Biomechanical analysis of expert anesthesiologists and novice residents performing a simulated central venous access procedure

PLoS One. 2021 Apr 30;16(4):e0250941. doi: 10.1371/journal.pone.0250941. eCollection 2021.

Abstract

Background: Central venous access (CVA) is a frequent procedure taught in medical residencies. However, since CVA is a high-risk procedure requiring a detailed teaching and learning process to ensure trainee proficiency, it is necessary to determine objective differences between the expert's and the novice's performance to guide novice practitioners during their training process. This study compares experts' and novices' biomechanical variables during a simulated CVA performance.

Methods: Seven experts and seven novices were part of this study. The participants' motion data during a CVA simulation procedure was collected using the Vicon Motion System. The procedure was divided into four stages for analysis, and each hand's speed, acceleration, and jerk were obtained. Also, the procedural time was analyzed. Descriptive analysis and multilevel linear models with random intercept and interaction were used to analyze group, hand, and stage differences.

Results: There were statistically significant differences between experts and novices regarding time, speed, acceleration, and jerk during a simulated CVA performance. These differences vary significantly by the procedure stage for right-hand acceleration and left-hand jerk.

Conclusions: Experts take less time to perform the CVA procedure, which is reflected in higher speed, acceleration, and jerk values. This difference varies according to the procedure's stage, depending on the hand and variable studied, demonstrating that these variables could play an essential role in differentiating between experts and novices, and could be used when designing training strategies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anesthesiologists / education*
  • Anesthesiologists / standards
  • Biomechanical Phenomena
  • Clinical Competence / standards
  • Female
  • Humans
  • Internship and Residency / standards*
  • Internship and Residency / statistics & numerical data
  • Male
  • Motion
  • Patient Simulation
  • Simulation Training / methods*
  • Task Performance and Analysis

Grants and funding

FA: National Commission for Scientific and Technological Research (CONICYT) under the Fund for the Promotion of Scientific and Technological Development (Fondo de Fomento al Desarrollo Científico y Tecnológico, FONDEF). Project grant: ID18I10219. https://www.conicyt.cl/fondef/2018/01/24/concurso-idea-de-investigacion-y-desarrollo-2018 IV: National Agency for Research and Development (ANID) under the Scholarship Program DOCTORADO BECAS CHILE/2020 - 21202032. https://www.anid.cl/concursos/concurso/?id=236 The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.