title: An innovative nonanimal simulation trainer for chest tube insertion in neonates.
abstract: OBJECTIVE
  Competence in the chest tube insertion procedure is vital for practitioners who take care of critically ill infants. The use of animals for training is discouraged, and there are no realistic simulation models available for the neonatal chest tube insertion procedure. The objective of this study was to assess the effectiveness of teaching the chest tube insertion procedure by using an easily constructed, nonanimal simulation model.
  
  
  METHODS
  An inexpensive infant chest tube insertion model was developed by using simple hardware. A prospective cohort study with pre-posttest intervention design was conducted with pediatric and combined internal medicine-pediatrics residents. Residents completed a questionnaire about their previous experience of chest tube insertion, knowledge, self-evaluation of knowledge, comfort, and skills; pre, post, and a month after an individualized education session and demonstration of the procedure on the model. Clinical skills were assessed by using a 32-point scoring system when residents performed the procedure on the model immediately after training and a month later.
  
  
  RESULTS
  All residents had significant improvement in knowledge and self-evaluation of knowledge, comfort, and skills scores after the education session and training on the model and this improvement was retained after 1 month (P < .001). Clinical skills scores decreased slightly 1 month after training (P = .08). Scores were not significantly different between the levels of trainees.
  
  
  CONCLUSIONS
  An educational intervention using an easily constructed and inexpensive chest tube insertion model is effective in improving knowledge, comfort, and skills in trainees. The model can be used repeatedly to maintain proficiency.
authors.affiliation: MedStar Georgetown University Hospital, Washington, District of Columbia dr_guptaashish@yahoo.com.
authors.forename: Ashish O
authors.initials: AO
authors.lastname: Gupta
authors.affiliation: MedStar Georgetown University Hospital, Washington, District of Columbia.
authors.forename: Jayashree
authors.initials: J
authors.lastname: Ramasethu
mesh_terms: D015505:Chest Tubes / Q000639:trends*; D002983:Clinical Competence; D015331:Cohort Studies; D006801:Humans; D007231:Infant, Newborn; D007396:Internship and Residency / Q000639:trends*; D007442:Intubation, Intratracheal / Q000379:methods / Q000639:trends*; D062069:Inventions / Q000639:trends*; D008348:Manikins; D011446:Prospective Studies
keywords: chest tube insertion; nonanimal model; pneumothorax; simulation