Interns' Success With Clinical Procedures in Infants After Simulation Training

Abstract

Participation in a single SBME mastery learning session was insufficient to affect pediatric interns' subsequent procedural success.

Impact of Just-in-Time and Just-in-Place Simulation on Intern Success With Infant Lumbar Puncture

“…[3][4][5][6][7][8][9][10] However, few multicenter data exist characterizing the impact of simulation training at the patient level, especially in pediatrics. [11][12][13][14][15] Our previous single-center study demonstrated that using simulation to train residents to a minimal standard could improve their clinical success with infant LP. 16,17 However, similar educational programs tested in other environments have not shown any improvements in clinical LP performance.…”

“…18,19 Furthermore, when we repeated our intervention in a multicenter setting, we failed to replicate our previous success. 11 In the current study conducted within International Network of SimulationBased Pediatric Innovation, Research, and Education (INSPIRE), we aimed to improve and standardize implementation of the intervention across multiple, varied settings. 20 This work was accomplished through monthly meetings among site directors to review barriers and facilitators and an annual inperson meeting where feasible enhancements for the coming year were discussed and decided.…”

“…Trained facilitators guided participants in 1-on-1 repetitive practice sessions until participants achieved a predefined level of mastery of the procedure on an infant LP simulator (BabyStap; Laerdal Medical, Stockholm, Sweden). 11,16,17 Mastery was defined as independent performance of all items on a subcomponent skills checklist (Supplemental Fig 2). Development and validation of the skill checklist has been previously described.…”

“…Development and validation of the skill checklist has been previously described. 11,16,28,29 Sessions ranged from ∼20 to 60 minutes. For cohort B2, this session differed slightly in that facilitator expert modeling of the procedure was added to the start of the session.…”

“…We therefore decided a priori that when cell count was not available, the LP would be coded as a success if, and only if, interns described first-attempt CSF as clear. Given the established success rate of 34% in our previous study (cohort A), 11 we needed 182 LPs in the intervention cohort to detect a 10% absolute difference in success rates with 80% power at the .05 significance level. Considering dropouts, missing values, and other missing data, we planned to enroll $250 interns per cohort.…”