Lumbar puncture simulation in pediatric residency training: improving procedural competence and decreasing anxiety

• DOI: 10.1186/s12909-016-0722-1
• Publication Date: 2016-08-08T08:41:10Z
• Authors: Hugh J. McMillan; Hilary Writer; Katherine A. Moreau; Kaylee Eady; Erick Sell; Anna-Theresa Lobos; Jenny Grabowski; Asif Doja
• Keywords: State-Trait Anxiety Inventory

Pediatric residents must become proficient with performing a lumbar puncture (LP) during training. Residents have traditionally acquired LP skills by observing the procedure performed more senior resident or staff physician and then attempting themselves. This process can result in variable procedural skill acquisition trainee discomfort. study assessed changes self-reported anxiety when were provided an opportunity to participate interactive training session practice LPs using simulator.All pediatric at our institution invited participate. asked report their post-graduate year (PGY), prior attempts scores as measured standardized State-Trait Anxiety Inventory - State Scale (STAI-S) completing observed pre-test infant-sized simulator. Staff physicians scored each resident's previously published 21-point scoring system. participated lecture on technique given for staff-supervised, small group simulator-based within 1 month of pre-test. Repeat post-test was 4 months.Of who completed (N = 20), 16/20 (80 %) both post-test. Their PGY level was: PGY1 (38 %), PGY2 (25 PGY3 PGY4 (12 %). Procedural improved 15/16 (paired t-test; p < 0.001), driven significant improvement (P 0.015) (p 0.003) but not PGY4. Overall higher baseline than post testing (mean ± SD; 44.8 12.1 vs 39.7 9.4; NS) however only experienced reduction t-test, 0.04).LP simulation combined may be useful tool improving competence decreasing levels, particularly among those earlier stage residency