Assessing Best Practices in a Simulated Lumbar Puncture Workshop With Medical Students.

Abstract

Introduction: Simulation labs provide trainees the opportunity to practice procedures in a safe, controlled, nonjudgmental environment. It is unclear which teaching method leads to the highest levels of trainee skill competency when learning complex simulated procedures, such as lumbar puncture.

Methods: First-year medical students participated in a randomized controlled trial of an early-exposure simulated lumbar puncture (sLP) workshop. All were randomized to 1 of 2 teaching methods: 1) traditional "see one, do one" method or 2) Peyton's 4-step method. Students were taught how to perform an sLP based on the specific teaching method. Competence during sLP attempts was assessed using binary checklists, and student confidence was assessed using pre- and post-workshop surveys. Independent t tests and bivariate correlations were performed.

Results: Thirty-five first-year medical students participated in the sLP workshops. There were no statistically significant differences between the "see one, do one" method and Peyton's 4-step teaching method in checklist scores (P = .121, Cohen's d = 0.540) or change in confidence (P = .631, Cohen's d = 0.164). The difference in the speed of task completion favored Peyton's teaching method (P = .044, Cohen's d = -0.711). None of these outcomes demonstrated a significant correlation with each other within the cohort, the Peyton's subgroup, or the "see one, do one" subgroup.

Discussion: In this study, the traditional "see one, do one" model and Peyton's 4-step approach produced similar skill acquisition and confidence levels among medical students during an sLP workshop. Peyton's 4-step approach led to faster procedural completion times.

Conclusion: The current study adds to the body of literature that has failed to find a notable impact in skill competence outcomes when teaching complex procedures.