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Simulation-based educational curriculum for fluoroscopically guided lumbar puncture improves operator confidence and
Austin R Faulkner1, Austin C Bourgeois1, Yong C Bradley1
1Department of Radiology, University of Tennessee Graduate School of Medicine, 1924 Alcoa Hwy, UTMC Nuclear Medicine, Knoxville, TN 37920.
A new simulation-based training program for fluoroscopically guided lumbar puncture (FGLP) significantly reduced fluoroscopy time and improved operator confidence in radiology residents. This training utilized an inexpensive lumbar spine phantom, enhancing procedure efficiency and reducing patient radiation dose without affecting success rates.
Area of Science:
- Medical Education
- Radiology
- Interventional Procedures
Background:
- Fluoroscopically guided lumbar puncture (FGLP) is a common procedure with higher success rates than bedside techniques.
- FGLP exposes patients and staff to ionizing radiation.
- Improving FGLP efficiency and safety is crucial for resident training.
Purpose of the Study:
- To evaluate a simulation-based FGLP training program using an inexpensive lumbar spine phantom.
- To determine if the training improves operator confidence and efficiency.
- To assess the impact of the training on patient radiation dose.
Main Methods:
- A curriculum included a lecture and hands-on training with a lumbar spine phantom prototype.
- Six radiology residents (PGY-2) trained using the phantom before clinical procedures.
- Compared fluoroscopy time (FT) and success rates of 114 trained residents' procedures to 514 untrained residents' procedures.
Main Results:
- The trained group showed a statistically significant reduction in average FT (25% decrease, P = .002).
- This reduction was observed in aggregate, for myelography, and for diagnostic indications.
- No significant difference in FGLP success rates was found between the trained and untrained groups.
Conclusions:
- Simulation-based FGLP training improved operator confidence and reduced fluoroscopy time.
- The training enhanced resident procedure efficiency and reduced patient radiation dose.
- The inexpensive, durable phantom is effective and adaptable for various interventional procedures.
