Browsing by Subject "Competency-Based Education"
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Item Standardization of Internal Jugular Central Venous Catheter Insertion Between Multiple Specialties with Simulation(2018-03-29) Weia, Benjamin Chun-Bang; Reed, W. Gary; Sulistio, Melanie; Phelps, EleanorBACKGROUND: Insertion of central venous catheters is a medical procedure with the risk of adverse outcomes. Between the different specialties at the University of Texas Southwestern Medical Center (UT Southwestern), there is a wide variation in the training and performance of the procedure. At other medical institutions, standardization of central venous catheter insertion decreased the frequency of adverse outcomes including failure, infection, pneumothorax, and arterial puncture. SPECIFIC AIM: Increase compliance with a standardized method for central venous catheter insertion among resident physicians in six departments at UT Southwestern to 95% as measured by a checklist by July 2019. METHODS: Consensus was achieved on a standardized method between six departments by a modified Delphi method. A training curriculum was created for the standardized method by following the Define-Measure-Analyze-Design-Validate (DMADV) framework. In designing the curriculum, strategies were utilized from implementation science, mastery-based learning, and simulation education. During the design phase, the curriculum was improved through two Plan-Do-Study-Act cycles with two pilot training sessions. RESULTS: Created a checklist for measuring compliance to the standardized method and a written exam for measuring knowledge required for the method. Designed multiple manuals and a video for learners and educators to standardize the training. CONCLUSION: A standardized method for inserting central venous catheters has been developed with consensus between multiple departments in a large academic institution. To introduce compliance with the method, a simulation-based training curriculum has been implemented. These achievements allow for the following phase of training resident physicians at UT Southwestern and measuring for an increase in compliance to the standardized method for central venous catheter insertion.Item The teaching and evaluation of clinical competence: an undergraduate medical education perspective(2015-01-30) Wagner, James M.Item UT Southwestern Standardization of IJ CVC Insertion Across Multiple Specialties(2018-03-29) Kuo, Eric Jia-Young; Reed, W. Gary; Sulistio, Melanie; Phelps, EleanorBACKGROUND: Standardization of procedures decreases patient complications and improves patient care. University of Texas Southwestern(UTSW) Medical Center is a large academic institution that fosters/trains physicians from all over the country and world. The diversity of physician background in specialties and clinical interests leads to a large variation for the teaching and insertion of internal jugular(IJ) central venous catheters (CVC). In order to improve clinical training of residents and decrease patient harm, the standardization of IJ CVC insertion was undertaken at UTSW. OBJECTIVE: Standardize IJ CVC Insertion Across All Specialties at UTSW METHODS: Stakeholders were identified at the project's inception for proper sponsorship and support. Consensus across multiple specialties was achieved using a modified Delphi method. Process Map was generated using previously identified standards of practice1,2,3 for CVC insertion and modified for implementation according to resources specific to UTSW hospital system. UTSW Checklist was created based on expert consensus and the UTSW process map that included elements from work done by other academic institutions4-12. Education resources were created tailored to the UTSW process map in order to create a simulation training for future physicians and residents at UTSW. Training Video and exams were created to measure learner's competency/retention of UTSW IJ CVC insertion. RESULTS: Consensus for one method of IJ CVC insertion across multiple specialties was achieved. Checklist, educator manual, learner manual, and video were created specific to UTSW CVC insertion method. Simulation training of UTSW Physicians was begun on March 19, 2018. CONCLUSION: Creation of the UTSW IJ CVC insertion method and a simulation curriculum to teach residents/physicians was successful. Future work could be collected on hospital complications rates associated with CVC insertion and comparing the complications of 2018-2019 year to prior 2017-2018 year. Residents can be followed at 6 months intervals out of simulation training to determine retention and mastery of skill.