title: Training modalities and self-confidence building in performance of life-saving procedures.
abstract: OBJECTIVE
  Physicians and paramedics in the Israel Defense Forces are trained to perform advanced medical procedures using standardized training modalities, such as manikins. We studied the association of experience using these training modalities with self-reported confidence in procedure performance.
  
  
  METHODS
  Providers were sent a questionnaire regarding their experience with and self-confidence levels for performing endotracheal intubation, cricothyroidotomy, needle chest decompression, tube thoracostomy, and intraosseous infusion.
  
  
  RESULTS
  Provider level (physician or paramedic) and gender were associated with reported self-confidence levels. Manikin and supervised and unsupervised patient experience exhibited positive associations with self-confidence, but (animal) model experience did not. For many procedure-training modality pairs, we identified a plateau level above which additional experience was minimally associated with an increase in self-confidence.
  
  
  CONCLUSIONS
  Among military advanced life support providers, self-confidence levels in procedure performance are positively associated with experience gained from manikins and supervised and unsupervised patient application. We were not able to demonstrate a clear benefit of an animal model in increasing self-confidence. A plateau was generally identified, indicating decreased benefit from the use of a particular training modality for a particular procedure. Modifying training regimens in light of these findings may help maximize the self-confidence of advanced life support providers more efficiently.
authors.affiliation: Trauma Branch, Surgeon General Headquarters, Medical Corps, Israel Defense Forces, Ramat Gan, Israel.
authors.forename: Ilia
authors.initials: I
authors.lastname: Sergeev
authors.forename: Ari M
authors.initials: AM
authors.lastname: Lipsky
authors.forename: Ori
authors.initials: O
authors.lastname: Ganor
authors.forename: Gadi
authors.initials: G
authors.lastname: Lending
authors.forename: Gadi
authors.initials: G
authors.lastname: Abebe-Campino
authors.forename: Alex
authors.initials: A
authors.lastname: Morose
authors.forename: Udi
authors.initials: U
authors.lastname: Katzenell
authors.forename: Nachman
authors.initials: N
authors.lastname: Ash
authors.forename: Elon
authors.initials: E
authors.lastname: Glassberg
mesh_terms: D000328:Adult; D000488:Allied Health Personnel; D002983:Clinical Competence; D004635:Emergency Medicine / Q000193:education*; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008889:Military Personnel; D012649:Self Concept; D011795:Surveys and Questionnaires; D013663:Teaching / Q000379:methods*