Simulator for teaching ultrasound-guided PICC placement
Abstract:
Background: Ultrasound-guided peripherally inserted central catheter (PICC) placement requires stable probe handling and continuous needle-tip tracking, yet novice nurses have limited opportunities for repeated clinical practice.
Objective: This study aimed to evaluate the association between porcine tissue-based simulation training and early ultrasound-guided PICC placement performance among trainees.
Methods: This quasi-experimental study enrolled 216 infusion-therapy nurse trainees in Sichuan, China (2018-2021). Trainees were assigned by training period to a porcine tissue simulator group (n = 115) or a traditional arm-model group (n = 101). In each trainee’s first clinical PICC after training, two preceptors assessed probe handling (vein identification within 10 s; maintenance of vessel centering), puncture behaviors (needle advancement aligned with the vertical centerline of the target vein on the ultrasound short-axis view; intraluminal needle-tip centering; continuous needle-tip visualization), and procedural familiarity scores.
Results: Vein identification within 10 s was similar between groups (93.0% vs 90.1%, p = 0.435). Compared with the arm-model group, the simulator group more often maintained vessel centering (90.4% vs 70.3%, p < 0.001), advanced the needle in alignment with the target vein (91.3% vs 69.3%, p < 0.001), achieved intraluminal needle-tip centering (87.0% vs 60.4%, p < 0.001), and maintained continuous needle-tip visualization (74.8% vs 50.5%, p < 0.001). Procedural familiarity scores were higher in the simulator group (94.3 ± 1.6 vs 93.4 ± 1.6, p < 0.001).
Conclusions: A porcine tissue-based ultrasound-capable simulator may be a feasible and accessible tool for early ultrasound-guided PICC training and was associated with better early performance in selected probe-handling and puncture behaviors during the first clinical case after training. These findings should be interpreted in light of the nonrandomized, time-based cohort design and require further validation.
Reference:
Deng L, He J, Gao L, Guo Q, Guo L. Evaluation of a porcine tissue-based simulator for teaching ultrasound-guided PICC placement. J Vasc Access. 2026 Oct 9:11297298261488204. doi: 10.1177/11297298261488204. Epub ahead of print. PMID: 42852665.