Implementation and evaluation of a course on central venous access for hemodialysis with simulators

Abstract

Introduction: the use of simulators for learning invasive maneuvers contributes to patients’ safety.
Objectives: to design and evaluate a course for learning how to introduce central venous catheters with Doppler ultrasound and the use of simulators.
Method: learning objectives, contents and didactics were defined. Initial and final skills were evaluated by means of an objective structured clinical evaluation (OSCE). The opinion of students and the level of self confidence achieved were evaluated. The impact on the clinical practice was determined by means of a record of the maneuvers of introduction of the central venous line in the following semester.
Results: the course was carried our in the first semester of 2015 for the seven Nephrology postgraduate students. It consisted of four modules (three hours) which comprised a theoretical introduction and practical activities, with the immediate feedback by professors. The satisfaction survey revealed the following: very satisfactory-excellent in 7/7 and the level of self-confidence increased in 4/7 participants. A significant improvement was noticed in the initial vs final OSCE (paired samples T-Test 0.05). A repairing instance was prepared. 64 central central venous lines were introduced by participants in the following course, and complications found included the following: two artery punctures, three hematomas localized, an artery aneurysm and a pneumothorax (10%), all of them evidenced a positive evolution.
Conclusions: the use of simulators in the learning of invasive maneuvers achieved a high level of satisfaction among participants, an increase in self-confidence and a significant improvement in technical aspects.