Simulation-based training improves applied clinical placement of ultrasound-guided PICCs

Purpose: Skilled placement of peripherally inserted central catheters (PICC) has a profound impact on patient well-being and costs of care. The use of ultrasound-guided methods and prescribed training for cannulation skills are evidence-based practice recommendations. The purpose of this study was to compare two methods of PICC instruction on the acquisition of applied skills. Methods: Residents were randomly assigned to one of two groups (N=16/16) of this blind-rater study and were trained to perform ultrasound-guided PICC cannulation using either simulation or apprenticeship methods. All residents were assessed placing a PICC in applied clinical patient care. Results: Residents who completed simulation training had significantly better transfer of skills to applied clinical practice than residents who received apprenticeship training, having better performance ratings on eight of nine procedure-specific task measures (p<0.05) and higher success rates in endpoint PICC placement. Conclusions: These results support the use of prescribed simulation-based training for the acquisition of requisite skills associated with PICC placement and expand on similar studies that suggest the advantages of simulation-based training for central line placement. Additionally, the data suggest that training using a single simulation model may support the acquisition of both central venous catheterization and PICC skills.