Reforming Pediatric Procedural Training

Study Overview
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Brief Summary
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This study is randomized trial of a procedural skills training curriculum utilizing simulation to teach basic procedural skills to pediatric residents.

Detailed Description
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This study is designed to evaluate a formal curriculum for teaching basic procedures to pediatric interns at Children's Hospital, Boston. The incoming class of interns for the academic year '05-06 will be randomly assigned to participate in the curriculum or not. Four procedures including intravenous catheter insertion, venipuncture (blood drawing), bag-and-mask ventilation, and lumbar puncture (spinal tap) will be taught. Interns will then be tested on their ability to perform these skills on anatomic models and on live patients. Our hypothesis is that interns receiving the formal curriculum will be more confident and more successful in performing these procedures than those who do not.

Official Title
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Reforming Pediatric Procedural Training: Developing an Evidence-Based Curriculum

Conditions
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Health Personnel, Healthy

Intervention / Treatment
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* Other: Formal Curriculum; Low-Fidelity Simulation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Pediatric Intern in the Boston Combined Residency Program for AY '05-'06 Exclusion Criteria: None
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention Arm<br>'Formal Curriculum; Low-Fidelity Simulation' Residents randomized to the intervention arm will receive the study skills training curriculum (the intervention). | Other: Formal Curriculum; Low-Fidelity Simulation<br>* The intervention was a formal procedural skills training curriculum consisting of didactic lectures and simulation training.<br>|
| No Intervention: Control<br>Residents randomized to the control arm will receive standard pediatric training. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 1. Percent successful IV placement over 6 months | % IVs successfully placed | 6/19/2005 - 6/30/2006 | 
| 2. Percent successful venipunctures over 6 months | % venipunctures with adequate sample for testing | 6/19/2005 - 6/30/2006 | 
| 3. Score on lumbar puncture subcomponent checklist on simulator at 6 months | % steps correct on checklist | 6/19/2005 - 6/30/2006 | 
| Score on bag mask ventilation 9BMV) subcomponent checklist on simulator at 6 months. | % steps correct on checklist | 6/19/2005 - 6/30/2006 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Bag Mask Ventilation: 1. Percentage able to successfully ventilate simulator at 0 and 6 months | Percentage able to successfully ventilate simulator at 0 and 6 months | 6/19/2005 - 6/30/2006 | 
| Average score on BMV checklist at 6 months | Average score on subcomponent checklist at 6 months | 6/19/2005 - 6/30/2006 | 
| Average time to success at 0 and 6 months | Average time to success at 0 and 6 months | 6/19/2005 - 6/30/2006 | 
| 4. Score (%) on BMV written test at 0 and 6 months | Score (%) on written test at 0 and 6 months | 6/19/2005 - 6/30/2006 | 
| 5. Average likert scale scores on confidence with BMV at 6 months | Average likert scale scores on confidence with procedures at 6 months | 6/19/2005 - 6/30/2006 | 
| IV insertion: 1. Percent successful PIV insertion on simulator at 0 and 6 months | Percent successful PIV insertion on simulator at 0 and 6 months | 6/19/2005 - 6/30/2006 | 
| Score (%) on PIV subcomponent checklist at 0 and 6 months | Score (%) on subcomponent checklist at 0 and 6 months | 6/19/2005 - 6/30/2006 | 
| Score (%) on PIV written test at 0 and 6 months | Score on written test | 6/19/2005 - 6/30/2006 | 
| Average likert scale scores on confidence with PIV at 6 months | Likert scale score | 6/19/2005 - 6/30/2006 | 
| Venipuncture: 1. Percent successful VP insertion on simulator at 0 and 6 months | % VP successul on simulator | 6/19/2005 - 6/30/2006 | 
| 2. Score (%) on VP subcomponent checklist at 0 and 6 months | Score on checklist | 6/19/2005 - 6/30/2006 | 
| 3. Score (%) on VP written test at 0 and 6 months | Score on written test | 6/19/2005 - 6/30/2006 | 
| 4. Average likert scale scores on confidence with VP at 6 months | Likert score | 6/19/2005 - 6/30/2006 | 
| Lumbar puncture: 1. Percentage of atraumatic LP attempts over 6 months | Successful LPs on patients | 6/19/2005 - 6/30/2006 | 
| 2. Score (%) on LP subcomponent checklist on simulator at 6 months | Score on checklist | 6/19/2005 - 6/30/2006 | 
| 3. Score (%) on subcomponent checklist on first live patient LP | checklist score | 6/19/2005 - 6/30/2006 | 
| 4. Number of LP attempts needed to demonstrate competence | number of LPs | 6/19/2005 - 6/30/2006 | 
| 5. Score (%) on LP written test at 0 and 6 months | Score on written test | 6/19/2005 - 6/30/2006 | 
| 6. Average likert scale scores on confidence with LP at 6 months | Likert score | 6/19/2005 - 6/30/2006 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Procedure, Training, Simulation, Pediatrics, Curriculum, Evaluation