The Impact of a Training Device on Perception and Performance by Novice Users of an Autoinjector

Abstract

The study was conducted to understand the effects of having access to different training materials in the interim between training and first use of an injection device for 27 injection-naïve participants. Participants were told they would be giving themselves a real injection of saline in the return session, and were not told that they would use injection pads until after subjective data was gathered during session 2. This deception paradigm was used to increase the external validity of the study. Participants self-trained in one of three conditions based on what they were given to take home: instructions for use, mechanical trainer, and/or a training video. Participants self-trained in session 1, performed a simulated injection in the session 2 two weeks later, and completed three online surveys in the interim. In session 2, a majority of participants were able to achieve minimally acceptable performance to deliver the medication during the simulated use of the autoinjector. Participants who took home a mechanical trainer had fewer use deviations than those who did not have the trainer at home. This difference was only seen in injection specific subtasks; performance on pre- and post-injection subtasks was low across all groups. Intermittent practice with a mechanical trainer was seen to improve performance on subtasks involved in the motor performance of the injection itself but did not impact performance or compliance with other tasks important to the injection. More holistic training solutions may be required to impact other aspects of the injection beyond the injection itself. While performance differed, subjective ratings did not differ, showing an overconfidence bias that may affect a user’s ability to self-report competence in device use.