Improving Trainee Competency and Comfort Level with Needle Driving Using Simulation Training

Chen, Hamilton; Kim, Robert; Perret, Danielle; Hata, Justin; Rinehart, Joseph; Chang, Eric Y.

doi:10.1093/pm/pnv056

Cited by 10 publications

(10 citation statements)

References 13 publications

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“…The authors thus concluded that a joint injection simulator appears to be an appropriate teaching aid to allow repeated training with the aim of acquiring the technical skills and con dence in the abilities in performing such procedures. This assertion substantiates the ndings of Chen et al [38] that have demonstrated the e ciency of simulation training in improving both the subjective comfort level and objective measurements of the skills required in performing injections among anaesthetic procedures. Meanwhile, the results from the studies carried out by Berman et al [32] and Gormley et al [22] suggest than practicing on a real body or human corpse provide slightly better learning curves than other designs of training courses, while the differences have not been found as statistically signi cant in the article by Fox et al [34] when comparing the cadaver group to the synthetic model one.…”

Section: Discussionsupporting

confidence: 89%

How to conduct post-graduate training of general practitioners in performing articular or abarticular corticosteroid injections in the knee and shoulder joints? Analysis of the current training courses, literature review and implementation of a new training program

Vrignaud

Dernis

2020

Preprint

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Background: While several studies have shown the usefulness and effectiveness of articular and abarticular corticosteroid injections performed by general practitioners, the main limitation that has been identified in expanding the use of these acts in everyday practice lies in a lack of training. Thus, this study aimed to determine the best settings for training courses concerning this subject.Methods: Our study was composed of two parts: the first one consisted in a survey concerning the improvements induced by training courses in the context of continuing medical education on the participants’ skills and degree of confidence, the second part was a review of the published literature about this topic.Results: As expected, every training program analysed through our survey generated improvements in the participants’ confidence in performing articular or abarticular injections. Furthermore, these findings are reflected in an increase in the proportion of such skills that the trainees complete by themselves. These results were reinforced by similar findings raised by the literature review. Moreover, it highlighted that hands-on training courses seemed to be the most efficient and that the use of synthetic models appeared to be a suitable alternative to human bodies or corpses, surrounded by less ethical and logistic concerns.Conclusion: This study supports the expansion of training courses for general practitioners on articular and abarticular injections. It also suggests that they should be based on a hands-on training design, possibly with the use of manikins.

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Section: Discussionsupporting

confidence: 89%

How to conduct post-graduate training of general practitioners in performing articular or abarticular corticosteroid injections in the knee and shoulder joints? Analysis of the current training courses, literature review and implementation of a new training program

Vrignaud

Dernis

2020

Preprint

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“…This study is consistent with prior research that demonstrates utility of simulation training in PM&R education. Simulation techniques have been applied broadly within PM&R education, with studies showing successful use in the instruction of musculoskeletal ultrasound, needle driving for interventional procedures, pressure ulcer and patient safety education, botulinum toxin injections and peripheral motor blocks, among others . Pilot studies have reported the feasibility of using simulation‐based education for teaching autonomic dysreflexia, a common urgent medical complication that occurs in patients with complete spinal cord injuries at T6 or above, to PGY‐2 PM&R residents .…”

Section: Discussionmentioning

confidence: 99%

“…Simulation training aims to mimic real‐life experience and is consistently associated with positive effects on knowledge, skills, and patient‐related outcomes . There is good evidence to support the use of simulation‐based methods in PM&R education . However, little evidence exists on the use of simulation technology for the instruction of urgent medical complications to PM&R residents .…”

Section: Introductionmentioning

confidence: 99%

Simulation‐Based Education for Urgent Medical Complications Common to the Rehabilitation Setting: An Educational Program for Physical Medicine and Rehabilitation Residents

