Educational effect of intraosseous access for medical students

The purpose of this study was to determine the educational effects of intraosseous (IO) vascular access for medical students and analyze the possibility of including IO access in medical education.

A before-and-after study was conducted in a course with 50 participating medical students. The course comprised a 1-hour didactic lecture and a 1-hour hands-on session with a battery-operated EZ-IO device (Vidacare Corp.) and artificial tibia. After the course, the participant skills were tested (final success rate, mean procedural time, and detailed skills) with regard to IO access. Before and after the course, the knowledge, possibility of clinical use, and adequacy of medical education on IO access were examined in a structured questionnaire.

The final success rate of insertion was 88% (n=44), and the mean procedural time for the first trial was 78.1±20.6 seconds. "Combination needle with drill" and "proper angle during insertion" were the procedures that were performed the best, and "dressing on insertion site" was the worst-performed procedure. "Proper location of landmarks" was the only significant skill factor that was related to the success of IO access between those who succeeded and failed (p<0.05). In the analysis of the structured questionnaire, median knowledge score, possibility for clinical use, and adequacy of IO access in medical education increased significantly after the course (p<0.01).

The educational effect of IO access for medical students was tremendous, and the knowledge of and attitude toward IO access improved significantly after the training course. We consider IO access to be adequate for medical education in Korea.