Development and Videographic Evaluation of a Vascular Access Simulation-Based Curriculum for Surgical and Medical Trainees.

Autor:	Pendleton A; From the Division of Vascular and Endovascular Surgery, Department of Surgery, University of Rochester, Rochester, NY., Bellomo TR; Division of Vascular and Endovascular Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA., Lella SK; Division of Vascular and Endovascular Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA., Jogerst K; Department of Surgery, Massachusetts General Hospital, Boston, MA., Stefanescu A; Interventional Cardiology, Massachusetts General Hospital, Boston, MA., Drachman D; Interventional Cardiology, Massachusetts General Hospital, Boston, MA., Zacharias N; Division of Vascular and Endovascular Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA., Dua A; Division of Vascular and Endovascular Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA.
Jazyk:	angličtina
Zdroj:	Annals of surgery open : perspectives of surgical history, education, and clinical approaches [Ann Surg Open] 2024 Jul 15; Vol. 5 (3), pp. e464. Date of Electronic Publication: 2024 Jul 15 (Print Publication: 2024).
DOI:	10.1097/AS9.0000000000000464
Abstrakt:	Background: There is a paucity of data evaluating femoral arterial access training, despite significant morbidity/mortality associated with incorrect femoral arterial access. The aim of this study was to develop and evaluate a novel 2-component simulation-based curriculum to address a lack of standardized access training and identify the most frequent errors in access. Methods: The femoral arterial access curriculum was developed through a multi-disciplinary collaboration and utilized in-person simulation sessions in conjunction with online and in-person didactic training. Access errors and curriculum efficacy were assessed using mixed-methodology evaluation of video recordings of trainee arterial access pre- and postcurriculum. All recordings were reviewed and scored by 2 blinded, independent investigators. Results: Twenty-six participants completed the curriculum with pre- and postcurriculum recordings. Sixteen participants (62%) were in their first year of residency training. Fifteen participants (58%) belonged to general surgery residency, 9 (35%) to emergency medicine, 1 to vascular surgery, and 1 to interventional radiology residency programs. The global rating for the overall ability to obtain femoral arterial access under ultrasound guidance (0 = fail, 4 = excellent) improved following the curriculum (0.87 ± 0.15, 2.79 ± 1.26, P < 0.0001). Fourteen participants (54%) were unable to independently complete the procedure before training, compared to only 2 participants (8%) following the curriculum. Procedural completion time decreased from 7.14 ± 4.26 to 3.81 ± 2.53 minutes ( P < 0.001). Most frequent errors, determined through qualitative analysis, included difficulty using the ultrasound and unsafe maneuvers. Conclusions: Before the curriculum, there were significant frequent errors in junior resident femoral arterial access with major patient safety concerns. A novel simulation-based femoral arterial access curriculum resulted in improved procedural skills across all metrics. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu