Simulation-Based Mastery Learning Improves Ultrasound-Guided Peripheral Intravenous Catheter Insertion Skills of Practicing Nurses

Ashley Elizabeth Amick*, Sarah E. Feinsmith, Evan M. Davis, Jordan Sell, Valerie MacDonald, Paul Trinquero, Arthur G. Moore, Victor Gappmeier, Katharine Colton, Andrew Cunningham, William Ford, Joseph Feinglass, Jeffrey H. Barsuk

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Introduction Difficult intravenous (IV) access (DIVA) is frequently encountered in the hospital setting. Ultrasound-guided peripheral IV catheter (USGPIV) insertion has emerged as an effective procedure to establish access in patients with DIVA. Despite the increased use of USGPIV, little is known about the optimal training paradigms for bedside nurses. Therefore, we developed and evaluated a novel, sustainable, USGPIV simulation-based mastery learning (SBML) curriculum for nurses. Methods This is a prospective cohort study of an USGPIV SBML training program for bedside nurses over a 12-month period. We evaluated skills and self-confidence before and after training and measured the proportion of the nurses achieving independent, proctor, and instructor status. Procedure logs and surveys were used to explore the nurse experience and utilization of USGPIV on real patients with DIVA 3 months after the intervention. Results Two hundred thirty-eight nurses enrolled in the study. The USGPIV skill checklist scores increased from median of 6.0 [interquartile range = 4.0-9.0 (pretest) to 29.0, interquartile range = 28-30 (posttest), P < 0.001]. The USGPIV confidence improved from before (mean = 2.32, SD = 1.17) to after (mean = 3.85, SD = 0.73, P < 0.001) training (5-point Likert scale). Sixty-two percent of the nurses enrolled achieved independent status, 47.5% became proctors, and 11.3% course trainers. At 3-month posttraining, the nurses had attempted a mean of 35.6 USGPIV insertions with an 89.5% success rate. Conclusions This novel USGPIV SBML curriculum improves nurses' insertion skills, self-confidence, and progresses patient care through USGPIV insertions on hospitalized patients with DIVA.

Original languageEnglish (US)
Pages (from-to)7-14
Number of pages8
JournalSimulation in Healthcare
Issue number1
StatePublished - Feb 1 2022


  • Simulation-based mastery learning
  • nursing education
  • ultrasound-guided peripheral intravenous catheter

ASJC Scopus subject areas

  • Education
  • Epidemiology
  • Medicine (miscellaneous)
  • Modeling and Simulation


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