Background: Midline catheters (MCs) are effective and safe devices that provide patients with intravenous access within hospitals and healthcare facilities. This study aimed to investigate emergency medicine physicians' and nurses' clinical skills and confidence in performing midline catheter insertion after a directed simulation course. Methods: This single-center study was conducted in King Faisal Specialist Hospital, Riyadh, Saudi Arabia, among physicians and nurses in the emergency department (ED). The study participants were recruited into a simulation course. The participants' practical skills were assessed for quality improvement, and retrospectively, the difference in pre-post measurement was analyzed, and a cross-sectional part that included a survey of self-rated comfort levels. Results: A total of 51 participants were included in the study. Two-thirds of the participants were physicians (66.7%), worked more than 15 shifts (66.7%), and were Saudi (66.7%). Most worked in governmental hospitals (90.2%), and about half were residents (43.1%). There was a significantly high level of agreement among the participants regarding the advantages of using a midline catheter over central venous catheters (CVC) (p-value <0.001). Participants’ total score regarding the comfort level in placing ultrasound-guided midline catheters and MC insertion procedural skills was significantly better after the training (p-value < 0.001 and <0.001, respectively). In addition, physicians showed significantly higher scores in improving their procedural skills after the training (p-value <0.001). Conclusion: Medline catheters are a valuable device that can improve managing such patients. Therefore, they should have adequate knowledge and acquired practical skills regarding managing MC devices. Physicians could achieve these skills through continuous training and practice.

Keywords: emergency medicine, midline, central lines, simulation.