title: Using simulation models to teach junior doctors how to insert chest tubes: a brief and effective teaching module.
abstract: BACKGROUND
  Pleural procedures may cause serious complications when incorrectly carried out. There is a need to find effective methods for teaching how to insert a chest drain safely.
  
  
  OBJECTIVE
  To assess the effectiveness of a programme for teaching chest tube insertion using a simulation model (SuperAnnie).
  
  
  METHODS
  Groups of four to six junior doctors were enrolled in a 2-h teaching session, covering both theoretical knowledge and practical chest tube insertion techniques using a simulation model. Before the teaching module, participants completed a questionnaire about their confidence and skill levels and were videotaped inserting a standard chest tube in the model. The assessments were repeated 1 month after the teaching module. The video clips were scored by two independent assessors using an 18-point scoring system that was blinded to whether the taping was pre- or post-teaching.
  
  
  RESULTS
  Forty-nine doctors completed the study. Baseline video assessment scores were low (median score 4 (maximum possible score 18), interquartile range (IQR) 2-7.5) and were not associated with past experience, the doctor's self-confidence level or their self-assessed skill rating. After teaching, video assessment scores improved significantly (mean score 13, IQR 10.5-15). Doctors with the lowest baseline scores showed the most improvement. There were also improvements in doctors' self-confidence and self-assessed skill levels, although there remained no association between these measures and video assessment scores.
  
  
  CONCLUSIONS
  A brief teaching module using a simulation model is effective in improving confidence and skill in chest tube insertion.
authors.affiliation: General Medicine Department, Middlemore Hospital, Aukland, New Zealand.
authors.forename: I A
authors.initials: IA
authors.lastname: Hutton
authors.forename: H
authors.initials: H
authors.lastname: Kenealy
authors.forename: C
authors.initials: C
authors.lastname: Wong
mesh_terms: D015505:Chest Tubes; D002983:Clinical Competence / Q000592:standards; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000379:methods* / Q000592:standards; D008297:Male; D017145:Models, Educational; D013663:Teaching / Q000379:methods* / Q000592:standards