Use of Simulation-Based Mastery Learning for Thoracentesis to Improve Outcomes

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

1000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-12-31

Study Completion Date

2016-05-31

Brief Summary

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The goal of the proposed research is to investigate the use a medical simulation and mastery learning (where all learners must reach a high standard before completion of training) curriculum to improve internal medicine residents' skills when performing thoracentesis procedures (remove fluid from around the lung) on patients. Additionally, we will evaluate how these skills affect patient outcomes by comparing thoracenteses performed by simulator-trained residents to those who have "traditional" training. This project will evaluate these overall hypotheses: simulation-based training using the mastery learning approach improves medicine resident's thoracentesis skills and improves patient outcomes and satisfaction.

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Detailed Description

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Given medical procedures are the second most common cause of the complications that afflict 3% of hospitalized patients, simulation-based mastery learning should be applied to procedures done in all medical centers. In academic hospitals, bedside procedures such as thoracentesis procedures are often performed by unsupervised medical trainees. Traditionally, medical trainees learn procedures relying on the historic "see one, do one, teach one" mentality. Unfortunately, this approach subjects patients to procedures before trainees are competent.

Through the use of medical simulation, medical educators can increase the essential knowledge and skills of trainees while assuring procedural competence and reducing patient exposure to undue risk. Medical simulation training using the mastery learning model improves clinical skills and reduces the risk of procedure-associated injury. Our research group pioneered the use of this evidence-based approach for teaching medical trainees. Mastery learning requires that all trainees demonstrate a uniformly high level of skill before training completion. This ensures competence on a medical simulator before actual patient encounters.

Conditions

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Misadventure During Thoracentesis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

OTHER

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Traditionally-trained Procedures

Patients who undergo thoracentesis procedures by traditionally-trained residents who have not undergone simulation-based mastery learning.

Group Type NO_INTERVENTION

No interventions assigned to this group

Simulator-trained Procedures

Patients who undergo thoracentesis procedures by residents who have undergone simulation-based mastery learning.

Group Type EXPERIMENTAL

Simulation-based mastery learning

Intervention Type OTHER

Internal Medicine residents are randomly selected to undergo simulation-based mastery learning.

Interventions

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Simulation-based mastery learning

Internal Medicine residents are randomly selected to undergo simulation-based mastery learning.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients:

* undergoing a thoracentesis procedure
* on internal medicine or hospitalist ward service
* English or Spanish Speaking
* 2nd and 3rd year internal medicine residents