title: The effect of bench model fidelity on fluoroscopy-guided transforaminal epidural injection training: a randomized control study.
abstract: OBJECTIVE
  The purpose of this study was to determine whether high-fidelity simulators provide greater benefit than low-fidelity models in training fluoroscopy-guided transforaminal epidural injection.
  
  
  METHODS
  This educational study was a single-center, prospective, randomized 3-arm pretest-posttest design with a control arm. Eighteen anesthesia and physical medicine and rehabilitation residents were instructed how to perform a fluoroscopy-guided transforaminal epidural injection and assessed by experts on a reusable injectable phantom cadaver. The high- and low-fidelity groups received 30 minutes of supervised hands-on practice according to group assignment, and the control group received 30 minutes of didactic instruction from an expert.
  
  
  RESULTS
  We found no differences at posttest between the high- and low-fidelity groups on global ratings of performance (P = 0.17) or checklist scores (P = 0.81). Participants who received either form of hands-on training significantly outperformed the control group on both the global rating of performance (control vs low-fidelity, P = 0.0048; control vs high-fidelity, P = 0.0047) and the checklist (control vs low-fidelity, P = 0.0047; control vs high-fidelity, P = 0.0047).
  
  
  CONCLUSIONS
  Training an epidural procedure using a low-fidelity model may be equally effective as training on a high-fidelity model. These results are consistent with previous research on a variety of interventional procedures and further demonstrate the potential impact of simple, low-fidelity training models.
authors: Comprehensive Spine Center, Interventional Pain Medicine Division, Lewes Beach, DE, USA.
authors: Alan
authors: A
authors: Gonzalez-Cota
authors: Srinivas
authors: S
authors: Chiravuri
authors: R Brent
authors: RB
authors: Stansfield
authors: Chad M
authors: CM
authors: Brummett
authors: Stanley J
authors: SJ
authors: Hamstra
mesh_terms: D000328:Adult; D000776:Anesthesiology / Q000193:education*; D057189:Checklist; D016009:Chi-Square Distribution; D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007268:Injections, Epidural; D007396:Internship and Residency; D059032:Learning Curve; D008297:Male; D008824:Michigan; D008953:Models, Anatomic; D009048:Motor Skills; D010810:Physical and Rehabilitation Medicine / Q000193:education*; D011446:Prospective Studies; D015641:Radiography, Interventional; D015642:Radiology, Interventional / Q000193:education*