• Dorothy Breen, Sean Farrelly, Eilis Condon, Cathy Armstrong, Kevin Doody, Michelle Duggan, and Anthony G Gallagher.
• From the University College Cork and Royal College of Surgeons in Ireland (DB), Cork University Hospital, Ireland (SF), College of Anaesthesiologists of Ireland (EC, CA), University Hospital Limerick, Limerick, Ireland (KD), Mayo University Hospital, Ireland (MD) and ORSI Academy, Belgium and School of Medicine, Ulster University, Northern Ireland and Faculty of Medicine, KU Leuven, Belgium (AGG).
• Eur J Anaesthesiol. 2023 Jun 1; 40 (6): 391398391-398.

BackgroundUltrasound-guided, internal jugular venous (IJV) cannulation is a core technical skill for anaesthesiologists and intensivists.ObjectivesAt a modified Delphi panel meeting, to define and reach consensus on a set of objective ultrasound-guided IJV cannulation performance metrics on behalf of the College of Anaesthesiologists of Ireland (CAI). To use these metrics to objectively score video recordings of novice and experienced anaesthesiologists.DesignAn observational study.SettingCAI, March to June 2016 and four CAI training hospitals, November 2016 to July 2019.ParticipantsMetric development group: two CAI national directors of postgraduate training (specialist anaesthesiolgists), a behavioural scientist, a specialist intensivist and a senior CAI trainee. Scoring by two blinded assessors of video recordings of novice ( n  = 11) and experienced anaesthesiologists ( n  = 15) ultrasound-guided IJV cannulations.Main Outcome MeasuresA set of agreed CAI objective performance metrics, that is, steps, errors, and critical errors characterising ultrasound-guided IJV cannulation. The difference in performance scores between novice and experienced anaesthesiologists as determined by skill level defined as being below or above the median total error score (errors plus critical errors): that is, low error (LoErr) and high error (HiErr), respectively.ResultsThe study identified 47 steps, 18 errors and 13 critical errors through six phases.Variability was observed in the range of total error scores for both novice (1 to 3) and experienced (0 to 4.5) anaesthesiologists. This resulted in two further statistically different subgroups (LoErr and HiErr) for both novice ( P  = 0.011) and experienced practitioners ( P  < 0.000). The LoErr-experienced group performed the best in relation to steps, errors and total errors. Critical errors were only observed in the experienced group.ConclusionA set of valid, reliable objective performance metrics has been developed for ultrasound-guided IJV cannulation. Considerable skill variability underlines the need to develop a CAI simulation-training programme using these metrics.Copyright © 2023 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.

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