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Unexpected Collateral Effects of Simulation-Based Medical Education.
MedLine Citation:
PMID:  22030762     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: Internal medicine residents who complete simulation-based education (SBE) in central venous catheter (CVC) insertion acquire improved skills that yield better patient care outcomes. The collateral effects of SBE on the skills of residents who have not yet experienced SBE are unknown. METHOD: In this retrospective, observational study, the authors used a checklist to test the internal jugular and subclavian CVC insertion skills of 102 Northwestern University second- and third-year internal medicine residents before they received simulation training. The authors compared, across consecutive academic years (2007-2008, 2008-2009, 2009-2010), mean pretraining scores and the percent of trainees who met or surpassed a minimum passing score (MPS). RESULTS: Mean internal jugular pretest scores improved from 46.7% (standard deviation = 20.8%) in 2007 to 55.7% (±22.5%) in 2008 and 70.8% (±22.4%) in 2009 (P < .001). Mean subclavian pretest scores changed from 48.3% (±25.5%) in 2007 to 45.6% (±31.0%) in 2008 and 63.6% (±27.3%) in 2009 (P = .04). The percentage of residents who met or surpassed the MPS before training for internal jugular insertion was 7% in 2007, 16% in 2008, and 38% in 2009 (P = .004); for subclavian insertion, the percentage was 11% in 2007, 19% in 2008, and 38% in 2009 (P = .028). CONCLUSIONS: SBE for senior residents had an effect on junior trainees, as evidenced by pretraining CVC insertion skill improvement across three consecutive years. SBE for a targeted group of residents has implications for skill acquisition among other trainees.
Authors:
Jeffrey H Barsuk; Elaine R Cohen; Joe Feinglass; William C McGaghie; Diane B Wayne
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-25
Journal Detail:
Title:  Academic medicine : journal of the Association of American Medical Colleges     Volume:  -     ISSN:  1938-808X     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8904605     Medline TA:  Acad Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Dr. Barsuk is associate professor of medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Ms. Cohen is research assistant, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Dr. Feinglass is research professor of medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Dr. McGaghie is Jacob R. Suker, MD, Professor of Medical Education, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Dr. Wayne is vice chair of education, internal medicine program director, and professor of medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
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