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A Comprehensive Workshop Using Simulation to Train Internal Medicine Residents in Bedside Procedures Performed by Internists FREE TO VIEW

Ryan Martin*, MD; David Gannon, MD; Jakeb Riggle, BS; Carol Lomneth, PhD; Troy Plumb, MD; James Sullivan, MD; Jennifer Fillaus, DO; M Susan Hallbeck, PhD
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University of Nebraska Medical Center, Omaha, NE

Chest. 2012;142(4_MeetingAbstracts):545A. doi:10.1378/chest.1390093
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SESSION TYPE: Outcomes/Quality Control Posters

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: Skills training in a simulation environment has been shown to improve the skill and confidence that residents have in performing procedures. Most studies of the value of simulation-based procedure training involve a single procedure. We designed, carried out, and evaluated a comprehensive workshop to train internal medicine residents in a simulation environment on bedside procedures commonly performed by internists.

METHODS: First-year internal medicine residents in the categorical, primary care, and internal medicine-pediatrics tracks at the University of Nebraska Medical Center underwent simulation training during a two-part workshop that included the following procedures: thoracentesis using ultrasound guidance, paracentesis using ultrasound guidance, lumbar puncture, sterile draping and suturing of a central venous catheter (CVC), internal jugular CVC insertion using ultrasound guidance, subclavian CVC insertion, and femoral CVC insertion using ultrasound guidance. All training was carried out using simulation mannequins, except the training on femoral CVC insertion which was carried out using lightly embalmed cadavers. Residents completed surveys consisting of 5-point Likert scales before and after training.

RESULTS: Residents’ confidence in their abilities to set up the procedure kit, use ultrasound to guide the procedure, and successfully complete the procedure were significantly greater on the post-training surveys compared to pre-training surveys for all training stations in the workshop. An unexpected finding was that residents’ perception of the value of simulation training showed a trend toward being increased after they had experienced simulation training.

CONCLUSIONS: We carried out a comprehensive workshop to train internal medicine residents to perform multiple bedside procedures. After the training, residents reported increased confidence in their ability to organize equipment, use ultrasound during the procedure, and complete the procedure successfully for all procedures in which they were trained. We also found a trend toward residents having an increased appreciation for the value of training in a simulation environment after experiencing simulation training.

CLINICAL IMPLICATIONS: A comprehensive procedure workshop using simulation can increase learner confidence as residents begin to learn how to do bedside procedures.

DISCLOSURE: The following authors have nothing to disclose: Ryan Martin, David Gannon, Jakeb Riggle, Carol Lomneth, Troy Plumb, James Sullivan, Jennifer Fillaus, M Susan Hallbeck

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University of Nebraska Medical Center, Omaha, NE




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