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Effectiveness of Implementing Simulation-based Education with Flipped Classroom in Ultrasound-guided Vascular Access

摘要


Purpose: Post-graduate trainees are expected to perform the clinical procedures of central venous catheter (CVC) insertion during their post-graduate year training (PGY). However, it is not one of the 81 minimal required clinical skills for medical graduates in Taiwan. Performing CVC insertion carries a certain level of risk of hemothorax, pneumothorax, and arterial puncture injuries. Studies have shown ultrasound-guided vascular access can minimize the number of punctures and the occurrence of complications. Therefore, it is somewhat important to utilize simulation-based education to introduce ultrasound-guided vascular access in general medicine training. Methods: This course used the flipped classroom model, included 18 PGY trainees during March 2020. Trainees were required to complete an online course and a written test before entering the practical session, which used the workshop model to deconstruct the four steps of ultrasound-guided vascular access. After completing the course, the trainee must finish the online written test and fill out a satisfaction survey. We used pair-t test to compare the pre-test and post-test to evaluate the effectiveness of this educational strategy. Results: The average trainees' satisfaction level towards the course is as high as 5.00. The mean test score improved from the pre-test, 52.2, to the post-test, 75.56, which is statistically significant. Especially the poke step after deliberate hand-on practice. Trainees have notably improved their learning effectiveness through high-fidelity simulation practices. Conclusions: Efficiency through simulation-based education for ultrasound-guided vascular access is excellent. The trainees can successfully perform ultrasound-guided central venous catheter insertion, and the level of improvement is also noticeable.

參考文獻


Azeem Tajani, Arthur Au, J. Matthew Fields:Ultrasound-Guided Central Venous Access. The Ultimate Guide to Point-of-Care Ultrasound-Guided Procedures. S.A.a.M. Blaivas, Editor. 2020, Springer Nature Switzerland. p. 81-98.
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Milling, T.J., Jr., et al.:Randomized, controlled clinical trial of point-of-care limited ultrasonography assistance of central venous cannulation: the Third Sonography Outcomes Assessment Program (SOAP-3) Trial. Crit Care Med 2005;33(8): 1764-9.
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Denadai, R., et al., Simulation-based ultrasound-guided central venous cannulation training program. Acta Cir Bras 2014;29(2): 132-44.

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