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J Surg Res. 2017 Jun 15;214:203-208. doi: 10.1016/j.jss.2017.02.071. Epub 2017 Mar 6.

A comparison of a homemade central line simulator to commercial models.

Author information

1
Department of Surgery, University of North Carolina, Chapel Hill, North Carolina. Electronic address: rebecca.brown@unchealth.unc.edu.
2
Department of Surgery, University of Michigan Hospitals, Ann Arbor, Michigan.
3
Department of Surgery, University of North Carolina, Chapel Hill, North Carolina.
4
The North Carolina Translational and Clinical Sciences (NC TraCS) Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
5
Department of Cardiothoracic Surgery, East Carolina University, Greenville, North Carolina.

Abstract

BACKGROUND:

Simulation is quickly becoming vital to resident education, but commercially available central line models are costly and little information exists to evaluate their realism. This study compared an inexpensive homemade simulator to three commercially available simulators and rated model characteristics.

MATERIALS AND METHODS:

Seventeen physicians, all having placed >50 lines in their lifetime, completed blinded central line insertions on three commercial and one homemade model (made of silicone, tubing, and a pressurized pump system). Participants rated each model on the realism of its ultrasound image, cannulation feel, manometry, and overall. They then ranked the models based on the same variables. Rankings were assessed with Friedman's and post hoc Conover's tests, using alphas 0.05 and 0.008 (Bonferroni corrected), respectively.

RESULTS:

The models significantly differed (P < 0.0004) in rankings across all dimensions. The homemade model was ranked best on ultrasound image, manometry measurement, cannulation feel, and overall quality by 71%, 67%, 53%, and 77% of raters, respectively. It was found to be statistically superior to the second rated model in all (P < 0.003) except cannulation feel (P = 0.134). Ultrasound image and manometry measurement received the lowest ratings across all models, indicating less realistic simulation. The cost of the homemade model was $400 compared to $1000-$8000 for commercial models.

CONCLUSIONS:

Our data suggest that an inexpensive, homemade central line model is as good or better than commercially available models. Areas for potential improvement within models include the ultrasound image and ability to appropriately measure manometry of accessed vessels.

KEYWORDS:

Central line insertion education; Central line insertion simulation; Medical education; Patient simulation; Resident training; Surgical procedures education

PMID:
28624045
DOI:
10.1016/j.jss.2017.02.071
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