Approximately 5 million central venous catheters (CVCs) are placed by physicians annually in the United States, with a complication rate of 15%. Guidelines and recommendations are continually being established and updated regarding CVC placement. While much has been done regarding training the technical skills of CVC placement using part-task trainers, successfully finding and cannulating a central vein is but one part of the process. In fact, many steps designed to prevent untoward involve non-technical skills which are perhaps more important in training practitioners to safely place CVCs.
This session details a game based around the placement of CVCs that will be used as a new teaching modality in a pilot program for instructing residents in safe CVC placement. Built using the Unreal platform with support from Arizona State University the games design incorporates current best-practices for CVC, and protocols used at The Mount Sinai Medical Center (MSMC) Department of Anesthesiology.
Users are able to play the game which begins before materials for line placement have been gathered and ends after line placement. Users receive feedback as to steps missed and areas for improvement as the stages of the game progress, followed by a report card after completion. Points are awarded for adhering to standard practices, while points are deducted for skipping steps or not adhering guidelines.
After a lengthy game development phase including several iterations; our CVC game was completed. The game was introduced at the Mt. Sinai Hospital within the department of anesthesiology. The game was rolled out as part of a pilot program where residents in the department of anesthesiology were randomized to have access to the game or to maintain standard practices. We then graded them on a standardized line placement to determine the effectiveness of our game. We found that those who had access to the game were able to place a CVC in safer manner than those who did not. They were also more comfortable with the process, and felt as though they were better equipped to teach others this skill