A blended approach to invasive bedside procedural instruction

Lenchus, Joshua D.; Issenberg, S. Barry; Murphy, Daniel J.; Everett-Thomas, Ruth; Erben, Laura; Arheart, Kristopher L.; Birnbach, David J.

doi:10.3109/0142159x.2010.509412

Cited by 48 publications

(45 citation statements)

References 15 publications

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“…The perceptions of the survey respondents presented here support these findings. Furthermore, instructional videos have been shown to be effective in teaching clinical skills like bedside procedures or resuscitation algorithms, either provided in classic fashion (Braslow et al, 1997;Carrero et al, 2009;Lenchus et al, 2011;Todd et al, 1998), or interactively embedded in virtual environments (de Vries and Handley, 2007;Lehmann et al, 2015;Ventre et al, 2011). As the participants in this survey underlined, constructive alignment with corresponding teaching activities is the key to successful implementation of learning activities (Biggs and Tang, 2007).…”

Section: Findings and Implications For Educational Practicementioning

confidence: 90%

Student perceptions of a video-based blended learning approach for improving pediatric physical examination skills

Lehmann

Seitz

Bosse

et al. 2016

Annals of Anatomy - Anatomischer Anzeiger

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Section: Findings and Implications For Educational Practicementioning

confidence: 90%

Student perceptions of a video-based blended learning approach for improving pediatric physical examination skills

Lehmann

Seitz

Bosse

et al. 2016

Annals of Anatomy - Anatomischer Anzeiger

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“…27 Our study evaluated the effect of simulation-based education with mastery learning for resident education using rigorous assessment standards. Earlier studies used simulation to evaluate LP skills of internal medicine, 28 emergency medicine, 29 and pediatric residents, 30 but mastery standards were not imposed. Use of the mastery model improves clinical care in advanced cardiac life support 13 and central venous catheter insertion.…”

Section: Resultsmentioning

confidence: 99%

Simulation-based education with mastery learning improves residents' lumbar puncture skills

Barsuk¹,

Cohen²,

Caprio³

et al. 2012

Neurology

231

195

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Objective:To evaluate the effect of simulation-based mastery learning (SBML) on internal medicine residents' lumbar puncture (LP) skills, assess neurology residents' acquired LP skills from traditional clinical education, and compare the results of SBML to traditional clinical education. Methods:This study was a pretest-posttest design with a comparison group. Fifty-eight postgraduate year (PGY) 1 internal medicine residents received an SBML intervention in LP. Residents completed a baseline skill assessment (pretest) using a 21-item LP checklist. After a 3-hour session featuring deliberate practice and feedback, residents completed a posttest and were expected to meet or exceed a minimum passing score (MPS) set by an expert panel. Simulatortrained residents' pretest and posttest scores were compared to assess the impact of the intervention. Thirty-six PGY2, 3, and 4 neurology residents from 3 medical centers completed the same simulated LP assessment without SBML. SBML posttest scores were compared to neurology residents' baseline scores.Results: PGY1 internal medicine residents improved from a mean of 46.3% to 95.7% after SBML (p Ͻ 0.001) and all met the MPS at final posttest. The performance of traditionally trained neurology residents was significantly lower than simulator-trained residents (mean 65.4%, p Ͻ 0.001) and only 6% met the MPS. Conclusions:Residents who completed SBML showed significant improvement in LP procedural skills. Few neurology residents were competent to perform a simulated LP despite clinical experience with the procedure. Neurology Lumbar puncture (LP) is commonly performed by physicians-in-training who often learn vicariously by observing procedures performed by peers. This method leads to uneven skill acquisition and trainee discomfort. 1The American Board of Psychiatry and Neurology, 2 the American Association of Neurology, 3 and the Accreditation Council for Graduate Medical Education 4 have no formal policies to ensure the competence of neurology residents at performing LP. The American Board of Internal Medicine does not require procedural competence in LP, but advises use of simulation training before procedures are performed on patients.5 Despite this, many residents will ultimately practice in a setting where competence in LP is required.Simulation technology increases procedural skill by providing the opportunity for deliberate practice in a safe environment. 6 Researchers at Northwestern University use simulation-based education to train medical residents to mastery skill levels in procedures such as central venous catheter insertion, 7-9 thoracentesis, 10 and advanced cardiac life support. 11 Mastery learning is a stringent form of competency-based education that requires trainees to acquire clinical skill mea-

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“…Five studies were identified [13, 16, 21-23]. All studies provided assessment tools for assessing competence in thoracentesis, though three of them focused on needle thoracentesis [13, 21, 22]. Two studies provided assessment tools for TPCT, but they used the Seldinger technique when inserting the catheter [16, 23].…”

Section: Methodsmentioning

confidence: 99%

Ensuring Basic Competence in Thoracentesis

et al. 2019

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Background: Trocar pigtail catheter thoracentesis (TPCT) is a common procedure often performed by junior physicians. Simulation-based training may effectively train physicians in the procedure prior to performing it on patients. An assessment tool with solid validity evidence is necessary to ensure sufficient procedural competence. Objectives: Our study objectives were (1) to collect evidence of validity for a newly developed pigtail catheter assessment tool (Thoracentesis Assessment Tool [ThorAT]) developed for the evaluation of TPCT performance and (2) to establish a pass/fail score for summative assessment. Methods: We assessed the validity evidence for the ThorAT using the recommended framework for validity by Messick. Thirty-four participants completed two consecutive procedures and their performance was assessed by two blinded, independent raters using the ThorAT. We compared performance scores to test whether the assessment tool was able to discern between the two groups, and a pass/fail score was established. Results: The assessment tool was able to discriminate between the two groups in terms of competence level. Experienced physicians received significantly higher test scores than novices in both the first and second procedure. A pass/fail score of 25.2 points was established, resulting in 4 (17%) passing novices and 1 (9%) failing experienced participant in the first procedure. In the second procedure 9 (39%) novices passed and 2 (18%) experienced participants failed. Conclusions: This study provides a tool for summative assessment of competence in TPCT. Strong validity evidence was gathered from five sources of evidence. A simulation-based training program using the ThorAT could ensure competence before performing thoracentesis on patients.

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A blended approach to invasive bedside procedural instruction

Abstract: A blended, standardized curriculum in invasive bedside procedural instruction can significantly improve performance in participants' medical knowledge and technical skills.

Cited by 48 publications

References 15 publications

Student perceptions of a video-based blended learning approach for improving pediatric physical examination skills

Student perceptions of a video-based blended learning approach for improving pediatric physical examination skills

Simulation-based education with mastery learning improves residents' lumbar puncture skills

Ensuring Basic Competence in Thoracentesis

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