Literature DB >> 15704776

A curricular initiative for internal medicine residents to enhance proficiency in internal jugular central venous line placement.

Gautam Ramakrishna1, Stuart T Higano, Furman S McDonald, Henry J Schultz.   

Abstract

OBJECTIVE: To determine the feasibility, efficacy, and outcomes of teaching Internal Jugular (IJ) central venous line placement (CVLP) to internal medicine residents in a hands-on training experience with adult patients. SUBJECTS AND METHODS: Data were obtained from 47 residents during their 3-year residency program through questionnaires and a proprietary system that tracks resident procedures. Twenty-five postgraduate year (PGY) 2 residents at the Mayo Clinic in Rochester, Minn, were assigned to IJ-CVLP training in the cardiac catheterization laboratory from January 2001 to June 2001. Their experience, analyzed immediately after training and at completion of residency, was compared with that of 22 PGY-2 residents in the same class who were not assigned to IJ-CVLP training.
RESULTS: The median Likert scores of the residents' self-reported perception of independence in IJ-CVLP increased from 3.0 (mean +/- SD score, 2.8+/-1.4) before the intervention to 5.0 (4.4+/-0.9) after the intervention (P<.001, signed rank test). At graduation, trained residents had performed more IJ-CVLPs than the control residents (mean +/- SD, 17.8+/-8.4 vs 9.8+/-6.3, respectively; P<.001). Residents who received IJ-CVLP training, compared with those who did not, showed a significant increase in the mean percentage of IJ-CVLPs performed independently between PGY-1 (2.2%) and PGY-3 (31.2%) (P=.008).
CONCLUSIONS: Training internal medicine residents to perform IJ-CVLP is feasible in the cardiac catheterization laboratory with supervision from an attending cardiologist. Trained residents performed significantly more IJ-CVLPs independently during their third year compared with their first year of training. We believe this initiative may be implemented successfully in graduate medical education curriculums.

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Year:  2005        PMID: 15704776     DOI: 10.4065/80.2.212

Source DB:  PubMed          Journal:  Mayo Clin Proc        ISSN: 0025-6196            Impact factor:   7.616


  4 in total

1.  Simulation-based training improves applied clinical placement of ultrasound-guided PICCs.

Authors:  Pamela Andreatta; Yifang Chen; Michael Marsh; Kyung Cho
Journal:  Support Care Cancer       Date:  2010-03-20       Impact factor: 3.603

2.  An intervention to improve procedure education for internal medicine residents.

Authors:  Amanda Lenhard; Moayyed Moallem; Ruth Ann Marrie; Jeffrey Becker; Allan Garland
Journal:  J Gen Intern Med       Date:  2008-01-23       Impact factor: 5.128

3.  Measuring competence in central venous catheterization: a systematic-review.

Authors:  Irene Wy Ma; Nishan Sharma; Mary E Brindle; Jeff Caird; Kevin McLaughlin
Journal:  Springerplus       Date:  2014-01-17

Review 4.  Central venous catheterization training: current perspectives on the role of simulation.

Authors:  Morgan I Soffler; Margaret M Hayes; C Christopher Smith
Journal:  Adv Med Educ Pract       Date:  2018-05-25
  4 in total

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