Unexpected collateral effects of simulation-based medical education

Area of Science:

• Medical Education
• Surgical Skills Training
• Patient Safety

Background:

• Simulation-based education (SBE) is recognized for enhancing central venous catheter (CVC) insertion skills.
• The impact of SBE on trainees who have not directly participated in the training remains unclear.

Purpose of the Study:

• To investigate the collateral effects of SBE on the CVC insertion skills of internal medicine residents prior to their own simulation training.
• To assess skill improvement in junior residents due to SBE implemented for senior residents.

Main Methods:

• A retrospective observational study analyzed CVC insertion skills of 102 residents using a checklist.
• Pretraining skills for internal jugular and subclavian CVC insertion were assessed across three academic years (2007-2010).
• Mean scores and the percentage of residents meeting a minimum passing score (MPS) were compared annually.

Main Results:

• Mean internal jugular CVC insertion scores significantly improved from 46.7% in 2007 to 70.8% in 2009 (P < .001).
• Mean subclavian CVC insertion scores improved from 48.3% in 2007 to 63.6% in 2009 (P = .04).
• The proportion of residents meeting the MPS for internal jugular and subclavian CVC insertion increased significantly by 2009.

Conclusions:

• Simulation-based education for senior residents positively influenced the pretraining CVC insertion skills of junior residents.
• These findings indicate that SBE for a specific group can lead to broader skill acquisition among trainees.
• Implementing SBE has implications for improving overall CVC insertion competency within residency programs.