Simulation-based Training for Neurology and Neurosurgery Residents in ICU Procedures
Isha Snehal1, Daryl Gress1, Makayla Schissel2, Subin Mathew 1
1Department of Neurological Sciences, 2Department of Biostatistics, University of Nebraska Medical Center
Objective:
The aim of this simulation-based training was to improve the knowledge, skillset, and confidence of neurology and neurosurgery junior residents.
Background:
Critically ill neurological patients require time-sensitive procedures. Neurology residents often feel under-prepared for emergency ICU procedures.
Design/Methods:
A 3-hour simulation session was held with a pretest and posttest study design. Prior to the training, trainees watched the New England Journal of Medicine procedural videos. Simulation stations for Arterial Line, Central venous line, Lumbar Puncture, and Intubation were arranged. The questionnaire was adapted from Michigan Standard Simulation Experience Scale and included 3 domains of simulation experience including knowledge, procedural skills, and quality of training. Questionnaire responses ranged as Very Poor, Poor, Average, Good, and Excellent which were respectively transformed into 1-5 for the analysis. The responses from pre- and post-simulation were compared using the sign test.
Results:
Of the 16 participants, 75% (n=12) were PGY 1, and 25% (n=4) were PGY 2. 87.5% were neurology and 12.5% neurosurgery residents with an average age of 29.3 years (SD: 3.81). 56.3%(n=9) were females. 56.3% (n=9) had prior experience performing procedures. There was a significant difference in the distribution of responses between the pre-simulation and the post-simulation responses for all questions. 75.1% of the participants post simulation showed better understanding of procedural related anatomical landmarks. Post-simulation responses consistently had a median response of 1 or 2 points greater. 12 (n%=75) responses were “Poor” or “Very Poor” for confidence in procedures pre-simulation. 11 (n%=73) responses were “Good” or “Excellent” for confidence in procedures post-simulation.
Conclusions:
Over 75% of trainees were not confident in performing ICU procedures pre-simulation, however, there was a significant improvement in confidence post-simulation. There were gaps in trainees' awareness despite watching the procedural videos. Implementing an innovative simulation training can improve knowledge and confidence in performing ICU procedures for residents.