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Pediatr Emerg Care. 2016 Jan;32(1):1-5. doi: 10.1097/PEC.0000000000000664.

An Educational Intervention to Improve Ultrasound Competency in Ultrasound-Guided Central Venous Access.

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From the *Division of Pediatric Emergency Medicine, Boston Medical Center and †Division of Emergency Medicine, Boston Children's Hospital, Boston, MA.



Ultrasound (US) guidance for central venous catheter (CVC) placement results in improved success and overall safety, but is a new skill for pediatric emergency medicine (PEM) physicians. No study to date has used simulation-based learning to evaluate the ability of PEM providers to perform US-guided CVC placement.Our objective was to assess the competency of physicians in a rarely performed procedure, US-guided CVC placement, before and after an educational intervention using simulation-based mastery learning.


We performed a prospective cohort study evaluating change in PEM physician competency in US-guided CVC placement before and after an educational intervention. Subjects participated in a curriculum composed of 3 sessions: an intervention session, a 2-month follow-up session, and a 12-month follow-up session. At each session, subjects were observed using US to guide CVC placement on a simulation model and technical skill was scored using a validated direct-observation checklist. Competency was defined as successfully completing 7 critical items on the checklist.


Of the 28 PEM physicians participating, competency improved from 32% at preintervention to 93% at 2-month follow-up (difference, 62%; 95% confidence interval, 36%-84%). At 12-month follow-up, competency remained high (85%; difference, 53%; 95% confidence interval, 32%-75%).


Physician competency in US-guided CVC placement improved with a simulation-based educational intervention, and the effect was maintained over time. This study may serve as a model for outcomes-based education and certification in rarely performed procedures in pediatrics.

[Indexed for MEDLINE]

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