Combining Immersive Simulation with a Collaborative Procedural Training on Local Anesthetic Systemic Toxicity and...

Area of Science:

• Emergency Medicine
• Medical Simulation
• Pain Management

Background:

• Emergency medicine training requires proficiency in diverse procedures and patient presentations.
• Simulation is crucial for rare pathologies and procedures, supplementing real-life exposure.
• Ultrasound (US)-guided nerve blocks (UGNB), like the fascia iliaca compartment block (FICB), are increasingly integrated into resident curricula.

Purpose of the Study:

• To assess the impact of a novel, sequential immersive and procedural simulation on resident knowledge and comfort with FICB and local anesthetic systemic toxicity (LAST).
• To evaluate resident perceptions of their ability to visualize anatomy, perform FICB, and manage LAST post-simulation.

Main Methods:

• A pilot study involved 19 residents (PGY 1-3) participating in two concurrent one-hour simulations focusing on FICB and LAST.
• Participants completed pre- and post-simulation surveys to gauge perceived knowledge and comfort levels.
• The Stuart-Maxwell test was used to analyze survey data for significant changes.

Main Results:

• Over half (56%) of participants lacked prior formal FICB training.
• Post-simulation, significant positive trends were observed in perceived confidence for anatomy visualization (P=0.10), FICB performance (P=0.08), and ability to teach peers (P=0.20).
• Perceived ability in diagnosing (P=0.12) and managing LAST (P=0.08) also showed improvement.

Conclusions:

• Combined immersive and procedural simulation offers a novel and effective method for training in complex procedures like FICB and managing critical complications such as LAST.
• Simulation-based training enhances resident confidence and perceived competence in procedural skills and critical care scenarios.
• This approach addresses a gap in the literature regarding intertwined procedural and critical care simulation.