Use of a national continuing medical education meeting to provide simulation-based training in temporary hemodialysis catheter insertion skills: A pre-test post-test study

TY - JOUR

T1 - Use of a national continuing medical education meeting to provide simulation-based training in temporary hemodialysis catheter insertion skills

T2 - A pre-test post-test study

AU - Clark, Edward G.

AU - Paparello, James J.

AU - Wayne, Diane B.

AU - Edwards, Cedric

AU - Hoar, Stephanie

AU - McQuillan, Rory

AU - Schachter, Michael E.

AU - Barsuk, Jeffrey H.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background: Simulation-based-mastery-learning (SBML) is an effective method to train nephrology fellows to competently insert temporary, non-tunneled hemodialysis catheters (NTHCs). Previous studies of SBML for NTHC-insertion have been conducted at a local level. Objectives: Determine if SBML for NTHC-insertion can be effective when provided at a national continuing medical education (CME) meeting. Describe the correlation of demographic factors, prior experience with NTHC-insertion and procedural self-confidence with simulated performance of the procedure. Design: Pre-test - post-test study. Setting: 2014 Canadian Society of Nephrology annual meeting. Participants: Nephrology fellows, internal medicine residents and medical students. Measurements: Participants were surveyed regarding demographics, prior NTHC-insertion experience, procedural self-confidence and attitudes regarding the training they received. NTHC-insertion skills were assessed using a 28-item checklist. Methods: Participants underwent a pre-test of their NTHC-insertion skills at the internal jugular site using a realistic patient simulator and ultrasound machine. Participants then had a training session that included a didactic presentation and 2 hours of deliberate practice using the simulator. On the following day, trainees completed a post-test of their NTHC-insertion skills. All participants were required to meet or exceed a minimum passing score (MPS) previously set at 79%. Trainees who did not reach the MPS were required to perform more deliberate practice until the MPS was achieved. Results: Twenty-two individuals participated in SBML training. None met or exceeded the MPS at baseline with a median checklist score of 20 (IQR, 7.25 to 21). Seventeen of 22 participants (77%) completed post-testing and improved their scores to a median of 27 (IQR, 26 to 28; p < 0.001). All met or exceeded the MPS on their first attempt. There were no significant correlations between demographics, prior experience or procedural self-confidence with pre-test performance. Limitations: Small sample-size and self-selection of participants. Costs could limit the long-term feasibility of providing this type of training at a CME conference. Conclusions: Despite most participants reporting having previously inserted NTHCs in clinical practice, none met the MPS at baseline; this suggests their prior training may have been inadequate.

AB - Background: Simulation-based-mastery-learning (SBML) is an effective method to train nephrology fellows to competently insert temporary, non-tunneled hemodialysis catheters (NTHCs). Previous studies of SBML for NTHC-insertion have been conducted at a local level. Objectives: Determine if SBML for NTHC-insertion can be effective when provided at a national continuing medical education (CME) meeting. Describe the correlation of demographic factors, prior experience with NTHC-insertion and procedural self-confidence with simulated performance of the procedure. Design: Pre-test - post-test study. Setting: 2014 Canadian Society of Nephrology annual meeting. Participants: Nephrology fellows, internal medicine residents and medical students. Measurements: Participants were surveyed regarding demographics, prior NTHC-insertion experience, procedural self-confidence and attitudes regarding the training they received. NTHC-insertion skills were assessed using a 28-item checklist. Methods: Participants underwent a pre-test of their NTHC-insertion skills at the internal jugular site using a realistic patient simulator and ultrasound machine. Participants then had a training session that included a didactic presentation and 2 hours of deliberate practice using the simulator. On the following day, trainees completed a post-test of their NTHC-insertion skills. All participants were required to meet or exceed a minimum passing score (MPS) previously set at 79%. Trainees who did not reach the MPS were required to perform more deliberate practice until the MPS was achieved. Results: Twenty-two individuals participated in SBML training. None met or exceeded the MPS at baseline with a median checklist score of 20 (IQR, 7.25 to 21). Seventeen of 22 participants (77%) completed post-testing and improved their scores to a median of 27 (IQR, 26 to 28; p < 0.001). All met or exceeded the MPS on their first attempt. There were no significant correlations between demographics, prior experience or procedural self-confidence with pre-test performance. Limitations: Small sample-size and self-selection of participants. Costs could limit the long-term feasibility of providing this type of training at a CME conference. Conclusions: Despite most participants reporting having previously inserted NTHCs in clinical practice, none met the MPS at baseline; this suggests their prior training may have been inadequate.

KW - Central venous catheterization

KW - Clinical competence

KW - Mastery learning

KW - Medical education

KW - Non-tunneled hemodialysis catheter

KW - Simulation-based education

KW - Temporary hemodialysis catheter

KW - Ultrasound

KW - Vascular access

UR - http://www.scopus.com/inward/record.url?scp=84991037669&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84991037669&partnerID=8YFLogxK

U2 - 10.1186/s40697-014-0025-6

DO - 10.1186/s40697-014-0025-6

M3 - Article

C2 - 25780614

AN - SCOPUS:84991037669

VL - 1

JO - Canadian Journal of Kidney Health and Disease

JF - Canadian Journal of Kidney Health and Disease

SN - 2054-3581

IS - 1

M1 - 25

ER -