Intraosseous access can be taught to medical students using the four-step approach

Afzali, Monika; Kvisselgaard, Ask D.; Lyngeraa, Tobias Stenbjerg; Viggers, Sandra

doi:10.1186/s12909-017-0882-7

Cited by 8 publications

(11 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As with regard to the success rate of the performances considered in the study, the data show statistically signi cant results between students and nurses, but the observed di erence on success rate and error placement is lower than the expected 7,8,9 . This result may be due to the facility of the technique execution and the ease of use of the EZ-IO device used in this study, as supported by the literature 2,19,20 . Even if the sample had lower success rates than other authors, average insertion times seem to be shorter 15,21,22 .…”

Section: Discussionsupporting

confidence: 70%

“…According to the literature, a signi cant number of participants have limited experience and knowledge about IO access and this surely a ects its frequency and use, even in the context of appropriate performance 19 . The perceived di culty about the selection of the reference point, the correct needle placement and the subsequent medication is comparable with the literature; thus more attention on these factors during the training is advisable 15 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Intraosseous access: a simulation analysis

Miki¹,

Rinaldi²,

Giorgio³

et al. 2023

View full text Add to dashboard Cite

Introduction: The priority in critical patients is to find a vascular access. The most used access is the peripheral venous access, but when its placement goes wrong or is difficult, the literature recommends implementing intraosseous (IO) access as a valid alternative. The IO access is a rapid, reliable and a relatively safe method. Despite the recommendations, IO access is rarely used when indicated. The objective of this study was to evaluate the critical points of the IO procedure, positioning time, percentage of success at first attempt in simulation and, in according to obtained outcomes, checking of the procedure inclusion within university programs. Material and methods: A sample of 84 people was recruited; among them 44 were students attending the third year of the Degree Course in Nursing of the University of Turin (site of Asti) and 40 nurses from intensive care unit and emergency ward of Cardinal Massaia Hospital of Asti. A short lesson about IO access took place, followed by a practical demonstration. Subsequently, the IO access insertion performance and difficulty perceived were evaluated. Statistical analysis was performed by means of inferential and descriptive bivariate analysis. Results: The average value of the performance “IO access insertion” was 12.2±1.22 (average of the assigned points by the sample). The average difficulty perceived was 1.65±0.42, and mainly found in “selection of the correct point of insertion” with a value of 2.64±0.87, “needle placement” with a medium value of 2.35±1.02 and “medication” with a value of 2.0±0.94. Average execution time of IO access and needle placement were 73.3 and 36.1 seconds, respectively. Finally, the success rate at the first attempt was 72.6%. Discussion: The IO access execution time, for the complete procedure and for the needle placement only, was below the 3 minutes. Among nurses and students, data of the success of the procedure show significant results, but the difference between subgroups is still lower than expected considering the results of the statistical analysis about procedure success, execution time and error percentage. Most critical issues were found in the retrieval of area of insertion, whereas the most difficulty perceived was on reference point selection, correct needle placement and medication. The procedure may become subject of teaching in the University. Conclusion: The study evaluates the possibility of the IO access use, by underlining how is necessary a training about it. The principal reason of ‘non-use’ of this device is the disinformation of healthcare professionals. The results seem to underline the importance of a possible integration of IO access technique in the programs of Degree Nursing Course and post-base course. This may improve nursing in emergency situations and therefore, patient outcomes. When healthcare staff training is possible, periodical refresh is particularly recommended in order to maintain the acquired skills.

show abstract

Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Intraosseous access: a simulation analysis

Miki¹,

Rinaldi²,

Giorgio³

et al. 2023

View full text Add to dashboard Cite

show abstract

“…14 Additionally, the feasibility and practicability of this model have been validated in the teaching of different skills. 15–17 In other, simpler model-trained procedures such as the external chest compression Peyton method did not seem to be beneficial. 18,19…”

Section: Introductionmentioning

confidence: 97%

The Role of Deconstructive Teaching in the Training of Laparoscopy

Balafoutas

Joukhadar

Kiesel

et al. 2019

JSLS

View full text Add to dashboard Cite

Background and Objectives: Skills-lab training is crucial for the development of advanced laparoscopic skills. In this study, we examined whether a systematic deconstructive and comprehensive tutoring approach improves training results in laparoscopic suturing and intracorporeal knot tying. Methods: Sixteen residents in obstetrics and gynecology participating in structured skills-lab laparoscopy training were randomized in 2 equal-sized groups receiving 1-on-1 tutoring either in the traditional method or according to the Peyton's 4-step approach, involving an additional training step, with the trainees instructing the tutor to perform the exercises. A validated assessment tool (revised Objective Structured Assessment of Technical Skills) and the number of completed square knots per training session and the mean time per knot were used to assess the efficacy of training in both groups. Results: Trainees in Peyton's group achieved significantly higher revised Objective Structured Assessment of Technical Skills scores (28.6 vs 23.9 points; P = .05) and were able to improve their scores during autonomous training repetitions, in contrast to the trainees not in Peyton's group (difference +4.75 vs –4.29 points, P = .02). Additionally, they seemed to be able to perform a greater number of successful knots during the exercise and to complete each knot quicker with the later observations failing to reach the threshold of statistical significance. Conclusion: Peyton's 4-step approach seemed to be superior for teaching laparoscopic skills to obstetrics and gynecology residents in the skills-lab setting and can be therefore proposed for training curricula.

