Lumbar puncture training with healthcare simulation improves self-confidence and practical skills of French medical residents in geriatrics

• Published in: European geriatric medicine 2023-06, Vol.14 (3), p.615-623
• Main Authors: Lilamand, Matthieu, Vrillon, Agathe, Gonzales-Marabal, Laurent, Sindzingre, Louise, Götze, Karl, Boddaert, Jacques, Pautas, Eric, François-Fasille, Véronique, Dumurgier, Julien, Paquet, Claire
• Format: Article
• Language: English
• Subjects: Education, Medical, Graduate - methods; Geriatrics; Geriatrics/Gerontology; Internal Medicine; Internship and Residency; Medicine; Medicine & Public Health; Research Paper; Simulation Training; Spinal Puncture - methods
• ISSN: 1878-7649; 1878-7657; 1878-7657
• DOI: 10.1007/s41999-023-00769-y

Key summary points Aim To study the skill level and self-confidence of residents in geriatrics regarding lumbar puncture and to assess the potential benefits of a specific type of training with simulation and virtual reality. Findings Most residents in geriatrics reported having received insufficient training during their second cycle of medical school and advocated for the need for additional LP lumbar puncture training. Simulation was associated with a significant gain in self-confidence. The post-training success rate of the residents in real-life clinical practice was good (85.8%). Message Simulation-training sessions were associated with significant benefits regarding self-confidence in lumbar puncture and should be regarded as an important educational tool in this setting. Purpose 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. Methods 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. Results 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%). Conclusion 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.