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Endoscopic Studies II: Thoracocentesis

Endoscopic Studies II: Thoracocentesis

Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...

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The effect of simulation-based mastery learning on thoracentesis referral patterns.

Jeffrey H Barsuk^1,2, Elaine R Cohen³, Mark V Williams⁴

¹Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois. jbarsuk@nm.org.

Journal of Hospital Medicine

|June 9, 2016

Summary

Simulation-based mastery learning significantly improves internal medicine residents' thoracentesis skills, leading to more bedside procedures and increased confidence. This training method offers a safer, more cost-effective alternative to referrals.

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Area of Science:

Medical Education
Internal Medicine
Simulation-Based Training

Background:

Thoracentesis is a common procedure for internal medicine residents and hospitalists.
Referrals to services like interventional radiology increase healthcare costs.
Simulation-based mastery learning (SBML) enhances procedural skills and confidence.

Purpose of the Study:

To evaluate the impact of SBML on internal medicine residents' simulated thoracentesis skills.
To compare thoracentesis referral patterns, confidence, and reasons for referral among different physician groups.

Main Methods:

A cohort of 112 internal medicine residents underwent thoracentesis SBML.
Surveys were administered to traditionally trained residents, SBML-trained residents, and hospitalist physicians.
Referral patterns, self-confidence, and reasons for referral were compared across groups.

Main Results:

SBML significantly improved residents' thoracentesis skills (pretest: 57.6% to post-test: 96.2%).
SBML-trained residents showed higher confidence and performed more bedside thoracenteses.
Traditionally trained residents were more likely to refer due to lower confidence; hospitalists referred due to time constraints.

Conclusions:

SBML effectively enhances thoracentesis skills and promotes bedside procedures.
Physician confidence and time availability are key factors influencing thoracentesis referral decisions.
SBML offers a valuable, cost-effective training approach for procedural competency.