Comparison of multimodal active learning and single-modality procedural simulation for central venous catheter insertion for incoming residents in anesthesiology: a prospective and randomized study

• DOI: 10.1186/s12909-022-03437-0
• Publication Date: 2022-05-11T00:02:29Z
• Authors: Antonia Blanie; Cécile Shoaleh; Fabien Marquion; Dan Benhamou
• Keywords: Catheterization, Central Venous; Active learning; Peyton’s 4-step; Kirkpatrick; 03 medical and health sciences; 0302 clinical medicine; Anesthesiology; Central Venous Catheters; Humans; Prospective Studies; LC8-6691; Research; 4. Education; R; Internship and Residency; Problem-Based Learning; Special aspects of education; 3. Good health; [SDV] Life Sciences [q-bio]; Flipped classroom; Medicine; Clinical Competence; Central venous catheter; Simulation

Abstract Background Active learning methods, including low-fidelity simulation, are useful but the incremental learning effect of each method is however limited. We designed this study to assess if combining flipped classroom and the modified Peyton’s « 4-steps» method during procedural simulation (intervention group [IG]) would provide better learning results than simulation alone (control group [CG]) in the context of central venous catheter insertion training.

Methods This prospective, single-center, and randomized study took place in 2017 in a single simulation center. All first year Anesthesiology residents of Ile de France area at the start of their residency were randomly included either in the IG or CG during a seminar aimed at providing initial procedural skills with low-fidelity simulation. A composite learning score which included knowledge MCQ and a questionnaire assessing satisfaction and value of the training session was recorded after training (primary outcome, /100). A randomized sub-group of learners of each group were video-recorded during central venous catheter insertion at the end of training and their skills were evaluated with validated tools, including a specific checklist and a global rating scale (GRS).

Results Among 89 anesthesiology residents, 48 and 41 learners were randomized in the intervention and control groups respectively. Of the IG residents, 40/48 (83%) had read the learning material prior to the session. There was no significant difference regarding the composite outcome ([IG]= 81.1 vs [CG] = 80.5 /100 (p = 0.68)). Results of the post-session MCQ knowledge questionnaire were also non-significantly different. Residents were similarly satisfied and described a significant improvement of their knowledge and skills after training. Learners highly valued the training session as a mean to improve their future practice. No significant differences regarding checklist and GRS scores were observed.

Conclusions A multimodal active learning strategy of procedural learning did not provide better learning outcomes when compared to a traditional simulation method. In both groups, satisfaction was high and perception of the acquired theoretical and practical knowledge was improved after training.