Use of a simulation‐based mastery learning curriculum to improve ultrasound‐guided vascular access skills of pediatric anesthesiologists

Ballard, Heather A; Tsao, Michelle; Robles, Alison; Phillips, Mitchell; Hajduk, John; Feinglass, Joseph

doi:10.1111/pan.13953

Cited by 15 publications

(15 citation statements)

References 28 publications

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“…We obtained study approval from the Lurie's Children's Hospital Institutional Review Board (IRB 2019–2860, approved 6/10/19, chairperson Jennifer Rubin), and the requirement for written informed consent was waived by the IRB. IRB approval was initially obtained for another prospective study evaluating IV insertion outcomes after an educational intervention 23 …”

Section: Methodsmentioning

confidence: 99%

Clinical and demographic factors associated with pediatric difficult intravenous access in the operating room

Ballard

Hajduk

Cheon

et al. 2022

Pediatric Anesthesia

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Background: Pediatric intravenous catheter insertion can be difficult in the operating room due to the technical challenges of small diameter vessels and the need to rapidly gain intravenous access in anesthetized children. Few studies have examined factors associated with difficult vascular access in the operating room, especially accounting for the increased possibility to use ultrasound guidance. Aims:The primary aim of the study was to identify factors associated with pediatric difficult vascular access in the operating room. Our primary hypothesis was that Black race, Hispanic ethnicity, and ultrasound use would be associated with pediatric difficult vascular access. Methods:We performed a retrospective analysis of prospectively collected data from a cohort of pediatric patients who had intravenous catheters inserted in the operating room at an academic tertiary care children's hospital from March 2020 to February 2021. We measured associations among patients who were labeled as having difficult vascular access (>2 attempts at access) with demographic, clinical, and hospital factors.Results: 12 728 intravenous catheter insertions were analyzed. Multivariable analysis showed significantly higher odds of difficult vascular access with Black non-Hispanic

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Section: Methodsmentioning

confidence: 99%

Clinical and demographic factors associated with pediatric difficult intravenous access in the operating room

Ballard

Hajduk

Cheon

et al. 2022

Pediatric Anesthesia

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“…Our curriculum in ultrasound-guided intravenous catheter insertion in pediatric patients showed that only 21% of attendings, fellows, or residents were able to meet a minimum passing score on a pretest checklist. 2 Fortunately, all of our participants were able to meet this standard after participation in the curriculum and also reported improved self-confidence with this skill. Fatima et al’s 1 study echoes previous literature that has shown that procedural experience does not ensure competence in trainees.…”

Section: To the Editormentioning

confidence: 75%

Moving Toward Competency-Based Training

DiBiase

Ballard

2022

Anesthesia &Amp; Analgesia

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“…When designing our module, we primarily used the simulation-based procedural training (SBPT) method as it had already shown efficacy in teaching ultrasound-guided procedures. 22 SBPT allows learners to gain procedural skills in a controlled, low-stakes, standardized, and supervised learning environment that can be designed to accommodate learners' specific needs and assess their skills against standards of achievement. 23 SBPT is now widely used in medical education in lieu of the traditional “see one, do one, teach one” apprentice model as it reduces harm to patients and has been associated with acquisition of procedural competency by learners.…”

Section: Introductionmentioning

confidence: 99%

Teaching Module on Ultrasound-Guided Venous Access Using a Homemade Gel Model for Fourth-Year Medical Students

et al. 2022

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Introduction Evidence supports an ultrasound-guided approach in patients with difficult vascular access. Prior research on teaching ultrasound-guided intravenous access has included only small groups of first- and second-year medical students. Methods We enrolled fourth-year medical students in our teaching module. The module featured a 6-minute prelearning narrated lecture and 5-minute orientation, followed by ultrasound-guided IV placement on homemade gel models. Facilitators were emergency medicine (EM) residents with a prespecified level of procedural ultrasound skills according to EM milestones. Students completed pre- and postmodule surveys. Facilitators completed the Directly Observed Procedural Skills Evaluation. Primary outcomes included global rating, proficiency on six procedural skills, and perceived learning. Results Our module was completed by 150 fourth-year medical students (94% of the class); 84% cannulated the vein in one attempt. We used a global rating scale to describe the students' cannulation abilities; 59% were trusted to perform this procedure with direct supervision and coaching, 29% with indirect supervision, and 8% without supervision. There was no association between a student's order of attempting IV access within the group and global rating ( p = .41). Students reported increased understanding of indications, antecubital anatomy, sonographic anatomy, and procedural comfort (12%, 29%, 38%, and 65% improvement pre- vs. postmodule, respectively; p < .001). Discussion Our module enabled more than one-third of fourth-year medical students to achieve an indirect supervision or better level of proficiency in ultrasound-guided IV access, with significant improvements in perceived knowledge. This module may be useful for other educators facilitating the transition to residency.

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Use of a simulation‐based mastery learning curriculum to improve ultrasound‐guided vascular access skills of pediatric anesthesiologists

Cited by 15 publications

References 28 publications

Clinical and demographic factors associated with pediatric difficult intravenous access in the operating room

Clinical and demographic factors associated with pediatric difficult intravenous access in the operating room

Moving Toward Competency-Based Training

Teaching Module on Ultrasound-Guided Venous Access Using a Homemade Gel Model for Fourth-Year Medical Students

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