Hybrid simulation for knee arthrocentesis: improving fidelity in procedures training.

ABSTRACT:

Background

Procedures form a core competency for internists, yet many do not master these skills during residency. Simulation can help fill this gap, but many curricula focus on technical skills, and overlook communication skills necessary to perform procedures proficiently. Hybrid simulation (HS) is a novel way to teach and assess procedural skills in an integrated, contextually-based way.

Aim

To create a HS model for teaching arthrocentesis to internal medicine residents.

Setting

Internal medicine residency program at the University of Toronto.

Participants

Twenty four second-year internal medicine residents.

Program description

Residents were introduced to HS, given practice time with feedback from standardized patients (SPs) and faculty, and assessed individually using a different scenario and SP. Physicians scored overall performance using a 6-point procedural skills measure, and both physicians and SPs scored communication using a 5-point communication skills measure.

Program evaluation

Realism was highly rated by residents (4.13/5.00), SPs (4.00) and physicians (4.33), and was perceived to enhance learning. Residents' procedural skills were rated as 4.21/6.00 (3.00 - 5.00; ICC = 0.77, [0.53 - 0.92]), comparable to an experienced post-graduate year (PGY) 2-3; and all but one resident was considered competent.

Discussion

HS facilitates simultaneous acquisition of technical and communication skills. Future research should examine whether HS improves transfer of skills to the clinical setting.

SUBMITTER: Stroud L 

PROVIDER: S-EPMC3631077 | biostudies-literature | 2013 May

REPOSITORIES: biostudies-literature