1. “Sim One, Do One” Infant Lumbar Puncture Simulator Improves Resident Confidence and Skills “Sim One, Do One” Infant Lumbar Puncture Simulator Improves Resident Confidence and Skills David Kessler, Marc Auerbach, Dennis Heon, Michael Tunik, Jessica Foltin NYU Langone Medical Center / Bellevue Hospital Center, Departments of Pediatrics and Emergency Medicine  Infant Lumbar Puncture (LP) is a skill pediatric residents should achieve  Resident confidence in skills is less for LP than for other procedures  Most programs currently train residents using the apprenticeship model  Simulators that replicate the experience of an infant LP exist for training  Both groups had short-term improvements in knowledge & confidence  LP simulator training improves knowledge, confidence and skills  LP simulator training promotes success with next clinical LP  LP simulators could provide a safe environment for skill development and the demonstration of provider competency BACKGROUND  We hypothesize that “practice makes perfect” interactive skill training on an LP simulator improves resident LP knowledge, confidence & skills  We hypothesize that competence on the simulator will lead to improved clinical performance (success with next clinical LP)  After data collection is completed we will analyze groups to compare:  improvement rates in knowledge, confidence & skills  clinical success rates & confidence with next clinical ILP  skill retention in the intervention group  Is competence on manikin associated with clinical success? (independent of group)  Planning underway to expand trial to multiple sites and to start including emergency medicine residents KNOWLEDGEKNOWLEDGE P=.018P=.001 P=.005 P=.014 This is a randomized clinical trial of a simulation educational intervention Pediatric Residents are randomized to EARLY or LATE simulator training Thank you to the Pediatric House Staff, Dr. Rhonda Graves, Dr. Steve Paik, Karl Santiago, the division of Pediatric Emergency Medicine & the Pediatric Simulation Center at Bellevue Hospital for all of their support Research supported by Rbabyfoundation.org and KiDS of NYU Clinical Outcomes SKILLS (Simulator) N=16 N=51 P=.026 OBJECTIVES METHODS PRELIMINARY RESULTS FINAL ASSESSMENT: KNOWLEDGE, CONFIDENCE, SKILLS & CLINICAL OUTCOMES SIMULATOR TRAINING "practice makes perfect" (try LP until successful) Current progress in timeline (6-12months later) Clinical outcomes self-reported after next LP BASELINE POST ASSESSMENT VIDEO TRAINING: Both groups watch LP and infant LP training video BASELINE PRE-ASSESSMENT INTERVENTION (EARLY SIM TRAINING) CONTROL (LATE SIM TRAINING) RANDOMIZED CONFIDENCECONFIDENCE KNOWLEDGE: 6 item quiz of infant LP questions CONFIDENCE: 4 point Likert scale “ I feel confident in my ability to perform an LP on an infant ” SKILLS: LP on simulator videotaped for blind rater& scored on 16 item “ critica LPl steps ” checklist KNOWLEDGE CONFIDENCE SKILLS (on simulator) SIMULATOR TRAINING "practice makes perfect" (try LP until successful) CONCLUSIONS FUTURE DIRECTIONS ACKNOWLEDGEMENTS (Intervention Only) N=24 P=.00004P=.005