Arin L Madenci1, Carolina V Solis, Marc A de Moya. 1. From the University of Michigan Medical School (A.L.M.), Ann Arbor, MI; Harvard School of Public Health (A.L.M., C.V.S.); and Division of Trauma, Emergency Surgery and Surgical Critical Care (M.A.D.M.), Department of Surgery, Massachusetts General Hospital, Boston, MA; Department of Surgery (C.V.S.), Duke University Medical Center, Durham, NC.
Abstract
INTRODUCTION: Simulation training for invasive procedures may improve patient safety by enabling efficient training. This study is a meta-analysis with rigorous inclusion and exclusion criteria designed to assess the real patient procedural success of simulation training for central venous access. METHODS: Published randomized controlled trials and prospective 2-group cohort studies that used simulation for the training of procedures involving central venous access were identified. The quality of each study was assessed. The primary outcome was the proportion of trainees who demonstrated the ability to successfully complete the procedure. Secondary outcomes included the mean number of attempts to procedural success and periprocedural adverse events. Proportions were compared between groups using risk ratios (RRs), whereas continuous variables were compared using weighted mean differences. Random-effects analysis was used to determine pooled effect sizes. RESULTS: We identified 550 studies, of which 5 (3 randomized controlled trials, 2 prospective 2-group cohort studies) studies of central venous catheter (CVC) insertion were included in the meta-analysis, composed of 407 medical trainees. The simulation group had a significantly larger proportion of trainees who successfully placed CVCs (RR, 1.09; 95% confidence interval [CI], 1.03-1.16, P<0.01). In addition, the simulation group had significantly fewer mean attempts to CVC insertion (weighted mean difference, -1.42; 95% CI, -2.34 to -0.49, P<0.01). There was no significant difference in the rate of adverse events between the groups (RR, 0.50; 95% CI, 0.19-1.29; P=0.15). CONCLUSIONS: Training programs should consider adopting simulation training for CVC insertion to improve the real patient procedural success of trainees.
INTRODUCTION: Simulation training for invasive procedures may improve patient safety by enabling efficient training. This study is a meta-analysis with rigorous inclusion and exclusion criteria designed to assess the real patient procedural success of simulation training for central venous access. METHODS: Published randomized controlled trials and prospective 2-group cohort studies that used simulation for the training of procedures involving central venous access were identified. The quality of each study was assessed. The primary outcome was the proportion of trainees who demonstrated the ability to successfully complete the procedure. Secondary outcomes included the mean number of attempts to procedural success and periprocedural adverse events. Proportions were compared between groups using risk ratios (RRs), whereas continuous variables were compared using weighted mean differences. Random-effects analysis was used to determine pooled effect sizes. RESULTS: We identified 550 studies, of which 5 (3 randomized controlled trials, 2 prospective 2-group cohort studies) studies of central venous catheter (CVC) insertion were included in the meta-analysis, composed of 407 medical trainees. The simulation group had a significantly larger proportion of trainees who successfully placed CVCs (RR, 1.09; 95% confidence interval [CI], 1.03-1.16, P<0.01). In addition, the simulation group had significantly fewer mean attempts to CVC insertion (weighted mean difference, -1.42; 95% CI, -2.34 to -0.49, P<0.01). There was no significant difference in the rate of adverse events between the groups (RR, 0.50; 95% CI, 0.19-1.29; P=0.15). CONCLUSIONS: Training programs should consider adopting simulation training for CVC insertion to improve the real patient procedural success of trainees.
Authors: Edward Ullman; Maura Kennedy; Francesco Dojmi Di Delupis; Paolo Pisanelli; Andrea Giuliattini Burbui; Meaghan Cussen; Laura Galli; Riccardo Pini; Gian Franco Gensini Journal: Intern Emerg Med Date: 2016-02-09 Impact factor: 3.397
Authors: Christoph F Dietrich; Rudolf Horn; Susanne Morf; Liliana Chiorean; Yi Dong; Xin-Wu Cui; Nathan S S Atkinson; Christian Jenssen Journal: J Thorac Dis Date: 2016-09 Impact factor: 2.895
Authors: Richard Amini; Lori Ann Stolz; Elliot Breshears; Asad E Patanwala; Nicholas Stea; Nicolaus Hawbaker; Matthew Thompson; Arthur Barry Sanders; Srikar Adhikari Journal: Intern Emerg Med Date: 2016-08-26 Impact factor: 3.397
Authors: Matthew S Braga; Michelle D Tyler; Jared M Rhoads; Michael P Cacchio; Marc Auerbach; Akira Nishisaki; Robin J Larson Journal: BMJ Simul Technol Enhanc Learn Date: 2015-10-05
Authors: Rasmus Jørgensen; Christian B Laursen; Lars Konge; Pia Iben Pietersen Journal: Scand J Trauma Resusc Emerg Med Date: 2021-06-27 Impact factor: 2.953
Authors: Se Uk Lee; Yoon Ha Joo; Ikwan Chang; Do Kyun Kim; Jung Chan Lee; Jae Yun Jung; Joong Wan Park; Young Ho Kwak Journal: IEEE J Transl Eng Health Med Date: 2021-06-28 Impact factor: 3.316