Interns' Success With Clinical Procedures in Infants After Simulation Training
BACKGROUND AND OBJECTIVE: Simulation-based medical education (SBME) is used to teach residents. However, few studies have evaluated its clinical impact. The goal of this study was to evaluate the impact of an SBME session on pediatric interns’ clinical procedural success.
METHODS: This randomized trial was conducted at 10 academic medical centers. Interns were surveyed on infant lumbar puncture (ILP) and child intravenous line placement (CIV) knowledge and watched audiovisual expert modeling of both procedures. Participants were randomized to SBME mastery learning for ILP or CIV and for 6 succeeding months reported clinical performance for both procedures. ILP success was defined as obtaining a sample on the first attempt with <1000 red blood cells per high-power field or fluid described as clear. CIV success was defined as placement of a functioning catheter on the first try. Each group served as the control group for the procedure for which they did not receive the intervention.
RESULTS: Two-hundred interns participated (104 in the ILP group and 96 in the CIV group). Together, they reported 409 procedures. ILP success rates were 34% (31 of 91) for interns who received ILP mastery learning and 34% (25 of 73) for controls (difference: 0.2% [95% confidence interval: –0.1 to 0.1]). The CIV success rate was 54% (62 of 115) for interns who received CIV mastery learning compared with 50% (58 of 115) for controls (difference: 3% [95% confidence interval: –10 to 17]).
CONCLUSIONS: Participation in a single SBME mastery learning session was insufficient to affect pediatric interns’ subsequent procedural success.
- clinical skills
- clinical competence/standards
- competency-based education/methods
- educational measurement/methods
- education/medical/graduate methods
- internship and residency/methods
- practice (psychology)
- prospective studies
- outcome assessment (health care)
- patient simulation
- randomized controlled trial
- spinal puncture
- CIV —
- child intravenous line
- CSF —
- cerebrospinal fluid
- ILP —
- infant lumbar puncture
- IV —
- intravenous line
- LP —
- lumbar puncture
- SBME —
- simulation-based medical education
- Accepted November 19, 2012.
- Copyright © 2013 by the American Academy of Pediatrics