Peripheral venous catheter insertion simulation training: A randomized controlled trial comparing performance after instructor-led teaching versus peer-assisted learning - 15/02/17

Doi : 10.1016/j.accpm.2016.11.007

Sophie Pelloux ^a,^⁎ , Arnaud Grégoire ^b,^c, Patrice Kirmizigul ^b, Sandrine Maillot ^d, Bernard Bui-Xuan ^b, Guy Llorca ^b, Sylvain Boet ^e,^f,^g, Jean-Jacques Lehot ^b,^h, Thomas Rimmelé ^b,^c
^a Département de médecine générale, faculté de médecine Lyon Est, université Claude-Bernard Lyon 1, 69008 Lyon, France
^b Centre lyonnais d’enseignement par la simulation en santé, université Claude-Bernard Lyon 1, 69008 Lyon, France
^c Service d’anesthésie-réanimation, hôpital Edouard-Herriot, hospices civils de Lyon, 69003 Lyon, France
^d Institut de formation en soins infirmiers de Bourgoin-Jallieu, 38300 Bourgoin-Jallieu, France
^e Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ontario, Ottawa ON K1H 8L6, Canada
^f Skills and Simulation Centre (uOSSC), The Ottawa Hospital Research Institute, Ontario, Ottawa ON K1Y 4E9, Canada
^g Department of Innovation in Medical Education, University of Ottawa, Ontario, Ottawa ON K1H 8M5, Canada
^h Service d’anesthésie-réanimation, hôpital Pierre-Wertheimer, hospices civils de Lyon, 69500 Bron, France

^⁎Corresponding author. Tel.: +33(0)478 772 807; fax: +33(0)478 772 850. Département de médecine générale, faculté de médecine Lyon Est, université Claude-Bernard Lyon 1, 8, avenue Rockefeller, 69008 Lyon, France.

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Abstract

Introduction

Peripheral venous catheter insertion is a procedural skill that every medical student should master. Training is often limited to a small number of students and is poorly evaluated. The objective of this study was to evaluate the performance of peer-assisted learning in comparison to instructor-led teaching for peripheral venous catheter insertion training.

Methods

Students were randomized to the control group attending a traditional instructor-led training session (slideshow and demonstration by an anesthetist instructor, followed by training on a procedural simulator) or to the test group attending a peer-assisted training session (slideshow and demonstration video-recorded by the same instructor, followed by training on a procedural simulator). The primary endpoint was the performance of peripheral venous catheter insertion, assessed on procedural simulator one week later by blinded experts using a standardized 20-item grid. Students self-evaluated their confidence levels using a numeric 10-point scale.

Results

Eighty-six students were included, 73 of whom attended the assessment session. The median performance score was 12/20 [8–15] in the instructor-led teaching group versus 13/20 [11–15] in the peer-assisted learning group (P=0.430). Confidence levels improved significantly after the assessment session and were significantly higher in the peer-assisted learning group (7.6/10 [7.0–8.0] versus 7.0/10 [5.0–8.0], P=0.026).

Conclusion

Peer-assisted learning is effective for peripheral venous catheter insertion training and can be as effective as instructor-led teaching. Given the large number of students to train, this finding is important for optimizing the cost-effectiveness of peripheral venous catheter insertion training.

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Keywords : Peripheral venous catheter insertion, Motor skills, Simulation training, Instructor-led teaching, Peer-assisted learning, Medical education