Serious Gaming to Improve the Safety of Central Venous Catheter Placement

Approximately 5 million central venous catheters (CVCs) are placed by physicians annually in the United States, with a complication rate of 15%.(1) Guidelines and recommendations are continually being established and updated regarding CVC placement.(2) While much has been done regarding training the technical skills of CVC placement using part-task trainers (i.e., mannequins), successfully finding and cannulating a central vein is but one part of the process. In fact, many steps designed to prevent untoward complications involve non-technical skills which are perhaps more important in training practitioners to safely place CVCs. First in aviation and now in healthcare, practitioners are being trained in realistic and highly interactive simulated environments so they can learn not just technical skills, but the key management and non-technical steps which make their task safer.(3) One modality being used to improve performance is video gaming simulation, or "serious gaming." Gaming as a learning tool is being increasingly utilized in health care fields and can lead to better skill-based outcomes.(4) As such, we have developed a game based around the placement of CVCs that will be used as a new teaching modality in a pilot program for instructing residents in safe CVC placement.