title: Short- and long-term transfer of urethral catheterization skills from simulation training to performance on patients.
abstract: BACKGROUND
  Inexperienced interns are responsible for most iatrogenic complications after urethral catheterization (UC). Although training on simulators is common, little is known about the transfer of learned skills to real clinical practice. This study aimed to evaluate the short- and long-term effects of UC simulated skills training on performance on real patients and to examine whether watching a video of the procedure immediately before assessment enhanced clinical performance.
  
  
  METHODS
  This was an experimental study of the effect of a UC simulation-based skills course on medical students' short-term (after one week) and long-term (after six weeks) performance. The additional effect of video instruction before performance testing on real patients was studied in a randomized trial. Sixty-four students participated in the study, which was preceded by a pilot study investigating the validity aspects of a UC assessment form.
  
  
  RESULTS
  The pilot study demonstrated sufficient inter-rater reliability, intra-class correlation coefficient 0.86, and a significant ability to discriminate between trainee performances when using the assessment form, p= 0.001. In the main study, more than 90% of students demonstrated an acceptable performance or better when tested on real patients. There was no significant difference in the total score between the one-week and the six-week groups when tested on real patients and no significant difference between the video and the control groups.
  
  
  CONCLUSIONS
  Medical students demonstrated good transfer of UC skills learned in the skills lab to real clinical situations up to six weeks after training. Simulated UC training should be the standard for all medical school curricula to reduce avoidable complications. However, this study did not demonstrate that an instructional video, as a supplement to simulated skills training, improved clinical UC performance.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN:ISRCTN90745002.
authors: Centre for Clinical Education, University of Copenhagen and The Capital Region of Denmark, Rigshospitalet Afsnit 5404, Teilumbygningen,Blegdamsvej 9, Copenhagen Ø DK-2100, Denmark. tobiastodsen@gmail.com
authors: Tobias
authors: T
authors: Todsen
authors: Mikael V
authors: MV
authors: Henriksen
authors: Charles B
authors: CB
authors: Kromann
authors: Lars
authors: L
authors: Konge
authors: Jesper
authors: J
authors: Eldrup
authors: Charlotte
authors: C
authors: Ringsted
mesh_terms: D002982:Clinical Clerkship / Q000379:methods* / Q000592:standards; D002983:Clinical Competence / Q000592:standards; D004521:Educational Measurement; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D013664:Teaching Materials; D013997:Time Factors; D014521:Urethra; D014546:Urinary Catheterization / Q000592:standards; D014741:Video Recording; D055815:Young Adult