We conducted a study to compare the performance of a virtual coach built into the central venous access simulator to that of an average human instructor. The data from this study, performed on resident trainees, are aiding the development of a virtual coach for practicing clinicians.
Average Human Instructor vs Virtual Coach Study for Central Venous Access
- Group A (n=27) trains with virtual coach
- Group B (n=27) trains with average human instructor
- Ultrasound-guided short and long axis techniques used for internal jugular (IJ) vein; landmark-based technique for infraclavicular subclavian (SC) venous access
- Participants were evaluated on 3 trials each for IJ access and SC access
- Success was defined as venous access within one try – 3 attempts (miss, pull needle back, redirect) allowed without pneumothorax or arterial puncture
- Proportion is the number of successful accesses divided by the total number of tries
The performance of the virtual coach group is non-inferior to the human instructor group for ultrasound-guided internal jugular (IJ) access (trials 2 and 3), and for infraclavicular subclavian (SC) access (trial 6). Most notable is the result for short axis ultrasound-guided IJ access because this is the most common approach used in our clinical setting. Having established evidence of non-inferiority, we are using the central venous access simulator and the virtual coach for a system-wide mastery training of all anesthesiology, surgery and emergency medicine residents performing ultrasound-guided IJ central venous access, annually.
Lampotang et al 2018: Non-inferiority Assessment of a Self-study, Self-debriefing Mixed Reality Simulator for Central Venous Access