Pre-clerkship procedural training in venipuncture: a prospective cohort study on skills acquisition and durability

Abstract

Background The effectiveness of simulation-based training for skill acquisition is widely recognized. However, the impact of simulation-based procedural training (SBPT) on pre-clerkship medical students and the retention of procedural skills learned through this modality are rarely investigated. Methods A prospective cohort study was conducted among pre-clerkship medical students. Learners underwent SBPT in venipuncture in the skills laboratory. Assessments were conducted at two main points: 1) immediate assessment following the training and 2) delayed assessment one year after training. Learner self-assessments, independent assessor assessments for procedural competency, and communication skills assessments were conducted in both instances. The students were assessed for their competency in performing venipuncture by an independent assessor immediately following the training in the simulated setting and one-year post-training in the clinical setting, using the Integrated Procedural Protocol Instrument (IPPI). The student’s communication skills were assessed by standardized patients (SP) and actual patients in the simulated and clinical settings, respectively, using the Communication Assessment Tool (CAT). Results Fifty-five pre-clerkship medical students were recruited for the study. A significant increase was observed in self-confidence [mean: 2.89 SD (Standard Deviation) (0.69)] and self-perceived competency [mean: 2.42 SD (0.57)] in performing venipuncture, which further improved at the delayed assessment conducted in the clinical setting (p < 0.001). Similarly, the IPPI ratings showed an improvement [immediate assessment: mean: 2.25 SD (1.62); delayed assessment: mean: 2.78 SD (0.53); p < 0.01] in venipuncture skills when assessed by an independent assessor blinded to the study design. A significant difference (p < 0.01) was also observed in doctor-patient communication when evaluated by SPs [mean: 2.49 SD (0.57)] and patients [mean: 3.76 SD (0.74)]. Conclusion Simulation-based venipuncture training enabled students to perform the procedure with confidence and technical accuracy. Improved rating scores received at a one-year interval denote the impact of clinical training on skills acquisition. The durability of skills learned via SBPT needs to be further investigated.

Clinical Simulation for Procedural Expertise: State of Education and Application

“…The study designs adopted for investigating the transfer of skills to clinical practice ranged from randomized control trials (RCT) (Jensen et al, 2014;Kodikara et al, 2023a;Lee et al, 2015) and pre and post-test studies (Barsuk et al, 2016;Cannon et al, 2014;Kodikara et al, 2023b). reported a significant improvement in skill performance.…”

“…This was a blinded RCT that compared simulation-based training with regular institution-specific training. Kodikara et al (2023a) conducted an RCT that compared simulatortrained medical students' performance with bedside venipuncture training. They reported a significant improvement in skills in the simulator-trained group.…”

Early introduction of simulation in the medical curriculum: the MedInTo perspective

“…Skill acquisition : Simulation-based training allows students to practice and refine their technical skills before working with real patients. They can learn and practice procedures such as suturing ( 18 ), phlebotomy ( 19 , 20 ), or catheter insertion ( 21 ) on high-fidelity manikins or virtual reality simulators. This early exposure helps students gain proficiency and confidence in performing these skills ( 22 , 23 ).…”