Abstract
BackgroundMedical students often learn the skills necessary to perform a central venous catheterization in the operating room after simulator training. We examined the performance of central venous catheterization by medical students from the logbooks during their rotation in department of anesthesiology.MethodsFrom the logbooks of medical students rotating in our department between January 2011 and June 2012, we obtained the kind and the number of central venous catheterization students had done, the results of the procedures whether they were success or failed, the reasons of the failures, complications, and the student self-reported confidence and satisfaction of their performance.ResultsThere were 93 medical students performed 875 central venous catheterizations with landmark guidance on patients in the operating theater, and the mean number of catheterizations performed per student was 9.4 ± 2.0, with a success rate of 67.3%. Adjusted for age, sex, body mass index, surgical category, ASA score and insertion site, the odds of successful catherization improved with cumulative practice (odds ratio 1.10 per additional central venous catheterization performed; 95% confidence interval 1.05–1.15). The major challenge students encountered during the procedure was the difficulty of finding the central veins, which led to 185 catheterizations failed. The complication rate of central venous catheterization by the students was 7.8%, while the most common complication was puncture of artery. The satisfaction and confidence of students regarding their performance increased with each additional procedure and decreased significantly if failure or complications had occurred.ConclusionA student logbook is a useful tool for recording the actual procedural performance of students. From the logbooks, we could see the students’ performance, challenges, satisfaction and confidence of central venous catheterization were improved through cumulative clinical practice of the procedure.
Highlights
Medical students often learn the skills necessary to perform a central venous catheterization in the operating room after simulator training
Central venous catheterization (CVC) is a basic clinical skill of doctors working in the departments of internal medicine, surgery, critical care, pediatrics, anesthesiology, and emergency
The highest success rate of the catheterization of central vein was in the right internal jugular vein (70.6%), followed by the right femoral vein (60.4%), the left internal jugular vein (59%), and the left femoral vein (56.2%)
Summary
Medical students often learn the skills necessary to perform a central venous catheterization in the operating room after simulator training. We examined the performance of central venous catheterization by medical students from the logbooks during their rotation in department of anesthesiology. Central venous catheterization (CVC) is a basic clinical skill of doctors working in the departments of internal medicine, surgery, critical care, pediatrics, anesthesiology, and emergency. The simulator-trained medical students performed CVCs on patients in the operating theater. Teaching this invasive skill to medical students has been an important task in our anesthesiology department. We requested all the students to record every CVC they performed in their logbooks which were given to them at the beginning of their course in anesthesiology
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