Objectives
The study authors hypothesized that a combination of previously used (path length,
translational motions, and time) and novel (rotational sum) motion metrics could be
used to analyze learning curves of anesthesiology interns (postgraduate year 1) practicing
central venous catheter placement in the simulation setting. They also explored the
feasibility of using segmented motion recordings to inform deliberate practice.
Design
A prospective cohort study.
Setting
A single academic medical center.
Participants
Anesthesiology interns (postgraduate year 1).
Interventions
Anesthesiology interns underwent a 2-day training course in which they performed 9
central venous catheter placements, while attached to motion sensors on the dorsum
of their dominant hand and ultrasound probe.
Measurements and Main Results
Motion metrics were analyzed using generalized estimating equations for both the overall
procedure and predefined segments. Five attending anesthesiologists performed 3 trials
each for comparison. Overall, there was a negative trend in path length, translational
motions, rotational sum, and time (p < 0.001), with the exception of translational
motions of the ultrasound probe. Interns reached within 1 standard deviation of the
attending anesthesiologists by trials 7-to-8 for most metrics. Segmentation identified
specific components of the procedure that were either significantly improved upon
or required deliberate practice. The novel metric of rotational sum exhibited a moderate-to-strong
positive correlation with other metrics (p < 0.001).
Conclusions
A comprehensive series of motion metrics was able to describe the learning curves
of novices training to perform central venous catheter placement in the simulation
setting. Furthermore, it was determined that segmentation may provide additional insight
into skill acquisition and inform deliberate practice.
Key Words
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Article info
Publication history
Published online: February 01, 2022
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