Simulation-based training improves applied clinical placement of ultrasound-guided PICCs

Skilled placement of peripherally inserted central catheters (PICC) has a profound impact on patient well-being and costs of care. The use of ultrasound-guided methods and prescribed training for cannulation skills are evidence-based practice recommendations. The purpose of this study was to compare two methods of PICC instruction on the acquisition of applied skills. Residents were randomly assigned to one of two groups (N = 16/16) of this blind-rater study and were trained to perform ultrasound-guided PICC cannulation using either simulation or apprenticeship methods. All residents were assessed placing a PICC in applied clinical patient care. Residents who completed simulation training had significantly better transfer of skills to applied clinical practice than residents who received apprenticeship training, having better performance ratings on eight of nine procedure-specific task measures (p < 0.05) and higher success rates in endpoint PICC placement. These results support the use of prescribed simulation-based training for the acquisition of requisite skills associated with PICC placement and expand on similar studies that suggest the advantages of simulation-based training for central line placement. Additionally, the data suggest that training using a single simulation model may support the acquisition of both central venous catheterization and PICC skills.