The Development of a Simulated Umbilical Line Insertion Model and Curriculum in the Neonatal Intensive Care Unit.

Sunayna Gupta,Douglas M Campbell,Madeline Drake,Michael Sgro,Ra Han,Kathleen Hollamby,Avery Longmore

doi:10.7759/cureus.13418

Abstract

BackgroundInsertion of an umbilical venous catheter (UVC) is a required skill for pediatric residents to learn and perform effectively. However, there is known variability in the ability of residents to perform this essential neonatal skill.ObjectiveThe objective of our study was to create a competency-based curriculum for umbilical vein catheter insertion using a human umbilical tissue simulated model, and to assess the feasibility of the curriculum on resident learners during their neonatology rotations.MethodsWe evaluated the curriculum by assessment of resident learning, reactions, and behaviours. Performance was assessed using the Ottawa Surgical Competency Operating Room Evaluation (O-SCORE).ResultsA total of 14 residents were included for analysis. The majority were ‘senior’ residents (postgraduate year (PGY)-3 and PGY-4 n = 10; PGY-1 n =4), and they reported a wide range of previous experience with UVC insertion prior to this curriculum implementation. The residents’ reaction to the curriculum was overwhelmingly positive. All residents maintained or improved in their knowledge assessment. O-SCORE results showed improvement in UVC insertion before and after curriculum completion for both junior (2.5 +/- 0.71 to 4.5 +/- 0.41) and senior (3.55 +/- 0.42 to 4.95 +/- 0.15, p < 0.001) residents. The mean improvement in O-SCORE was greater for junior residents than senior residents.ConclusionThe results of this study demonstrate the feasibility and emerging impact of a competency-based curriculum using simulation for procedural skills.

Highlights

The majority were ‘senior’ residents (postgraduate year (PGY)-3 and PGY-4 n = 10; PGY-1 n =4), and they reported a wide range of previous experience with umbilical venous catheter (UVC) insertion prior to this curriculum implementation
The mean improvement in Ottawa Surgical Competency Operating Room Evaluation (O-SCORE) was greater for junior residents than senior residents
Placement of an umbilical venous catheter (UVC) is an important skill for the resuscitation of critically ill newborns, and one of the most common procedures performed in neonatal intensive care units (NICUs) [1]

Summary

Introduction

Placement of an umbilical venous catheter (UVC) is an important skill for the resuscitation of critically ill newborns, and one of the most common procedures performed in neonatal intensive care units (NICUs) [1]. A 2007 survey of pediatric residency program directors showed that some of the current educational methods for procedural teaching were not sufficient for graduating residents to gain competence in important procedural skills [5]. Teaching umbilical line placement with the use of real umbilical cords has been described [6,7,8,9,10]. Pediatric residents may prefer learning with real umbilical cord tissue [8,10]. Insertion of an umbilical venous catheter (UVC) is a required skill for pediatric residents to learn and perform effectively. There is known variability in the ability of residents to perform this essential neonatal skill

Methods

Results

Discussion

Conclusion