Department of Geriatrics Hôpital Lariboisière Fernand-Widal, AP-HP.Nord Université Paris Cité, Paris, France.
AP-HP.Nord Université Paris Cité, Cognitive Neurology Center Hôpital Lariboisière-Fernand Widal, 200 rue du Faubourg Saint-Denis, 75010, Paris, France.
Eur Geriatr Med. 2023 Jun;14(3):615-623. doi: 10.1007/s41999-023-00769-y. Epub 2023 Mar 28.
To assess the skill level and self-confidence of medical residents in geriatrics with regard to conducting the lumbar puncture (LP) procedure and to study the potential benefits of training with simulation and virtual reality.
First, a questionnaire survey was conducted among all French residents in geriatrics in the Paris area to assess their knowledge and self-confidence regarding the practice of LP in older adults. Second, we set up a simulation LP training session combined with virtual reality (3D video) training for selected respondents of the first survey. Third, we performed post-simulation survey for the attendees of the simulation training. Finally, a follow-up survey was conducted to examine the change in self-confidence and the success rate in clinical practice.
Fifty-five residents responded to the survey (response rate = 36.4%). The importance of mastering LP was fully recognized by the residents in geriatrics (95.3%), so most of them (94.5%) advocated for the need for additional practical training. Fourteen residents took part in the training (average rating = 4.7 on a 5-point scale). Simulation was regarded by 83% of the respondents as the most useful tool for their practice. We observed a significant pre/post-training mean improvement in self-estimated success of 20.6% (Wilcoxon matched-pairs signed-rank W = - 36, p = 0.008). The post-training success rate of the residents in real-life clinical practice was good (85.8%).
Residents were aware of the importance of mastering LP and requested additional training. Simulation may represent a major driver to improve their self-confidence and practical skills.
评估老年医学住院医师进行腰椎穿刺(LP)的技能水平和自信心,并研究模拟和虚拟现实培训的潜在益处。
首先,对巴黎地区所有的老年医学住院医师进行了一项问卷调查,以评估他们在老年人中进行 LP 的实践知识和自信心。其次,我们为第一份调查的部分受访者设立了一个结合虚拟现实(3D 视频)的模拟 LP 培训课程。然后,我们对模拟培训的参与者进行了模拟后调查。最后,进行了随访调查,以检查自信心的变化和临床实践中的成功率。
55 名住院医师对调查做出了回应(回应率=36.4%)。老年医学住院医师充分认识到掌握 LP 的重要性(95.3%),因此他们中的大多数人(94.5%)主张需要额外的实践培训。14 名住院医师参加了培训(平均评分为 5 分制的 4.7 分)。83%的受访者认为模拟是他们实践中最有用的工具。我们观察到自我评估成功率有显著的预/后训练平均提高了 20.6%(Wilcoxon 配对符号秩检验 W=-36,p=0.008)。住院医师在现实临床实践中的术后成功率较高(85.8%)。
住院医师意识到掌握 LP 的重要性,并要求额外的培训。模拟可能是提高他们的自信心和实践技能的主要驱动力。