title: Tube thoracostomy training with a medical simulator is associated with faster, more successful performance of the procedure.
abstract: OBJECTIVE
  Tube thoracostomy (TT) is a commonly performed intensive care procedure. Simulator training may be a good alternative method for TT training, compared with conventional methods such as apprenticeship and animal skills laboratory. However, there is insufficient evidence supporting use of a simulator. The aim of this study is to determine whether training with medical simulator is associated with faster TT process, compared to conventional training without simulator.
  
  
  METHODS
  This is a simulation study. Eligible participants were emergency medicine residents with very few (≤3 times) TT experience. Participants were randomized to two groups: the conventional training group, and the simulator training group. While the simulator training group used the simulator to train TT, the conventional training group watched the instructor performing TT on a cadaver. After training, all participants performed a TT on a cadaver. The performance quality was measured as correct placement and time delay. Subjects were graded if they had difficulty on process.
  
  
  RESULTS
  Estimated median procedure time was 228 seconds in the conventional training group and 75 seconds in the simulator training group, with statistical significance (P=0.040). The difficulty grading did not show any significant difference among groups (overall performance scale, 2 vs. 3; P=0.094).
  
  
  CONCLUSIONS
  Tube thoracostomy training with a medical simulator, when compared to no simulator training, is associated with a significantly faster procedure, when performed on a human cadaver.
authors.affiliation: Department of Emergency Medicine, CHA University School of Medicine, Seongnam, Korea.
authors.forename: Tae Nyoung
authors.initials: TN
authors.lastname: Chung
authors.affiliation: Department of Emergency Medicine, Changwon Fatima Hospital, Changwon, Korea.
authors.forename: Sun Wook
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Je Sung
authors.initials: JS
authors.lastname: You
authors.affiliation: Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hyun Soo
authors.initials: HS
authors.lastname: Chung
keywords: Cadaver; Chest tubes; Education; Simulation training