Simulator-based ultrasound training for identification of endotracheal tube placement in a neonatal intensive care unit using point of care ultrasound
| Autor: | Shabina Ariff, Ali Shabbir Hussain, Sajid Bashir Soofi, Khushboo Q. Ali, Hasan S. Merali, Uzair Ansari, Shaun K. Morris, Mark Oliver Tessaro |
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| Rok vydání: | 2020 |
| Předmět: |
Neonatal intensive care unit
medicine.medical_treatment Point-of-Care Systems Resuscitation education lcsh:Medicine Environment controlled Education 03 medical and health sciences 0302 clinical medicine Intensive Care Units Neonatal medicine Intubation Intratracheal Intubation Humans Pakistan 030212 general & internal medicine Point of care ultrasound Child Simulation Endotracheal tube Ultrasonography lcsh:LC8-6691 lcsh:Special aspects of education business.industry lcsh:R Ultrasound Infant Newborn Neonates 030208 emergency & critical care medicine General Medicine Ultrasound training Test (assessment) Identification (information) Clinical Competence business Research Article |
| Zdroj: | BMC Medical Education BMC Medical Education, Vol 20, Iss 1, Pp 1-11 (2020) |
| ISSN: | 1472-6920 |
| Popis: | BackgroundSimulators are an extensively utilized teaching tool in clinical settings. Simulation enables learners to practice and improve their skills in a safe and controlled environment before using these skills on patients. We evaluated the effect of a training session utilizing a novel intubation ultrasound simulator on the accuracy of provider detection of tracheal versus esophageal neonatal endotracheal tube (ETT) placement using point-of-care ultrasound (POCUS). We also investigated whether the time to POCUS image interpretation decreased with repeated simulator attempts.MethodsSixty neonatal health care providers participated in a three-hour simulator-based training session in the neonatal intensive care unit (NICU) of Aga Khan University Hospital (AKUH), Karachi, Pakistan. Participants included neonatologists, neonatal fellows, pediatric residents and senior nursing staff. The training utilized a novel low-cost simulator made with gelatin, water and psyllium fiber. Training consisted of a didactic session, practice with the simulator, and practice with intubated NICU patients. At the end of training, participants underwent an objective structured assessment of technical skills (OSATS) and ten rounds of simulator-based testing of their ability to use POCUS to differentiate between simulated tracheal and esophageal intubations.ResultsThe majority of the participants in the training had an average of 7.0 years (SD 4.9) of clinical experience. After controlling for gender, profession, years of practice and POCUS knowledge, linear mixed model and mixed effects logistic regression demonstrated marginal improvement in POCUS interpretation over repeated simulator testing. The mean time-to-interpretation decreased from 24.7 (SD 20.3) seconds for test 1 to 10.1 (SD 4.5) seconds for Test 10,p ConclusionWe found a three-hour simulator-based training session had a significant impact on technical skills and performance of neonatal health care providers in identification of ETT position using POCUS. Further research is needed to examine whether these skills are transferable to intubated newborns in various health settings.Trial registrationClinicalTrials.gov Identifier:NCT03533218. Registered May 2018. |
| Databáze: | OpenAIRE |
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