title: The use of tissue models for vascular access training. Phase I of the procedural patient safety initiative.
abstract: BACKGROUND
  Following the Institute of Medicine report "To Err is Human," the Agency for Healthcare Research and Quality identified proper central venous catheter (CVC) insertion techniques and wide sterile barriers (WSB) as 2 major quality indicators for patient safety. However, no standard currently exists to teach proper procedural techniques to physicians.
  
  
  OBJECTIVE
  To determine whether our nonhuman tissue model is an effective tool for teaching physicians proper wide sterile barrier technique, ultrasound guidance for CVC placement, and sharps safety.
  
  
  METHODS
  Educational sessions were organized for physicians at Cedars-Sinai Medical Center. Participants had a hands-on opportunity to practice procedural skills using a nonhuman tissue model, under the direct supervision of experienced proceduralists.
  
  
  RESULTS
  An anonymous survey was distributed to participants both before and after training, measuring their reactions to all aspects of the educational sessions relative to their prior experience level.
  
  
  CONCLUSIONS
  The sessions were rated highly worthwhile, and statistically significant improvements were seen in comfort levels with ultrasound-guided vascular access and WSB (P<.001). Given the revitalized importance of patient safety and the emphasis on reducing medical errors, further studies on the utility of nonhuman tissue models for procedural training should be enthusiastically pursued.
authors.affiliation: Division of General Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Mark.Ault@cshs.org
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Ault
authors.forename: Bradley T
authors.initials: BT
authors.lastname: Rosen
authors.forename: Brian
authors.initials: B
authors.lastname: Ault
mesh_terms: D000818:Animals; D002405:Catheterization, Central Venous / Q000379:methods*; D002645:Chickens; D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000379:methods*; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D008297:Male; D019300:Medical Errors / Q000517:prevention & control*; D008505:Medical Staff, Hospital; D008953:Models, Anatomic; D009726:Nurses; D015397:Program Evaluation; D013337:Students, Medical; D018084:Ultrasonography, Interventional