Development of a Cadaver Laboratory Curriculum for Interventional Spine Procedures for Physical Medicine and Rehabilitation Residents

Berlin, Evan; Khan, Samir; Roehmer, Christian; Sherwood, David R.; Yang, Aaron

doi:10.1097/phm.0000000000001884

Cited by 2 publications

(2 citation statements)

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“…This is a field that requires proficiency in interventional pain procedures. Additionally for PM&R residents, there are ACGME requirements for exposure to interventional pain procedures [1,2,8,[9][10][11][12]. Despite these factors, the ideal method of teaching relevant procedures during PM&R residency training has not been examined closely.…”

Section: Discussionmentioning

confidence: 99%

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Comparing the Effectiveness of Hands-on vs. Observational Training of Residents in Interlaminar Epidural Steroid Injections (ILESI) Using a High-Fidelity Spine Simulator

Sim,

Caparó,

Varrassi

et al. 2023

Cureus

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Introduction The Accreditation Council for Graduate Medical Education (ACGME) requires that residents in the Physical Medicine and Rehabilitation (PM&R) residency observe or perform certain interventional procedures, one of which is an interlaminar epidural steroid injection (ILESI). While the traditional learning model relying heavily on observation is commonplace, it leaves the practice phase of learning to happen on real patients. High-fidelity simulation may be a worthwhile alternative as a training approach to increase physician comfort with the procedure and improve patient safety. Methods Current PM&R residents from two programs between their second and fourth year, inclusively, who lacked prior training experience in ILESI attended one hour of either: (1) an experimental arm of supervised hands-on training on a simulation device or (2) a control arm observing the procedures performed by an attending on the same device. Assignments were made based on resident schedule availability. Pre-training knowledge, training, and post-training knowledge were assessed at the Multidisciplinary Pain Clinic at Montefiore Medical Center. Participants were assessed on their procedural competence using an adapted version of a previously published grading checklist before the session. Participants also evaluated their confidence in performing the procedure prior to and after training. Data was analyzed using the Wilcoxon signed-rank test and the Wilcoxon rank-sum test. SAS Version 9.4 was used for analysis. Results Fifteen residents initially participated, but three residents dropped out at the 15-week follow-up. There was a significant increase in test scores in both arms immediately after the intervention (p=0.008 in control, p=0.016 in the experiment), with greater improvement shown in the hands-on training group (p=0.063). At the 15-week follow-up, there was no significant change in test scores in the control arm (p=0.969) while there was a decrease in the experiment arm (p<0.001). Conclusion Hands-on learning with high-fidelity simulation demonstrated more improvement for short-term motor-skill acquisition, while observational learning with repetition showed more benefits for long-term retention. Optimal procedural training should employ both educational modalities for best short- and long-term results.

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Section: Discussionmentioning

confidence: 99%

“…Pain medicine is recognized as a multidisciplinary specialty and is a popular fellowship choice among Physical Medicine and Rehabilitation (PM&R) residents [ 1 , 2 ]. The Accreditation Council for Graduate Medical Education (ACGME) now requires PM&R residents to observe or perform certain interventional pain procedures [ 1 ].…”

Section: Introductionmentioning

confidence: 99%