traditionally-trained) underwent assessment of internal jugular THDC insertion skill using a CVC simulator. Subsequently, 12 first-year fellows (simulator-trained) underwent baseline testing and received a 2-hour education session featuring deliberate practice with the CVC simulator. Simulator-trained fellows were retested after the intervention and expected to meet or exceed a minimum passing score. Predictor: Completion of CVC simulation education session. Outcomes: THDC insertion skill performance. Measurements: Skills examination was scored on a 27-item checklist. Minimum passing score was set by an expert panel. Results: Performance of traditionally-trained graduating fellows in THDC insertion was poor (mean, 53.1%), and only 17% met the minimum passing score. Performance of simulator-trained first-year fellows improved from a mean of 29.5% to a mean of 88.6% after simulator training (P = 0.002). Simulator-trained fellows showed significantly higher THDC insertion performance than traditionally-trained graduating fellows (P = 0.001). The education program was rated highly. Limitations: Although it represents fellows from 3 programs, sample size was small. Conclusions: A curriculum featuring deliberate practice dramatically increased the skill of nephrology fellows to mastery standards in THDC insertion. This program illustrates a feasible and reliable mechanism to achieve and document procedural competency.
KW - Central venous catheterization
KW - clinical competence
KW - mastery learning
KW - medical education
KW - nephrology
KW - simulation-based education
KW - temporary hemodialysis catheter
KW - ultrasound
UR - http://www.scopus.com/inward/record.url?scp=67449135870&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=67449135870&partnerID=8YFLogxK
U2 - 10.1053/j.ajkd.2008.12.041
DO - 10.1053/j.ajkd.2008.12.041
M3 - Article
C2 - 19376620
AN - SCOPUS:67449135870
VL - 54
SP - 70
EP - 76
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
SN - 0272-6386
IS - 1
ER -