Introduction: Ultrasound-guided technique is a gold standard of central venous catheterization. However, lethal complications have been reported, even while using ultrasound guidance. We introduced skill assessment to the conventional hands-on seminar. A high task test is likely to produce negative emotions. On the other hand, positive emotions can produce motivation to learn and facilitate the development of competence. Therefore, in this study, we surveyed the emotional impact of the task test on participants.
Method: The ethics committee approved the research. Residents were recruited using a poster. The seminar was scheduled for 180 minutes and consisted of a short lecture, demonstration by an ultrasound expert, and hands-on training using a simulator under expert supervision. The residents freely participated in the task test. Skill assessment was conducted based on three factors: needle visualization (evaluated to 5 levels, 5: clearly visible, 1: invisible), hand-eye coordination (5: excellent, 1: unacceptable), and no penetrating the posterior wall. The achievement goal was set to level 3 or higher, and necessitated no posterior wall penetration. A post-seminar evaluation questionnaire was administered, and self-confidence was measured using a Likert scale. 
Results: Twenty-three residents participated. All residents took and passed the task tests until the end of the course and agreed to respond to the questionnaire. They were very satisfied with the course (median 5: “extremely satisfied,” range 5-4) and reported high levels of self-confidence (median 4: “my skill progressed well,” range 5-3). 
Discussion and Conclusion: The task test evaluating skills is key for outcome-based education. Usually, tests cause a negative impact on education. However, trainees are likely eager to understand their own skill levels. This seminar resulted in high satisfaction and self-confidence. We believe that this task test for ultrasound-guided central venous catheterization will have good emotional impacts.
This research was supported by AMED under Grant Number JP15km0908001.

Skill assessment of simulation training for ultrasound-guided central venous catheterization