Education, Teaching, and Quality Improvement |

Multiple Modality Simulation Chest Tube Insertion - Is More Learning Always Better? FREE TO VIEW

Soraya Nazerali-Lorenzon, MBBS; Alasdair Nazerali-Maitland, MBBS
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SGUL, Vancouver, BC, Canada

Chest. 2015;148(4_MeetingAbstracts):466A. doi:10.1378/chest.2214935
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SESSION TITLE: Education and Simulation

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Procedural skills training for medical learners can be challenging. Often relegated to occur during postgraduate training, there is often a long lag time between when these skills are taught and when they are called upon in an acute situation. This study attempts to determine if multiple-modality teaching, compared to traditional teaching, improves short and long-term retention of clinical procedures, specifically chest tube insertion. Multiple-modality simulation for procedural skills, need not be more time-consuming than didactic teaching, even though it may cover the subject material in more depth. Initial learning through various modalities - videos, lectures, and interactive sessions - as well as procedural learning itself, should increase students’ retrieval of a particular clinical skill and related pathophysiology.

METHODS: The participants of this study were twenty undergraduate students. The students were randomized into two groups: a control group that was given a 15- minute lecture prior to a 45-minute laboratory demonstration on chest drain insertion. The multiple modality group was given the same 15-minute lecture but in addition to this, they were given additional teaching (designed to maximize Mayer's Cognitive Theory of Multimedia Learning) with an instructional video, a radiology teaching session and further interactive explanation of the pathophysiology. The group then had 30 minutes for the lab-session component. Both groups were administered both an immediate and delayed written assessment to test knowledge retention.

RESULTS: We performed a mixed ANOVA statistical analysis on the groups. The multi-modality group scored higher by approximately 13% on the delayed assessment and 15% lower at immediate assessment. Effect size for the MML learning was 0.298 or ~ 0.3.

CONCLUSIONS: Compared to other simulation-based procedural training systematic reviews, the effect size from this study was smaller. Systematic reviews show improved knowledge, but small/moderate patient benefits. Other studies looked at more common procedural skills (arterial line insertion and central venous catheter insertion) rather than rarer, hard to teach procedures like chest tube insertion.

CLINICAL IMPLICATIONS: The results suggest that multiple-modality teaching is associated with improved knowledge retention with chest tube insertion. In a high-stakes environment such as the ICU - we may have to accept smaller effect sizes when it comes to interventions that involve SBME = something is better than nothing.

DISCLOSURE: The following authors have nothing to disclose: Soraya Nazerali-Lorenzon, Alasdair Nazerali-Maitland

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