Abstract
BackgroundInexperienced interns are responsible for most iatrogenic complications after urethral catheterization (UC). Although training on simulators is common, little is known about the transfer of learned skills to real clinical practice. This study aimed to evaluate the short- and long-term effects of UC simulated skills training on performance on real patients and to examine whether watching a video of the procedure immediately before assessment enhanced clinical performance.MethodsThis was an experimental study of the effect of a UC simulation-based skills course on medical students’ short-term (after one week) and long-term (after six weeks) performance. The additional effect of video instruction before performance testing on real patients was studied in a randomized trial. Sixty-four students participated in the study, which was preceded by a pilot study investigating the validity aspects of a UC assessment form.ResultsThe pilot study demonstrated sufficient inter-rater reliability, intra-class correlation coefficient 0.86, and a significant ability to discriminate between trainee performances when using the assessment form, p= 0.001. In the main study, more than 90% of students demonstrated an acceptable performance or better when tested on real patients. There was no significant difference in the total score between the one-week and the six-week groups when tested on real patients and no significant difference between the video and the control groups.ConclusionsMedical students demonstrated good transfer of UC skills learned in the skills lab to real clinical situations up to six weeks after training. Simulated UC training should be the standard for all medical school curricula to reduce avoidable complications. However, this study did not demonstrate that an instructional video, as a supplement to simulated skills training, improved clinical UC performance.Trial registrationCurrent Controlled Trials ISRCTN:ISRCTN90745002
Highlights
Inexperienced interns are responsible for most iatrogenic complications after urethral catheterization (UC)
Pilot study An experienced urologist, a UC skills teacher, and an educational researcher developed the assessment form (Figure 1), which was based on an objective structured clinical examination (OSCE) checklist previously used to
We found no significant difference between the group who watched the instructional video before performing UC on a real patient and the control group
Summary
Inexperienced interns are responsible for most iatrogenic complications after urethral catheterization (UC). Training on simulators is common, little is known about the transfer of learned skills to real clinical practice. This study aimed to evaluate the short- and long-term effects of UC simulated skills training on performance on real patients and to examine whether watching a video of the procedure immediately before assessment enhanced clinical performance. Previous research has shown that inexperienced interns are responsible for most iatrogenic complications [6]. The majority of complications can be prevented using the proper UC technique, and for patient safety, Training procedural skills (such as UC) in simulation laboratories is common in many medical schools, yet skills training consumes considerable faculty teaching time and economic resources. A major concern with procedural skills training in a simulated setting is retention and transfer of the learned skills to real practice [11]. Few studies have shown that simulation training improves participants’ performance on real patients [14,15], and no studies have investigated UC performance
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