From the simulation center to the bedside: Validating the efficacy of a dynamic haptic robotic trainer in internal jugular central venous catheter placement

Hong-En Chen; Cheyenne C Sonntag; Katelin A Mirkin; David F Pepley; David C Han; Jason Z Moore; Scarlett R Miller

doi:10.1016/j.amjsurg.2019.10.026

From the simulation center to the bedside: Validating the efficacy of a dynamic haptic robotic trainer in internal jugular central venous catheter placement

Am J Surg. 2020 Feb;219(2):379-384. doi: 10.1016/j.amjsurg.2019.10.026. Epub 2019 Oct 21.

Authors

Hong-En Chen¹, Cheyenne C Sonntag², Katelin A Mirkin², David F Pepley³, David C Han⁴, Jason Z Moore⁵, Scarlett R Miller⁶

Affiliations

¹ Department of Industrial and Manufacturing Engineering, Pennsylvania State University, University Park, PA, 16802, USA.
² Department of Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, 17033, USA.
³ Department of Mechanical and Nuclear Engineering, Pennsylvania State University, University Park, PA, 16802, USA.
⁴ Department of Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, 17033, USA; Penn State Heart and Vascular Institute, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, 17033, USA; School of Engineering Design, Technology, and Professional Programs, Pennsylvania State University, University Park, PA, 16802, USA.
⁵ Department of Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, 17033, USA; Department of Mechanical and Nuclear Engineering, Pennsylvania State University, University Park, PA, 16802, USA.
⁶ Department of Industrial and Manufacturing Engineering, Pennsylvania State University, University Park, PA, 16802, USA; Department of Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, 17033, USA; School of Engineering Design, Technology, and Professional Programs, Pennsylvania State University, University Park, PA, 16802, USA. Electronic address: scarlettmiller@psu.edu.

Abstract

Background: The objective of this study was to validate the transfer of ultrasound-guided Internal Jugular Central Venous Catheterization (US-IJCVC) placement skills from training on a Dynamic Haptic Robotic Trainer (DHRT), to placing US-IJCVCs in clinical environments. DHRT training greatly reduces preceptor time by providing automated feedback, standardizes learning experiences, and quantifies skill improvements.

Methods: Expert observers evaluated DHRT-trained (N = 21) and manikin-trained (N = 36) surgical residents on US-IJCVC placement in the operating suite using a US-IJCVC evaluation form. Performance and errors by DHRT-trained residents were compared to traditional manikin-trained residents.

Results: There were no significant training group differences between unsuccessful insertions (p = 0.404), assistance on procedure (p = 0.102), arterial puncture (p = 0.998), and average number of insertion attempts (p = 0.878). Regardless of training group, previous central line experience significantly predicted whether residents needed assistance on the procedure (p = 0.033).

Conclusion: The results failed to show a statistical difference between DHRT- and manikin-trained residents. This study validates the transfer of skills from training on the DHRT system to performing US-IJCVC in clinical environments.

Keywords: Central venous catheterization; Simulation; Surgical education; Transfer; Validation.

Publication types

Comparative Study
Research Support, N.I.H., Extramural
Validation Study

MeSH terms

Academic Medical Centers
Catheterization, Central Venous / methods*
Clinical Competence*
Education, Medical, Graduate / organization & administration*
Female
General Surgery / education*
Humans
Internship and Residency / organization & administration
Jugular Veins
Logistic Models
Male
Manikins
Pennsylvania
Robotic Surgical Procedures / education*
Simulation Training / methods*
Ultrasonography, Interventional / methods

Grants and funding

R01 HL127316/HL/NHLBI NIH HHS/United States