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

Support Care Cancer. 2011 Apr;19(4):539-43. doi: 10.1007/s00520-010-0849-2. Epub 2010 Mar 20.


Purpose: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Catheterization, Central Venous / methods*
  • Clinical Competence*
  • Curriculum
  • Educational Measurement
  • Evidence-Based Medicine
  • Humans
  • Internship and Residency / methods
  • Models, Anatomic*
  • Radiology / education*
  • Ultrasonography, Interventional / methods