Are residents in India trained in ultrasound guided central venous cannulation? A prospective survey on the training and practices of anaesthesiology residents in central venous cannulation

Background and Aims: The present survey aims to assess the training and practices of Indian anaesthesia residents in central venous cannulation, and the barriers for not using US (ultrasound) and practicing internationally accepted guidelines for improved patient safety. Methods: The cross-sectional survey was conducted among Doctor of Medicine (MD) and Diplomate of National board of examinations (DNB)anaesthesia residents from different medical institutes across the country.The questionnaire included 20 questions and was validated for content by 6 experts. It was formatted on Google Forms and the link was sent on different zonal PG groups using WhatsApp. Results: Supervised training method was reported by 84.9% and 74.9% of the residents for landmark and US-guided CVC insertion respectively. Only around 8-9% had attended simulation sessions. Almost one-third of the residents did not have a printed checklist for the same, and one-fifth did not obtain informed consent at alltimes. About 12.2% residents either never followed all aseptic guidelines, or followed them occasionally. The most common barriers for not using US by residents for CVC cannulation were its non-availability in the institute (16.9%), limited availability for residents (63.8%), longer procedure time and learning curve (16.4 % and 12.7% respectively), and faculty preference for teaching by landmark technique (13.4%). Conclusion: Although anaesthesiology residents are being trained in US-guided CVC insertion, there are various barriers to its use in clinical practice like limited availability of USG for residents after routine hours, longer procedure time and learning curve, and faculty preference for teaching by landmark technique. The survey advocates and encourages simulation based training for the residents, and workshops for training and teaching of US and simulation for the faculty