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Part versus Whole: A Randomized Trial of Central Venous Catheterization Education

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Title: Part versus Whole: A Randomized Trial of Central Venous Catheterization Education
Language: English
Authors: Chan, Angela, Singh, Sunita, Dubrowski, Adam
Source: Advances in Health Sciences Education. Oct 2015 20(4):1061-1071.
Availability: Springer. 233 Spring Street, New York, NY 10013. Tel: 800-777-4643; Tel: 212-460-1500; Fax: 212-348-4505; e-mail: service-ny@springer.com; Web site: http://www.springerlink.com
Peer Reviewed: Y
Page Count: 11
Publication Date: 2015
Document Type: Journal Articles
Reports - Research
Descriptors: Health Education, Control Groups, Experimental Groups, Skill Development, Retention (Psychology), Rating Scales, Check Lists, Clinical Experience, Competence
DOI: 10.1007/s10459-015-9586-0
ISSN: 1382-4996
Abstract: Central venous catheterization (CVC) is a complex but commonly performed procedure. How best to teach this complex skill has not been clearly delineated. We conducted a randomized trial of the effects of two types of teaching of CVC on skill acquisition and retention. We randomly assigned novice internal medicine residents to learning CVC in-part or in-whole. The part-group was taught the first part of the procedure, followed by practice, followed by being taught the second and final portion of the procedure, and followed by practice. The whole-group was taught the procedure in its entirety, followed by practice. Teaching and practice time for both groups was otherwise held constant. Performances were assessed at baseline, post-training, and at 1 month. The primary outcome was skill retention at 1-month, rated by using a global rating scale and a 22-item checklist, and defined as the score increase between 1-month and baseline. Skill acquisition is defined as the score increase post-training and baseline. Raters were blinded to the participants' identity, group assignment, and time point. Participants in the part-task group outperformed the whole-task group in skill acquisition (2.2 ± 0.8 vs 1.3 ± 1.0; g = 1.01; p = 0.04) and in skill retention (1.5 ± 0.7 vs 0.5 ± 0.8; g = 1.39; p = 0.006) using the global rating scale. Scores rated by the checklist were not significantly different (52.0 ± 25.3 vs 43.5 ± 23.4; g = 0.33; p = 0.47 for skill acquisition; and 48.5 ± 34.9 vs 41.1 ± 20.4; g = 0.35; p = 0.44 for skill retention). For teaching ultrasound-guided CVC to novice learners, teaching in part is preferable than teaching in whole.
Abstractor: As Provided
Number of References: 38
Entry Date: 2015
Accession Number: EJ1074008
Database: ERIC
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  Data: Part versus Whole: A Randomized Trial of Central Venous Catheterization Education
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  Data: <searchLink fieldCode="AR" term="%22Chan%2C+Angela%22">Chan, Angela</searchLink><br /><searchLink fieldCode="AR" term="%22Singh%2C+Sunita%22">Singh, Sunita</searchLink><br /><searchLink fieldCode="AR" term="%22Dubrowski%2C+Adam%22">Dubrowski, Adam</searchLink>
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  Data: <searchLink fieldCode="SO" term="%22Advances+in+Health+Sciences+Education%22"><i>Advances in Health Sciences Education</i></searchLink>. Oct 2015 20(4):1061-1071.
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  Data: Springer. 233 Spring Street, New York, NY 10013. Tel: 800-777-4643; Tel: 212-460-1500; Fax: 212-348-4505; e-mail: service-ny@springer.com; Web site: http://www.springerlink.com
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  Data: Central venous catheterization (CVC) is a complex but commonly performed procedure. How best to teach this complex skill has not been clearly delineated. We conducted a randomized trial of the effects of two types of teaching of CVC on skill acquisition and retention. We randomly assigned novice internal medicine residents to learning CVC in-part or in-whole. The part-group was taught the first part of the procedure, followed by practice, followed by being taught the second and final portion of the procedure, and followed by practice. The whole-group was taught the procedure in its entirety, followed by practice. Teaching and practice time for both groups was otherwise held constant. Performances were assessed at baseline, post-training, and at 1 month. The primary outcome was skill retention at 1-month, rated by using a global rating scale and a 22-item checklist, and defined as the score increase between 1-month and baseline. Skill acquisition is defined as the score increase post-training and baseline. Raters were blinded to the participants' identity, group assignment, and time point. Participants in the part-task group outperformed the whole-task group in skill acquisition (2.2 ± 0.8 vs 1.3 ± 1.0; g = 1.01; p = 0.04) and in skill retention (1.5 ± 0.7 vs 0.5 ± 0.8; g = 1.39; p = 0.006) using the global rating scale. Scores rated by the checklist were not significantly different (52.0 ± 25.3 vs 43.5 ± 23.4; g = 0.33; p = 0.47 for skill acquisition; and 48.5 ± 34.9 vs 41.1 ± 20.4; g = 0.35; p = 0.44 for skill retention). For teaching ultrasound-guided CVC to novice learners, teaching in part is preferable than teaching in whole.
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      – SubjectFull: Control Groups
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      – SubjectFull: Experimental Groups
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      – SubjectFull: Skill Development
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      – SubjectFull: Retention (Psychology)
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      – TitleFull: Part versus Whole: A Randomized Trial of Central Venous Catheterization Education
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