title: The distracted intravenous access (DIVA) test.
abstract: BACKGROUND
  The General Medical Council states that all medical graduates must be able to carry out practical procedures, including peripheral venous cannulation, safely and effectively. Teaching and assessments within primary medical training tend to focus on safety rather than 'effectiveness' or technical competence. This study aimed to develop and evaluate a test of automaticity of peripheral venous cannulation skill, appropriate to the level of a medical student.
  
  
  METHODS
  Two researchers developed the distracted intravenous access (DIVA) test. Three components are assessed simultaneously: ability to cannulate a plastic arm manikin, performance in an arithmetic test and speed of completion. Volunteers were recruited from three groups: novices (fourth-year medical students), intermediates (foundation year-1 doctors) and experts (anaesthetic and emergency medicine consultants and trainees). Immediately following the test, volunteers completed a questionnaire.
  
  
  RESULTS
  Mean scores differed between the three groups: novices (47.7%), intermediates (73.4%), experts (84.4%). Differences were statistically significant (p < 0.0005). The majority of participants found the test to be enjoyable (78%) and useful (76%). More students agreed that the test was fair (78%) than doctors (38%), but this difference was not statistically significant.
  
  
  CONCLUSIONS
  This study presents a feasible method of testing medical students' automaticity when performing peripheral venous cannulation. It has provided evidence of the construct validity and acceptability of the test. The authors suggest that clinical tutors consider offering the test as a formative assessment to final-year medical students in order to familiarise them with the level of proficiency required to perform peripheral venous cannulation when distracted.
authors.affiliation: Centre for Medical Education, University of Edinburgh, UK. sam.smith@ed.ac.uk
authors.forename: Samantha
authors.initials: S
authors.lastname: Smith
authors.forename: Victoria
authors.initials: V
authors.lastname: Tallentire
authors.forename: Morwenna
authors.initials: M
authors.lastname: Wood
authors.forename: Helen
authors.initials: H
authors.lastname: Cameron
mesh_terms: D002406:Catheterization, Peripheral / Q000379:methods*; D057189:Checklist; D002983:Clinical Competence; D004521:Educational Measurement / Q000379:methods*; D006801:Humans; D015203:Reproducibility of Results; D013337:Students, Medical; D013663:Teaching / Q000379:methods*; D013997:Time Factors