The Concept

Not everyone learns the same way, however we should probably all know the same things. Without a fundamental knowledge shared in common we cannot communicate, adapt practices and inform effective training. Thus the purpose of this course is to introduce central access at the most fundamental level, and provide a means to build a ‘bookshelf’ in the learner’s mind – a frame for them to put information, experience, practical tools and problem solving tactics in an organized way.


The course then dives into it’s true goal – to teach the technical skills required to be master proceduralists. Clinical knowledge, anatomy, sterile technique are important features to the procedure, but are taught through so many other modalities through medical school and residency and in other procedures – thus I have chosen to narrow the focus to practical technical skills of ultrasound guided line placement. I do so because of the hundreds of central lines I have witness performed these last 3 years, it is nearly always technical approach or equipment error and not lack of medical knowledge that drives failure. In my interviews with dozens of attendings and senior residents, this belief has been reinforced.


It is a complex 2 handed task, with discordant hand-eye movements in a high risk and high pressure situation – of course smart people are going to mess it up. I imagine walking a tightrope as a comparison task – all the books in the world aren’t going to help nearly so much as a few hours of practice on a tightrope a foot off the ground and some balance drills.


This course is developed with the junior resident in mind – and assumes they have learned little else prior (and forgotten most anyhow). It assumes no significant knowledge of ultrasound guidance, materials used, anatomy nor the procedure itself. I will add refreshers and advanced skill training later.

This Course Includes:

  • Learning Objectives

  • Training Drills

  • Conceptual Drawings

  • Instructional Videos

  • Simulation Resources

  • Curated Outside Resources