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Paracentesis Simulation: A Comprehensive Approach to Procedural Education.

Dana Sall1,2, Gregory W Wigger3, Benjamin Kinnear4,5,6

  • 1Assistant Professor, Department of Medicine, University of Cincinnati Medical Center.

Mededportal : the Journal of Teaching and Learning Resources
|February 26, 2019
PubMed
Summary

This study introduces a simulation-based curriculum for paracentesis (a common internal medicine procedure), enhancing resident competence and confidence. The program integrates didactics, hands-on simulation, and assessment for improved procedural skills and knowledge retention.

Keywords:
AscitesEditor's ChoiceParacentesisProcedural EducationSimulation

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Area of Science:

  • Medical Education
  • Simulation-Based Learning
  • Procedural Skills Training

Background:

  • Structured procedural education and competency assessment are critical for residency and fellowship programs.
  • Simulation offers a safe environment for learning and practicing procedural skills.
  • Paracentesis is a frequently performed procedure in internal medicine.

Purpose of the Study:

  • To develop and evaluate a comprehensive educational resource for paracentesis.
  • To enhance both cognitive and psychomotor skills related to paracentesis.
  • To assess competency using an entrustment-based tool in a simulated environment.

Main Methods:

  • Internal medicine and medicine-pediatric residents participated in a curriculum involving didactics, self-assessments, and simulation using a paracentesis trainer and ultrasound.
  • Learners performed assisted and unassisted paracentesis procedures, receiving feedback and evaluation via a procedural checklist, global skill assessment, and entrustment scale.
  • The curriculum included case-based reviews and a follow-up simulation session months later to assess skill retention.

Main Results:

  • Over 120 residents across all training levels completed the curriculum.
  • Residents reported increased self-confidence and competence in using ultrasound for ascites identification and performing paracentesis.
  • Learners provided positive feedback on the educational experience.

Conclusions:

  • The simulation curriculum effectively provides cognitive and psychomotor education for paracentesis in a low-risk setting.
  • This comprehensive approach, combining didactics, cases, and repeated simulations, aims to improve knowledge and skill retention for paracentesis.
  • The study highlights the value of simulation in procedural training for medical residents.