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. 2012 Mar;4(1):23-7.
doi: 10.4300/JGME-D-11-00161.1.

Simulation-based education with mastery learning improves paracentesis skills

Jeffrey H Barsuk, Elaine R Cohen, John A Vozenilek, Lanty M O'Connor, William C McGaghie, Diane B Wayne

Simulation-based education with mastery learning improves paracentesis skills

Jeffrey H Barsuk et al. J Grad Med Educ. 2012 Mar.

Abstract

Background: Paracentesis is a commonly performed bedside procedure that has the potential for serious complications. Therefore, simulation-based education for paracentesis is valuable for clinicians.

Objective: To assess internal medicine residents' procedural skills before and after simulation-based mastery learning on a paracentesis simulator.

Methods: A team with expertise in simulation and procedural skills developed and created a high fidelity, ultrasound-compatible paracentesis simulator. Fifty-eight first-year internal medicine residents completed a mastery learning-based intervention using the paracentesis simulator. Residents underwent baseline skill assessment (pretest) using a 25-item checklist. Residents completed a posttest after a 3-hour education session featuring a demonstration of the procedure, deliberate practice, ultrasound training, and feedback. All residents were expected to meet or exceed a minimum passing score (MPS) at posttest, the key feature of mastery learning. We compared pretest and posttest checklist scores to evaluate the effect of the educational intervention. Residents rated the training sessions.

Results: Residents' paracentesis skills improved from an average pretest score of 33.0% (SD = 15.2%) to 92.7% (SD = 5.4%) at posttest (P < .001). After the training intervention, all residents met or exceeded the MPS. The training sessions and realism of the simulation were rated highly by learners.

Conclusion: This study demonstrates the ability of a paracentesis simulator to significantly improve procedural competence.

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Figures

FIGURE 1
FIGURE 1
Ultrasound Image of the Paracentesis Simulator Demonstrating Anatomically Correct Appearance of Internal Organs
FIGURE 2
FIGURE 2
Paracentesis Procedure Using the Simulator
FIGURE 3
FIGURE 3
Pretest and Posttest Paracentesis Skill Scores on the 25-Item Checklist SEM  =  standard error of measurement; MPS  =  minimum passing score
See this image and copyright information in PMC

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