We appreciate the thoughtful critique of our article and would like to respond to the key points raised by Dr Powers. First, we thoroughly agree that adequate training is needed for the electromagnetic placement device (EMPD) to be used successfully. We acknowledge that training on use of the device in our institution was likely inadequate. The question is, “What is adequate?” The successes described in studies cited by Powers were achieved by highly trained individuals. For example, prior to data collection, clinicians in the Koopmann et al study (4 nurse practitioners and 1 physician assistant) had 2 months experience with the device after being trained by a company representative. Perhaps the answer is for institutions wishing to use the EMPD to require similar degrees of training and experience for any clinician before he or she is allowed to use the device. However,...

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