title: Expert Evaluation of a Chicken Tissue-based Model for Teaching Ultrasound-guided Central Venous Catheter Insertion.
abstract: BACKGROUND
  Ultrasound-guided central venous catheterization (CVC) is a commonly performed procedure which carries significant risks for complications. Current models used for simulation-based teaching are expensive and may not replicate tissue feel and ultrasound qualities of human tissues. We aimed to evaluate a tissue model composed of chicken breast and balloons and compare it to a commercially available mannequin.
  
  
  METHODS
  Forty attending physicians from four departments with extensive CVC experience were enrolled. Participants completed an ultrasound-guided central line placement utilizing both models during a hands-on workshop. Following CVC placement on each model, participants completed a survey to assess their experience with that particular model.
  
  
  RESULTS
  40 attending physicians (12 (30%) anesthesia, 11 (28%) emergency medicine, 11 (28%) internal medicine, and 6 (15%) surgery) participated in the study. The chicken model was rated significantly higher than the mannequin model with regard to ultrasound quality (p=0.02) and tissue feel (p=0.002). In a direct comparison, participants rated the chicken model more highly than the mannequin in all categories except similarity to the human anatomy. Overall the chicken model was preferred to the mannequin, (mean score 44.5; standard deviation 26.0). The mannequin was rated higher with regard to similarity to human anatomy (mean score 52.8; standard deviation 25.7). The comparison between key features (ultrasound characteristics, similarity to human anatomy and teaching trainees) of the models did not vary significantly by area of practice, with the exception of ease of use (p=0.045).
  
  
  CONCLUSIONS
  In this prospective study of experienced clinicians we found that a novel tissue model for ultrasound-guided CVC placement was rated more highly compared to a commercially available mannequin task trainer.
authors.affiliation: Department of Anesthesiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
authors.forename: Akiva
authors.initials: A
authors.lastname: Nachshon
authors.affiliation: Department of Anesthesiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
authors.forename: John D
authors.initials: JD
authors.lastname: Mitchell
authors.affiliation: Department of Anesthesiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
authors.forename: Ariel
authors.initials: A
authors.lastname: Mueller
authors.affiliation: Department of Anesthesiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
authors.forename: Valerie M
authors.initials: VM
authors.lastname: Banner-Goodspeed
authors.affiliation: Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
authors.forename: Jakob I
authors.initials: JI
authors.lastname: McSparron
keywords: central venous catheter; education; simulation training; ultrasonography