# CanSim: A novel simulator for training cannulation skills in dialysis care

> **NIH NIH K01** · CLEMSON UNIVERSITY · 2020 · $125,288

## Abstract

This K01 details a career development training and research plan for Dr. Joseph Singapogu, Research
Assistant Professor at Clemson University. Dr. Singapogu has a background in using simulation technology for
training clinical skills. The research plan of this proposal focuses on the development of a novel, state-of-the-
art training simulator for training cannulation skills of dialysis clinic personnel (Patient Care Technicians and
nurses). Dr. Singapogu's mentoring team consists of key leaders in nephrology, vascular access, cannulation
training, computer scientists, bioengineers and statisticians. The goals of his training plan are: (1) Coursework
in Clinical and Translational Research methods, (2) Practical clinical exposure along the continuum of care in
ESRD, (3) Biologically-based understanding of processes that affect vascular mechanics, and (4)
Computational and virtual modeling with cyberinfrastructure training.
 The survival of a patient with ESRD depends on a functioning vascular access through which blood is
drawn for dialysis. Of the currently available three options for vascular accesses, the arteriovenous fistula
(AVF) is the most preferred due to better patient outcomes. The Tunneled Dialysis Catheter (TDC) is the least
preferred vascular access due to increased likelihood of infections, complications and hospitalizations. Due to
the overwhelming evidence for the benefits of AVFs, the national Fistula First Breakthrough Initiative was
launched in 2004 with the goal of achieving a 66% fistula rate nationwide. As a result, the rates of incident and
prevalent AVFs have continued to rise.
 Though the widespread creation and use of AVFs are a welcome development, there has arisen the
serious challenge of AVF-related complications as a consequence. AVFs need to remain patent and usable for
hemodialysis, a condition fraught with vascular complications including non-maturation, thrombosis, stenosis
and hematoma formation. Thus, vascular access complications are called the “Achilles heel” of hemodialysis,
contributing to about 20% of hospitalizations in ESRD patients. AVF non-use due to any of these conditions, in
turn, results in TDC use, which only greatly increases the risk of infection and death. Consequently, the ESRD
medical community has collectively called for reduced TDC usage and the need to facilitate prolonged AVF
patency.
 One of the main contributing factors related to AVF complications, prolonged TDC use and lack of AVF
use is the lack of cannulation skills. 99% of patients on hemodialysis receive dialysis treatments multiple times
a week from Patient Care Technicians (PCTs) and nurses. Through these clinical personnel spend a significant
time delivering dialysis treatments, there is currently no standard to test or train PCTs and nurses to
safely and effectively cannulate AVFs. In this project, I propose to develop and test a novel simulator for
teaching cannulation skills (called the “CanSim”) to PCTs and nurses. I will c...

## Key facts

- **NIH application ID:** 9963226
- **Project number:** 5K01DK111767-05
- **Recipient organization:** CLEMSON UNIVERSITY
- **Principal Investigator:** Ravikiran Singapogu
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $125,288
- **Award type:** 5
- **Project period:** 2016-09-15 → 2021-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9963226

## Citation

> US National Institutes of Health, RePORTER application 9963226, CanSim: A novel simulator for training cannulation skills in dialysis care (5K01DK111767-05). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/9963226. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*