Human participants will include medical residents. Each year the entering 1st year medical residents at Hershey Medical Center and Cedars-Sinai Medical Center will be taught to perform these procedures using the DHRT or the DHRT+ devices. The resident's performance will be measured and evaluated by these devices during the training. The technique of the training does not differ from what is currently taught at either of these institutions. In addition the residents will be required to pass the same skills assessment currently required at their institution. Upon successfully passing the skills assessment the residents will perform CVC interventions on under supervision. After the procedure the investigators will examine patient files to determine any changes in central line related complications and infection rates due to new clinical educational practices.
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Change in Central Line Related Complications due to new Resident Central Line Training Procedures
Timeframe: baseline (pre-intervention), post-intervention
Change in Central Line Related Infections due to new Resident Central Line Training Procedures
Timeframe: baseline (pre-intervention), post-intervention