ArticleInternational journal of environmental research and public health2020
Delphi Method to Achieve Clinical Consensus for a BPMN Representation of the Central Venous Access Placement for Training Purposes.
Article in International journal of environmental research and public health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A quality assessment and systematic review of clinical practice guidelines on central venous catheter care in China and internationally.BMC infectious diseases · 2026Pooled it
- The Sequence of Steps: A Key Concept Missing in Surgical Training-A Systematic Review and Recommendations to Include It.International journal of environmental research and public health · 2023Pooled it
- Process-oriented feedback for ultrasound-guided central venous access training: a randomized controlled trial.BMC anesthesiology · 2025Trial
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Proper teaching of the technical skills necessary to perform a medical procedure begins with its breakdown into its constituent steps. Currently available methodologies require substantial resources and their results may be biased. Therefore, it is difficult to generate the necessary breakdown capable of supporting a procedural curriculum. The aim of our work was to breakdown the steps required for ultrasound guided Central Venous Catheter (CVC) placement and represent this procedure graphically using the standard BPMN notation.
methodsWe performed the first breakdown based on the activities defined in validated evaluation checklists, which were then graphically represented in BPMN. In order to establish clinical consensus, we used the Delphi method by conducting an online survey in which experts were asked to score the suitability of the proposed activities and eventually propose new activities.
resultsSurveys were answered by 13 experts from three medical specialties and eight different institutions in two rounds. The final model included 28 activities proposed in the initial model and four new activities proposed by the experts; seven activities from the initial model were excluded.
conclusionsThe proposed methodology proved to be simple and effective, generating a graphic representation to represent activities, decision points, and alternative paths. This approach is complementary to more classical representations for the development of a solid knowledge base that allows the standardization of medical procedures for teaching purposes.
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