Gaubert Sinead, Blet Alice, Dib Fadia, Ceccaldi Pierre-François, Brock Thomas, Calixte Maude, De Macédo Léa, Dujardin Tiphaine, Jean-Louis Ludivine, Leghima Dhihia, Mouyal Samuel, Tordjman Dan David, Plaisance Patrick, Roos Caroline, Remini Sid-Ahmed, Roux Damien, Paquet Claire
Université de Paris, Medical School, Paris, France.
Cognitive Neurology Center, AP-HP, Lariboisière Fernand-Widal Hospital, F-75010, Paris, France.
BMC Med Educ. 2021 Jan 6;21(1):18. doi: 10.1186/s12909-020-02452-3.
Lumbar puncture (LP) is an invasive medical procedure that can be done by any doctor. Several simulation-based trainings have been built however the evaluations of the theoretical knowledge and the impact of the simulation-based training have never been performed in real life. The objective was to evaluate the impact of a LP training on the theoretical knowledge improvement and the performance of a LP in clinical practice.
Before and after medical students' training, theoretical knowledge and confidence level were assessed. Over a 6 months period, the impact of simulation training was evaluated by the success rate of students' first LP carried out in hospitalized patients and compared to the results of a no-training control.
Students' theoretical knowledge and confidence level showed significant improvement after simulation training on 115 students (p < 0.0001). The evaluation in real life based on 41 students showed that the success rate of the first LP in patients was higher in the LP simulation group compared to the control group (67% vs 14%, p = 0.0025). The technical assistance was also less frequently needed in the LP simulation group (19% vs 57%, respectively, p = 0.017). The rate of students who participated in this educational study was low.
Simulation-based teaching was an effective way to improve students' theoretical and practical knowledge. Whether this approach translates to other procedural skills in real clinical settings merits further study. The low participation rate in the study is due to the fact that students are not used to be included in educational studies and to the complexity of evaluation in routine clinical practice.
腰椎穿刺（LP）是一种任何医生都能进行的侵入性医疗操作。已经开展了多项基于模拟的培训，然而，从未在实际生活中对理论知识以及基于模拟的培训的影响进行评估。目的是评估LP培训对理论知识提升以及临床实践中LP操作表现的影响。
在医学生培训前后，评估其理论知识和信心水平。在6个月的时间里，通过学生在住院患者中首次进行LP的成功率来评估模拟培训的影响，并与未培训对照组的结果进行比较。
对115名学生进行模拟培训后，他们的理论知识和信心水平有显著提高（p < 0.0001）。基于41名学生的实际生活评估表明，LP模拟组患者首次LP的成功率高于对照组（67%对14%，p = 0.0025）。LP模拟组也较少需要技术协助（分别为19%对57%，p = 0.017）。参与这项教育研究的学生比例较低。
基于模拟的教学是提高学生理论和实践知识的有效方法。这种方法在实际临床环境中是否能转化为其他操作技能值得进一步研究。研究参与率低是因为学生不习惯参与教育研究以及常规临床实践评估的复杂性。
