Abstract
Proper teaching of the technical skills necessary to perform a medical procedure begins with its breakdown into its constituent steps. Currently available methodologies require substantial resources and their results may be biased. Therefore, it is difficult to generate the necessary breakdown capable of supporting a procedural curriculum. The aim of our work was to breakdown the steps required for ultrasound guided Central Venous Catheter (CVC) placement and represent this procedure graphically using the standard BPMN notation. Methods: We performed the first breakdown based on the activities defined in validated evaluation checklists, which were then graphically represented in BPMN. In order to establish clinical consensus, we used the Delphi method by conducting an online survey in which experts were asked to score the suitability of the proposed activities and eventually propose new activities. Results: Surveys were answered by 13 experts from three medical specialties and eight different institutions in two rounds. The final model included 28 activities proposed in the initial model and four new activities proposed by the experts; seven activities from the initial model were excluded. Conclusions: The proposed methodology proved to be simple and effective, generating a graphic representation to represent activities, decision points, and alternative paths. This approach is complementary to more classical representations for the development of a solid knowledge base that allows the standardization of medical procedures for teaching purposes.
Highlights
The development of procedural skills is an essential component in the process of training physicians of many medical specialties
Cognitive Task Analysis (CTA) has been used to make explicit the knowledge that experts have about a procedure
We used the activities defined in the checklists proposed by Barsuk et al [4] to evaluate the installation of dialysis catheters, which fulfills the requirement of representing all skills, ensuring the inclusion of procedural aspects related to motor skills, and those related to safety, infection control, and preparation
Summary
The development of procedural skills is an essential component in the process of training physicians of many medical specialties. It has been shown that superior technical performance positively affects patient outcomes [1] and that the presence of technical deficiencies is the most important factor associated with operator errors in hospitalized patients [2]. Procedural instruction using simulation before contact with patient has proven to be a useful tool in the development of these skills [3,4]. A first stage, before procedure training using simulation, is to break down the procedure into observable and ordered steps that allow a clear and thorough description, including those points where decisions are made [5,6]. Cognitive Task Analysis (CTA) has been used to make explicit the knowledge that experts have about a procedure.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: International Journal of Environmental Research and Public Health
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
