title: Transfer of simulated lumbar puncture training to the clinical setting.
abstract: OBJECTIVE
  To show that with a combination of evidence-based didactic and hands-on skill demonstration, pediatric interns will be able to correctly perform lumbar punctures (LPs) on neonates in the actual clinical setting.
  
  
  METHODS
  Twenty-three pediatric and internal medicine/pediatric first year residents attended a 1-hour course during their orientation. The course consisted of an evidence-based presentation, reviewing anatomy, indications, complications, and techniques for performing LPs, including a video presentation, followed by hands-on practice of LPs. All interns were anonymously surveyed preintervention and postintervention. The survey results were compared for each learner. After the intervention, interns were individually assessed by a single investigator using a standardized checklist during an LP of an actual pediatric patient during their first year of residency.
  
  
  RESULTS
  Pretest and posttest knowledge improved by approximately 12% (P < 0.05). Preintervention confidence and experience were low among learners. Twenty-one of 23 interns completed a follow-up assessment of an LP on an actual pediatric patient. The average on the assessment was 9.7 ± 1.1 of 11 (88% ± 10%). The average number of LP attempts was 1.4 ± 0.5. The steps most frequently missed were preparing the supplies and performing the LP with the bevel of the needle parallel to the spinal ligament, with only 48% of interns performing each of these steps correctly.
  
  
  CONCLUSIONS
  A task trainer-based course improved the confidence and knowledge about an important pediatric procedure. This confidence and knowledge can translate to actual clinical practice. Further investigations are necessary to support this knowledge and skill translation.
authors.affiliation: Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA. mlwhite@peds.uab.edu
authors.forename: Marjorie L
authors.initials: ML
authors.lastname: White
authors.forename: Rachel
authors.initials: R
authors.lastname: Jones
authors.forename: Lynn
authors.initials: L
authors.lastname: Zinkan
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Tofil
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003198:Computer Simulation; D004521:Educational Measurement; D004635:Emergency Medicine / Q000193:education*; D006801:Humans; D007231:Infant, Newborn; D007396:Internship and Residency; D010372:Pediatrics / Q000193:education*; D011446:Prospective Studies; D013129:Spinal Puncture; D014163:Transfer, Psychology; D014481:United States