Malmut

Rho

2019

PM&R

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Background: Simulation technology is being increasingly adopted into medical education and is consistently associated with positive effects on knowledge, skills, and patient-related outcomes. There is little evidence on the use of simulation technology for the instruction of urgent medical complications to physical medicine and rehabilitation (PM&R) residents. Objective: To examine whether a simulation-based educational program can improve PM&R resident confidence and knowledge in the assessment and management of urgent medical complications. Design: Pretest-posttest design. Setting: Academic freestanding acute inpatient rehabilitation hospital. Participants: Twelve Post-Graduate Year (PGY)-2 PM&R residents at the start of the academic year. Methods: Residents completed an integrated didactic and simulation-based curriculum on the assessment and management of five urgent medical complications: seizures, agitation, ventricular assist device (VAD)-associated complications, sympathetic storming, and autonomic dysreflexia. Simulations were conducted using a high-fidelity manikin. Main Outcome Measurements: Surveys and knowledge assessments were completed at baseline and immediately following training. Survey responses were recorded on a Likert scale ranging from 1 = strongly disagree to 5 = strongly agree. Multiple-choice knowledge assessments were scored out of 100%. Within-group differences from baseline to postintervention were analyzed. Results: There was a positive correlation between baseline experience and baseline confidence scores (r = 0.877). Improved confidence was demonstrated in the assessment and management of all five topics (P < .05). Knowledge assessment scores significantly improved from 57.8% (95% confidence interval [CI] 50.6% to 65.4%) at baseline to 85.0% (95% CI 81.6% to 88.4%) following the course (P < .001). The education program was rated highly by both learners (mean satisfaction score, Likert score [LS] = 4.6) and instructors (mean satisfaction score, LS = 4.5). Conclusions: Application of a simulation-based educational model to the instruction of urgent medical complications to PM&R residents resulted in increased knowledge with added benefits of confidence building and high levels of enjoyment. Level of Evidence: II

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“…Analysis was generally appropriate for study design, except one study which gave no quantitative analysis of the data obtained [34]. From a complexity viewpoint, 7 studies gave only descriptive analysis [23,27,30,[33][34][35][36], whereas the other 7 studies gave a more complex and in-depth analysis of their data [24][25][26]28,29,31,32]. MERSQI scores were generally closely matched to the outcomes which had been drawn out of the studies as a separate data-point during data collection.…”

Section: Quality Of Studiesmentioning

confidence: 99%

“…Simulation, a simulator device, or a phantom anatomy (e.g. spinal-epidural manikin [37]) was the main educational intervention for 8 of the 14 studies [24,26,28,30,[33][34][35]. 226 trainees were included in the studies examining simulation.…”

Section: Simulationmentioning

confidence: 99%

Teaching trainees neuraxial anaesthesia. What is the evidence?

Garwood¹

2020

JAICM

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Central neuraxial blockade (CNB) describes a range of procedures that are used to provide perioperative anaesthesia and/or analgesia for patients undergoing a wide variety of surgical procedures. It represents a significant proportion of workload for both anaesthetists and those in training. The most effective method(s) for teaching and training novice anaesthetists to perform CNB remains unclear. This paper presents a systematic review of the literature and recommendations for educational techniques in clinical practice. A systematic review of the literature was undertaken. Medline, PubMed, ERIC, Cochrane library, PsycInfo, and HMIC databases were searched from inception to June 2018 for studies involving CNB skills teaching. Searches were limited to the English language and full text availability. Studies were analysed and quality scored using the MERSQI scale [1]. Outcomes for each intervention were also plotted against a modified Kirkpatrick's model. 14 papers (n=14) were included in the review. The mean MERSQI score was 12.43 (range 8.5-16). 9 of the studies had a MERSQI score above 12. The studies reported a range of educational and clinical outcomes; the modal outcome was improved knowledge and/or skills (2b). Interventions identified were the use of Ultrasound (2 studies), Educational multimedia (4 studies), Simulation (8 studies), Feedback delivery (1 study), Mental imagery (1 study), and Learning curves (1 study). The use of ultrasound imaging and simulated clinical practice demonstrated the most significant effects on trainee knowledge and skill; however, studies were generally small, and as both methods and outcomes showed marked heterogeneity, large scale, high quality studies would be beneficial to this important aspect of anaesthetic practice.

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Improving Trainee Competency and Comfort Level with Needle Driving Using Simulation Training

Cited by 10 publications

References 13 publications

How to conduct post-graduate training of general practitioners in performing articular or abarticular corticosteroid injections in the knee and shoulder joints? Analysis of the current training courses, literature review and implementation of a new training program

How to conduct post-graduate training of general practitioners in performing articular or abarticular corticosteroid injections in the knee and shoulder joints? Analysis of the current training courses, literature review and implementation of a new training program

Simulation‐Based Education for Urgent Medical Complications Common to the Rehabilitation Setting: An Educational Program for Physical Medicine and Rehabilitation Residents

Teaching trainees neuraxial anaesthesia. What is the evidence?

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