Interns' success with clinical procedures in infants after simulation training

Area of Science:

• Medical Education
• Pediatrics
• Simulation-Based Training

Background:

• Simulation-based medical education (SBME) is increasingly used for resident training.
• However, evidence on its direct clinical impact remains limited.
• This study addresses the need to evaluate SBME's effectiveness in improving procedural skills.

Purpose of the Study:

• To assess the impact of a single SBME mastery learning session on pediatric interns' clinical procedural success.
• Specifically, to evaluate its effect on infant lumbar puncture (ILP) and child intravenous line (CIV) placement.
• To determine if SBME translates to improved first-attempt success rates in real-world clinical scenarios.

Main Methods:

• A randomized trial involving 200 pediatric interns across 10 academic medical centers.
• Interns received audiovisual expert modeling for ILP and CIV procedures.
• Participants were randomized to SBME mastery learning for either ILP or CIV, with 6 months of reported clinical performance data collection.
• Control groups received standard training for the procedure they were not assigned to SBME.

Main Results:

• No significant difference in ILP success rates between the SBME group (34%) and the control group (34%).
• A modest, non-significant difference in CIV success rates, with the SBME group at 54% compared to 50% for controls.
• A total of 409 procedures were reported by the participating interns.

Conclusions:

• A single SBME mastery learning session was insufficient to significantly improve pediatric interns' procedural success rates.
• The findings suggest that more intensive or repeated simulation training may be necessary to achieve measurable clinical impact.
• Further research is warranted to explore optimal SBME strategies for procedural skill acquisition and retention.