R. F. Brown1, C. Tignanelli4, J. Grudziak1, S. Summerlin-Long1, J. Laux3, A. Kiser2, S. P. Montgomery1 1University Of North Carolina,Department Of Surgery,Chapel Hill, NC, USA 2Eastern Carolina University,Greenville, NC, USA 3University of North Carolina,The North Carolina Translational And Clinical Sciences (NC TraCS) Institute,Chapel Hill, NC, USA 4University Of Michigan,Ann Arbor, MI, USA
Introduction:
Simulation is quickly becoming a vital method in resident education, but commercially available central line models are costly and little information exists to evaluate their realism. This study compared an inexpensive homemade simulator to three commercially available simulators and rated model characteristics.
Methods:
Seventeen physicians, all having placed >50 lines in their lifetime, completed blinded central line insertions on four simulation models, three commercial and one homemade model created in our simulation lab with a silicone mold and tubing and a pressurized pump system. Participants rated each model on the realism of its ultrasound image, vessel appearance, tissue feel, manometry, and resistance, and then gave an overall rating. They then ranked the models by ultrasound, manometry, cannulation feel, and overall. The rankings were assessed with Friedman’s test and post-hoc Conover’s tests, using alphas 0.05 and 0.008 (Bonferroni corrected), respectively.
Results:
The models significantly differed (p<0.0004) in rankings across all four dimensions. The homemade model was ranked best on ultrasound image, manometry measurement, cannulation feel, and overall quality by 71, 67, 53, and 77% of raters respectively. It was also found to be statistically superior to the second rated model in all (p <0.003) except cannulation feel (p=0.134). Figure 1 lists mean ratings for model characteristics. Vessel appearance and manometry measurement received the lowest ratings, indicating less realistic simulation. The cost of the homemade model was $400 compared to $1500-$8000 for commercial models.
Conclusion:
Our data suggest that an inexpensive, homemade central line model is as good as or superior to commercially available models. Areas of deficiency within commercially available models included vessel appearance on ultrasound and ability to correctly measure manometry of accessed vessels.
