A Comprehensive Infant Lumber Puncture Novice Procedural Skills Training Package: An INSPIRE Simulation-Based Procedural Skills Training Package

Abstract

Abstract Introduction Infant lumbar puncture (LP) is such a common procedure performed by pediatric house staff that the ACGME states it is a required essential pediatric residency skill. However, as new learners enter a clinical setting, they may be asked to perform an LP without having had any experience on a live infant. The purpose of the materials in this mastery learning module is to provide a comprehensive simulation-based training and assessment package related to the infant LP procedure. Methods This multimodal package will use simulation as a formative assessment medium to review LP training on a simulator prior to performing an LP on a live infant patient. The simulated environment provides a means for trainees to achieve a specific competency level via practice without affecting live patients. In the context of the International Network for Simulation-based Pediatric Innovation, Research, and Education (INSPIRE) phases of training (i.e., learn, see, practice, prove, do, maintain), this simulation addresses the first four of these phases: (1) initial instruction about the procedure, (2) faculty-led demonstration, (3) hands-on simulation-based training, and (4) assessment on a simulator. Materials provided in this resource include an instruction guide, session outline/rating checklist, and a train-the-trainer video. Results Our work has demonstrated that under the right conditions participation in a simulation-based mastery learning with deliberate practice intervention improves infant LP skills. Fifty-one residents reported 32 clinical encounters. Sixteen of 17 subjects (94%) who received this module and performed a clinical infant LP obtained cerebrospinal fluid compared with 7 of 15 subjects (47%) in the control group. Discussion The use of this formative assessment in LP training has potentially broad implications in terms of resident education and improved clinical outcomes. If errors are identified and resolved in a simulated situation, not only will the trainee feel more confident, but also could lead to an improved clinical outcome on a live patient.

Keywords

• Infant
• Simulation
• Educational Measurement
• Learning
• Pediatrics
• Mastery Learning