show abstract

“…In general, the Peyton method is well suited for teaching even complex skills, as has been shown in several studies [24,25,27]. Compared to other imaging techniques based on standardized images, ultrasound findings depend on the technical skills of the examiner.…”

Section: The Methods Is Not Ideal For Teaching the Course Contentmentioning

confidence: 99%

Undergraduate Curricular Training in Musculoskeletal Ultrasound by Student Teachers: The Impact of Peytonʼs Four-Step Approach

Gradl-Dietsch¹,

Hitpaß

Gueorguiev

et al. 2018

Z Orthop Unfall

View full text Add to dashboard Cite

Zusammenfassung Hintergrund Der Ultraschall der Bewegungsorgane findet breite Anwendung in der Diagnostik von Pathologien und in der Intervention. Die frühe Implementierung von Ultraschallkursen in das medizinische Curriculum könnte zu einer besseren medizinischen Versorgung führen. Die Sonografie wird häufig mit der „See one, do one“-Methode angeleitet, obgleich unklar bleibt, ob dies die beste Herangehensweise darstellt. Die vorliegende Arbeit untersucht, ob die 4-Schritt-Methode nach Peyton konventionellen Lehrstrategien in der Vermittlung des muskuloskelettalen Ultraschalls durch Peer-Dozierende überlegen ist und wie die Technik von den Studierenden beurteilt wird. Material und Methoden Insgesamt absolvierten 491 Studierende (342 Frauen, 149 Männer) eine curriculare Lehrveranstaltung zum Thema Gelenksonografie. Ausgesuchte Schnitte an Knie und Schulter wurden randomisiert auf konventionelle Weise und nach der 4-Schritt-Methode nach Peyton von speziell geschulten Peer-Dozierenden unterrichtet. Die erlernten Fertigkeiten wurden in einer Objective structured practical Examination (OSPE) geprüft. Beurteilt wurde die benötigte Zeit zum Einstellen der Schnitte, die technische Durchführung und die Bildqualität. Die Studierenden wurden gebeten, den Kurs zu evaluieren. Ergebnisse Bezüglich der praktischen Ausführung und der Qualität der Schnittbilder zeigten sich die beiden Lehrmethoden sowohl für die Schulter- als auch für die Kniegelenksonografie als ebenbürtig. Der Vergleich der Lehrinhalte (Knie vs. Schulter) hatte signifikante Differenzen bezüglich der Bildauswertung (Knie 6,5 ± 1,7 Punkte, Schulter 6,0 ± 1,9 Punkte; p < 0,001), der benötigten Zeit (Knie 36 ± 21 s, Schulter 43 ± 20 s; p < 0,001) und des Erreichens der Bestehensgrenze von 60% (Knie: 73% der Studierenden, Schulter: 61% der Studierenden; p < 0,001) gezeigt. Unabhängig von der Lehrmethode bewerteten die Studierenden die Peer-Dozierenden als kompetent und befanden die Inhalte als adäquat für den Unterricht durch Gleichgestellte. Über 70% der Studierenden hatten Spaß an den Kursstunden. Sowohl der Knie- als auch der Schultergelenkkurs wurden im Mittel mit über 8 von 10 Punkten bewertet. Schlussfolgerung Für die Vermittlung von Grundkenntnissen der Gelenksonografie sind die konventionelle Methode und die 4-Schritt-Methode nach Peyton ebenbürtig. Die Durchführung des Unterrichts durch Peer-Dozierende wird positiv bewertet und findet hohe Akzeptanz bei den Studierenden. Unterschieden im Schwierigkeitsgrad und der Komplexität der Lehrinhalte ist in künftigen Kursen Rechnung zu tragen.

show abstract

Intraosseous access can be taught to medical students using the four-step approach

Cited by 8 publications

References 32 publications

Intraosseous access: a simulation analysis

Intraosseous access: a simulation analysis

The Role of Deconstructive Teaching in the Training of Laparoscopy

Undergraduate Curricular Training in Musculoskeletal Ultrasound by Student Teachers: The Impact of Peytonʼs Four-Step Approach

Contact Info

Product

Resources

About