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

Abstract:

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. Simulator-trained 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 < 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 < 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.

journal_name

Neurology

journal_title

Neurology

authors

Barsuk JH,Cohen ER,Caprio T,McGaghie WC,Simuni T,Wayne DB

doi

10.1212/WNL.0b013e31825dd39d

subject

Has Abstract

pub_date

2012-07-10 00:00:00

pages

132-7

issue

2

eissn

0028-3878

issn

1526-632X

pii

WNL.0b013e31825dd39d

journal_volume

79

pub_type

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