Teaching Ultrasound-Guided Venous Cannulation to Newly Qualified Doctors

Abstract

Background Venous cannulation is an essential task that allows the intravenous administration of fluids and medications. In the United Kingdom, this task is often performed by newly qualified Foundation Year 1 (FY1) doctors; however, difficulties are commonly encountered. The usage of ultrasound increases the chance of successful cannulation, provided the operator has been trained. Some medical schools now include ultrasound in their undergraduate curricula, though this is far from universal. Methods Forty-eight FY1s received a one-hour teaching session on ultrasound-guided venous cannulation, delivered by near-peer Education Fellows. FY1s completed questionnaires immediately after the teaching session, and a follow-up questionnaire three months later. Findings 44.44% of FY1s felt "fairly" or "very" confident in ultrasound-guided venous cannulation at follow-up, compared to 6.66% before the session. Sixty-three attempts were made in the month before the follow-up survey, compared to six in the month prior to the teaching session. The success rate at follow-up was 60% (38/63), up from 50% (3/6) prior to the session. One third fewer cannulas were escalated to senior doctors (72 vs 48), although there was little change in escalations to anesthetists, from 15 vs 18. FY1s identified the lack of ultrasound machines on the wards as a barrier to using ultrasound-guided venous cannulation more often. Conclusion A short, near-peer teaching session can improve FY1s' confidence, usage, and success rates in ultrasound-guided venous cannulation.

Keywords: foundation year 1; intravenous cannulation; near peer teaching; nhs england; post grad medical education; practical skills; ultrasound-guided.

Figure 1. FY1s’ confidence in ultrasound-guided venous cannulation before and immediately after the teaching session, and at follow-up three months later.

Figure 2. Bar chart comparing the total number of attempts made at ultrasound-guided cannulation in the month before the teaching session and the month prior to follow-up.

Figure 3. Number of FY1s who reported a given number of attempts at US-guided venous cannulation in the month before the teaching session and the month prior to follow-up.

Figure 4. Number of times FY1s reported escalating a cannula to their own senior (blue) and anaesthetics (orange) in the month before the teaching session and the month prior to follow-up.

Figure 5. Bar chart showing successful (green) and unsuccessful (red) attempts at ultrasound-guided venous cannulation in the month before the teaching session and the month prior to follow-up.