title: Interns' success with clinical procedures in infants after simulation training.
abstract: OBJECTIVE
  Simulation-based medical education (SBME) is used to teach residents. However, few studies have evaluated its clinical impact. The goal of this study was to evaluate the impact of an SBME session on pediatric interns' clinical procedural success.
  
  
  METHODS
  This randomized trial was conducted at 10 academic medical centers. Interns were surveyed on infant lumbar puncture (ILP) and child intravenous line placement (CIV) knowledge and watched audiovisual expert modeling of both procedures. Participants were randomized to SBME mastery learning for ILP or CIV and for 6 succeeding months reported clinical performance for both procedures. ILP success was defined as obtaining a sample on the first attempt with <1000 red blood cells per high-power field or fluid described as clear. CIV success was defined as placement of a functioning catheter on the first try. Each group served as the control group for the procedure for which they did not receive the intervention.
  
  
  RESULTS
  Two-hundred interns participated (104 in the ILP group and 96 in the CIV group). Together, they reported 409 procedures. ILP success rates were 34% (31 of 91) for interns who received ILP mastery learning and 34% (25 of 73) for controls (difference: 0.2% [95% confidence interval: -0.1 to 0.1]). The CIV success rate was 54% (62 of 115) for interns who received CIV mastery learning compared with 50% (58 of 115) for controls (difference: 3% [95% confidence interval: -10 to 17]).
  
  
  CONCLUSIONS
  Participation in a single SBME mastery learning session was insufficient to affect pediatric interns' subsequent procedural success.
authors: Columbia University College of Physicians and Surgeons, New York, NY 10032, USA. dk2592@columbia.edu
authors: David O
authors: DO
authors: Kessler
authors: Grace
authors: G
authors: Arteaga
authors: Kevin
authors: K
authors: Ching
authors: Laura
authors: L
authors: Haubner
authors: Gunjan
authors: G
authors: Kamdar
authors: Amanda
authors: A
authors: Krantz
authors: Julie
authors: J
authors: Lindower
authors: Michael
authors: M
authors: Miller
authors: Matei
authors: M
authors: Petrescu
authors: Martin V
authors: MV
authors: Pusic
authors: Joshua
authors: J
authors: Rocker
authors: Nikhil
authors: N
authors: Shah
authors: Christopher
authors: C
authors: Strother
authors: Lindsey
authors: L
authors: Tilt
authors: Eric R
authors: ER
authors: Weinberg
authors: Todd P
authors: TP
authors: Chang
authors: Daniel M
authors: DM
authors: Fein
authors: Marc
authors: M
authors: Auerbach
mesh_terms: D002406:Catheterization, Peripheral / Q000379:methods / Q000592:standards*; D002983:Clinical Competence / Q000592:standards*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007396:Internship and Residency / Q000379:methods / Q000592:standards*; D013129:Spinal Puncture / Q000379:methods / Q000592:standards*; D011795:Surveys and Questionnaires