The efficacy of ultrasonography on learning curve and inter-subject performance variability in radial artery cannulation in standardized training for residents: a randomized controlled trial

Aim: To evaluate the effect of ultrasound (US) on learning curve and inter-subject performance variability of residents in radial artery cannulation.Material and methods: Twenty non-anesthesiology residents who received standardized training in an anesthesiology department were selected and divided...

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Published inMedical ultrasonography Vol. 25; no. 2; pp. 139 - 144
Main Authors Shi, Li, Ju, Yu, Rui, Na, Cao, Yuanyuan, Shan, Tao, Chen, Lihai
Format Journal Article
LanguageEnglish
Published Romania Romanian Society of Ultrasonography in Medicine and Biology 26.06.2023
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ISSN1844-4172
2066-8643
DOI10.11152/mu-3922

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Abstract Aim: To evaluate the effect of ultrasound (US) on learning curve and inter-subject performance variability of residents in radial artery cannulation.Material and methods: Twenty non-anesthesiology residents who received standardized training in an anesthesiology department were selected and divided into two groups: anatomy group or US group. After training of relevant anatomy, US recognition and puncture skill, residents selected 10 patients either under US or anatomical localization performing radial artery catheterization. The number and time of successful cases of catheterization were recorded, success rate of first attempt and catheterization, as well as the total success rate of catheterization were calculated. The learning curve and inter-subject performance variability of residents were also calculated. Complications and the residents’ satisfaction for teaching and self-confidence before puncture were also recorded.Results: Compared to the anatomy group, total success rate and the success rate at first attempt were higher in US-guided group (88% vs. 57%, 94% vs. 81%). The average performance time in the US group was significantly less (2.9±0.8 min vs. 4.2±2.1 min) and the mean number of attempts was 1.6, while 2.6 for the anatomy group. With performing cases increasing, the average puncture time of residents in the US group decreased by 19s, while 14s in the anatomy group. More local hematoma occurred in the anatomy group. The satisfaction and confidence degree of residents were higher in US group ([98.5±6.5] vs [68.5±7.3], [90.2±8.6] vs [56.3±5.5]).Conclusion: US can significantly shorten the learning curve, reduce the inter-subject performance variability, improve the first attempt and total success rate of radial artery catheterization for non-anesthesiology residents.
AbstractList To evaluate the effect of ultrasound (US) on learning curve and inter-subject performance variability of residents in radial artery cannulation. Twenty non-anesthesiology residents who received standardized training in an anesthesiology department were selected and divided into two groups: anatomy group or US group. After training of relevant anatomy, US recognition and puncture skill, residents selected 10 patients either under US or anatomical localization performing radial artery catheterization. The number and time of successful cases of catheterization were recorded, success rate of first attempt and catheterization, as well as the total success rate of catheterization were calculated. The learning curve and inter-subject performance variability of residents were also calculated. Complications and the residents' satisfaction for teaching and self-confidence before puncture were also recorded. Compared to the anatomy group, total success rate and the success rate at first attempt were higher in US-guided group (88% vs. 57%, 94% vs. 81%). The average performance time in the US group was significantly less (2.9±0.8 min vs. 4.2±2.1 min) and the mean number of attempts was 1.6, while 2.6 for the anatomy group. With performing cases increasing, the average puncture time of residents in the US group decreased by 19s, while 14s in the anatomy group. More local hematoma occurred in the anatomy group. The satisfaction and confidence degree of residents were higher in US group ([98.5±6.5] vs [68.5±7.3], [90.2±8.6] vs [56.3±5.5]). US can significantly shorten the learning curve, reduce the inter-subject performance variability, improve the first attempt and total success rate of radial artery catheterization for non-anesthesiology residents.
Aim: To evaluate the effect of ultrasound (US) on learning curve and inter-subject performance variability of residents in radial artery cannulation.Material and methods: Twenty non-anesthesiology residents who received standardized training in an anesthesiology department were selected and divided into two groups: anatomy group or US group. After training of relevant anatomy, US recognition and puncture skill, residents selected 10 patients either under US or anatomical localization performing radial artery catheterization. The number and time of successful cases of catheterization were recorded, success rate of first attempt and catheterization, as well as the total success rate of catheterization were calculated. The learning curve and inter-subject performance variability of residents were also calculated. Complications and the residents’ satisfaction for teaching and self-confidence before puncture were also recorded.Results: Compared to the anatomy group, total success rate and the success rate at first attempt were higher in US-guided group (88% vs. 57%, 94% vs. 81%). The average performance time in the US group was significantly less (2.9±0.8 min vs. 4.2±2.1 min) and the mean number of attempts was 1.6, while 2.6 for the anatomy group. With performing cases increasing, the average puncture time of residents in the US group decreased by 19s, while 14s in the anatomy group. More local hematoma occurred in the anatomy group. The satisfaction and confidence degree of residents were higher in US group ([98.5±6.5] vs [68.5±7.3], [90.2±8.6] vs [56.3±5.5]).Conclusion: US can significantly shorten the learning curve, reduce the inter-subject performance variability, improve the first attempt and total success rate of radial artery catheterization for non-anesthesiology residents.
[...]radial artery cannulation can be difficult, leading to hematoma formation, bleeding, or spasm of the artery [4], Catherization can be challenging for some reasons: the variation of radial artery, at times particularly in some specific scenarios such as hemodynamically unstable patients, altered vascular anatomy or in obese patients and more importantly, lack of residents' experience [5]. [...]radial artery catheterization success rate varied greatly among novice residents. Assuming a difference in means of 30% in first attempt success rate between the ultrasound group and the anatomy group, the necessary minimum sample size to achieve the desired power of 0.8 and alpha error of 0.05 was 80 artery cannulations (40 per group). To account for a 5% drop out rate, and increasing the reliability of this study, 120 additional cannulations were recruited. [...]the first attempt success rate was measured in a total of 200 artery cannulations. Since this study consisted of 20 nonanesthesiology residents in our tertiary academic medical center, ten real patients per resident were recruited.
Author Ju, Yu
Cao, Yuanyuan
Shan, Tao
Shi, Li
Chen, Lihai
Rui, Na
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Snippet Aim: To evaluate the effect of ultrasound (US) on learning curve and inter-subject performance variability of residents in radial artery cannulation.Material...
To evaluate the effect of ultrasound (US) on learning curve and inter-subject performance variability of residents in radial artery cannulation. Twenty...
[...]radial artery cannulation can be difficult, leading to hematoma formation, bleeding, or spasm of the artery [4], Catherization can be challenging for some...
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StartPage 139
SubjectTerms Anatomy
Anesthesiology
Catheterization, Peripheral - methods
Catheterization, Peripheral - standards
Confidence
Health care facilities
Hematoma
Humans
Internship and Residency - methods
Internship and Residency - standards
Intubation
Learning Curve
Learning curves
Radial Artery - diagnostic imaging
Success
Teaching
Ultrasonic imaging
Ultrasonography - standards
Veins & arteries
Work Performance
Title The efficacy of ultrasonography on learning curve and inter-subject performance variability in radial artery cannulation in standardized training for residents: a randomized controlled trial
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