title: When should we perform a repeat training on adrenaline auto-injector use for physician trainees?
abstract: BACKGROUND
  Studies demonstrate that both doctors and patients may use adrenaline auto-injector improperly and the usage skills are improved by training. In this study, we aimed to determine the appropriate frequency of training to maintain skills for adrenaline auto-injector use.
  
  
  METHODS
  We invited all interns of 2011-2012 training period. At baseline, all participants were given theoretical and practical training on adrenaline auto-injector use. The participants were randomly assigned into two groups. We asked those in group 1 to demonstrate the use of adrenaline auto-injector trainer in the third month and those in group 2 in the sixth month.
  
  
  RESULTS
  One hundred and sixty interns were enrolled. Compared with the beginning score, demonstration of skills at all the steps and total scores did not change for the group tested in the third month (p=0.265 and p=0.888, respectively). However; for the group examined in the sixth month; the demonstration of skills for proper use of the auto-injector at all steps and the mean time to administer adrenaline decreased (p=0.018 and p<0.001, respectively). Besides, the group which was tested in the third month was better than the group which was tested in the sixth month in terms of demonstrating all steps (p=0.014), the total score (p=0.019), mean time of change to administer adrenaline (p<0.001) and presumptive self-injection into thumb (p=0.029).
  
  
  CONCLUSIONS
  Auto-injector usage skills of physician trainees decrease after the sixth month and are better in those who had skill reinforcement at 3 months, suggesting continued education and skill reinforcement may be useful.
authors.affiliation: Department of Pediatric Allergy and Asthma, Gazi University Faculty of Medicine, Ankara, Turkey. Electronic address: erdemtopal44@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Topal
authors.affiliation: Department of Pediatric Allergy and Asthma, Gazi University Faculty of Medicine, Ankara, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Bakirtas
authors.affiliation: Department of Pediatric Allergy and Asthma, Gazi University Faculty of Medicine, Ankara, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Yilmaz
authors.affiliation: Department of Pediatric Allergy and Asthma, Gazi University Faculty of Medicine, Ankara, Turkey.
authors.forename: I H E
authors.initials: IH
authors.lastname: Karagol
authors.affiliation: Department of Pediatric Allergy and Asthma, Gazi University Faculty of Medicine, Ankara, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Arga
authors.affiliation: Department of Pediatric Allergy and Asthma, Gazi University Faculty of Medicine, Ankara, Turkey.
authors.forename: M S
authors.initials: MS
authors.lastname: Demirsoy
authors.affiliation: Department of Pediatric Allergy and Asthma, Gazi University Faculty of Medicine, Ankara, Turkey.
authors.forename: I
authors.initials: I
authors.lastname: Turktas
mesh_terms: D000328:Adult; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D004503:Education, Medical, Graduate / Q000379:methods*; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular / Q000379:methods; D007396:Internship and Residency; D008297:Male; D055815:Young Adult
chemical_list: D001993:Bronchodilator Agents; D004837:Epinephrine
keywords: Adrenaline; Anaphylaxis; Auto-injector; Skill; Training; Usage