• Simul Healthc · Aug 2019

    Randomized Controlled Trial

    Physician Versus Nonphysician Instruction: Evaluating an Expert Curriculum-Competent Facilitator Model for Simulation-Based Central Venous Catheter Training.

    • Andrew N Musits, Paul E Phrampus, John W Lutz, Todd M Bear, Stephanie I Maximous, Andrew J Mrkva, and John M OʼDonnell.
    • From the Department of Emergency Medicine (A.N.M.), Brown University Warren Alpert Medical School, Providence, RI; Department of Emergency Medicine (P.E.P.), University of Pittsburgh School of Medicine; Wi... more nter Institute for Simulation Education and Research (J.W.L., P.E.P., J.M.O.), University of Pittsburgh; Department of Behavioral and Community Health Sciences (T.M.B., A.J.M.), University of Pittsburgh School of Public Health; Department of Medicine (S.I.M.), Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine; and Department of Nurse Anesthesia (J.M.O.), University of Pittsburgh School of Nursing, Pittsburgh, PA. less
    • Simul Healthc. 2019 Aug 1; 14 (4): 228-234.

    IntroductionHealthcare simulation supports educational opportunities while maintaining patient safety. To reduce costs and increase the availability of training, a randomized controlled study evaluated central venous catheter (CVC) insertion training in the simulation laboratory with nonphysician competent facilitators (NPCFs) as instructors.MethodA group of learners naive to central line placement participated in a blended curriculum consisting of interactive online materials and simulation-based training. Learners were randomized to training with NPCFs or attending physician faculty. The primary outcome was simulated CVC insertion task performance, graded with a validated checklist by blinded physician reviewers. Learner knowledge and satisfaction were also evaluated. Analysis was conducted using noninferiority testing.ResultsEighty-five students, 11 attending physicians, and 7 NPCFs voluntarily participated. Noninferiority testing of the difference in CVC insertion performance between NPCF-trained learners versus physician-trained learners found no significant difference [rejecting the null hypothesis of inferiority using an 8% noninferiority margin (P < 0.01)]. In addition, there was no difference found between the 2 groups on pre/post knowledge scores, self-reported learner comfort, course satisfaction, or instructor satisfaction.ConclusionsAn introductory CVC curriculum can be taught to novice learners by carefully trained and supported NPCFs and achieve skill and knowledge outcomes similar to learners taught by physicians.

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