title: Assessment of central venous catheterization in a simulated model using a motion-tracking device: an experimental validation study.
abstract: BACKGROUND
  Central venous catheterization (CVC) is a basic requirement for many medical specialties. Simulated training in CVC may allow the acquisition of this competency but few reports have established a valid methodology for learning and acquiring procedural skills for CVC. This study aims to validate the use of a tracking motion device, the imperial college surgical assessment device (ICSAD), by comparing it with validated global rating scales (GRS) to measure CVC performance in a simulated torso.
  
  
  METHODS
  Senior year medical students, first and last year residents (PGY1, LYR), and expert anesthesiologists performed a jugular CVC assessment in a simulated model (Laerdal IV Torso). A validated GRS for objective assessment of technical skills and motion analysis by ICSAD was used. Statistical analysis was performed through Mann-Whitney and Kruskal-Wallis tests for construct validity and Spearman correlation coefficients between the ICSAD and GRS scores for concurrent validity between both.
  
  
  RESULTS
  32 subjects were recruited (10 medical students, 8 PGY1, 8 LYR and 8 experts). Total path length measured with ICSAD and GRS scores were significantly different between all groups, except for LYR compared to experts (p = 0.664 for GRS and p = 0.72 for ICSAD). Regarding jugular CVC procedural time, LYR and experts were faster than PGY1 and MS (p < 0.05). Spearman correlation coefficient was -0.684 (p < 0.001) between ICSAD and GRS scores.
  
  
  CONCLUSIONS
  ICSAD is a valid tool for assessment of jugular CVC since it differentiates between expert and novice subjects, and correlates with a validated GRS for jugular CVC in a simulated torso.
authors.affiliation: Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Julián
authors.initials: J
authors.lastname: Varas
authors.affiliation: Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Pablo
authors.initials: P
authors.lastname: Achurra
authors.affiliation: Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Felipe
authors.initials: F
authors.lastname: León
authors.affiliation: Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Richard
authors.initials: R
authors.lastname: Castillo
authors.affiliation: Anesthesiology Division, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago, Chile.
authors.forename: Natalia
authors.initials: N
authors.lastname: De La Fuente
authors.affiliation: Department of Surgery, Faculty of Medicine, McGill University, Montreal, Canada ; Arnold and Blema Steinberg Medical Simulation Centre, Faculty of Medicine, McGill University, Montreal, Canada.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Aggarwal
authors.affiliation: Anesthesiology Division, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago, Chile.
authors.forename: Leticia
authors.initials: L
authors.lastname: Clede
authors.affiliation: Anesthesiology Division, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago, Chile.
authors.forename: María P
authors.initials: MP
authors.lastname: Bravo
authors.affiliation: Anesthesiology Division, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago, Chile.
authors.forename: Marcia
authors.initials: M
authors.lastname: Corvetto
authors.affiliation: Anesthesiology Division, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago, Chile.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Montaña
keywords: Central venous catheterization; Medical simulation; Medical training; Objective skills assessment; Tracking motion device