title: Simulation-based medical education training improves short and long-term competency in, and knowledge of central venous catheter insertion: A before and after intervention study.
abstract: BACKGROUND
  Multimodal educational interventions have been shown to improve short-term competency in, and knowledge of central venous catheter (CVC) insertion.
  
  
  OBJECTIVE
  To evaluate the effectiveness of simulation-based medical education training in improving short and long-term competency in, and knowledge of CVC insertion.
  
  
  METHODS
  Before and after intervention study.
  
  
  METHODS
  University Geneva Hospital, Geneva, Switzerland, between May 2008 and January 2012.
  
  
  METHODS
  Residents in anaesthesiology aware of the Seldinger technique for vascular puncture.
  
  
  METHODS
  Participants attended a half-day course on CVC insertion. Learning objectives included work organization, aseptic technique and prevention of CVC complications. CVC insertion competency was tested pretraining, posttraining and then more than 2 years after training (sustainability phase).
  
  
  METHODS
  The primary study outcome was competency as measured by a global rating scale of technical skills, a hand hygiene compliance score and a checklist compliance score. Secondary outcome was knowledge as measured by a standardised pretraining and posttraining multiple-choice questionnaire. Statistical analyses were performed using paired Student's t test or Wilcoxon signed-rank test.
  
  
  RESULTS
  Thirty-seven residents were included; 18 were tested in the sustainability phase (on average 34 months after training). The average global rating of skills was 23.4 points (±SD 4.08) before training, 32.2 (±4.51) after training (P < 0.001 for comparison with pretraining scores) and 26.5 (±5.34) in the sustainability phase (P = 0.040 for comparison with pretraining scores). The average hand hygiene compliance score was 2.8 (±1.0) points before training, 5.0 (±1.04) after training (P < 0.001 for comparison with pretraining scores) and 3.7 (±1.75) in the sustainability phase (P = 0.038 for comparison with pretraining scores). The average checklist compliance was 14.9 points (±2.3) before training, 19.9 (±1.06) after training (P < 0.001 for comparison with pretraining scores) and 17.4 (±1.41) (P = 0.002 for comparison with pretraining scores). The percentage of correct answers in the multiple-choice questionnaire increased from 76.0% (±7.9) before training to 87.7% (±4.4) after training (P < 0.001).
  
  
  CONCLUSIONS
  Simulation-based medical education training was effective in improving short and long-term competency in, and knowledge of CVC insertion.
authors.affiliation: From the Division of Anaesthesiology (VCF, CI, CDC, BW, GLS); Infection Control Program, University Hospitals of Geneva and Geneva Faculty of Medicine (WZ); and UDREM (Unit for Development and Research in Medical Education), Geneva Faculty of Medicine, University of Geneva, Geneva, Switzerland (GLS).
authors.forename: Vanessa
authors.initials: V
authors.lastname: Cartier
authors.forename: Cigdem
authors.initials: C
authors.lastname: Inan
authors.forename: Walter
authors.initials: W
authors.lastname: Zingg
authors.forename: Cecile
authors.initials: C
authors.lastname: Delhumeau
authors.forename: Bernard
authors.initials: B
authors.lastname: Walder
authors.forename: Georges L
authors.initials: GL
authors.lastname: Savoldelli
mesh_terms: D000776:Anesthesiology / Q000193:education*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods*; D062905:Central Venous Catheters; D057189:Checklist; D002983:Clinical Competence; D003162:Competency-Based Education / Q000379:methods*; D004503:Education, Medical, Graduate; D004521:Educational Measurement; D019983:Guideline Adherence; D006801:Humans; D006920:Hygiene; D007396:Internship and Residency; D016544:Patient Simulation