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

Northwestern University

Status: Completed

Conditions: Misadventure During Thoracentesis

Treatments: Other: Simulation-based mastery learning

Study type: Interventional

Funder types: Other; Other U.S. Federal agency

Identifiers

NCT01898247

STU00069024

Details and patient eligibility

About

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.

Full description

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.

Enrollment: 1,000 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

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

Exclusion criteria

• Cognitive impairment

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Single Group Assignment

Masking: Double Blind

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1,000 participants in 2 patient groups

Traditionally-trained Procedures

No Intervention group

Description:

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

Simulator-trained Procedures

Experimental group

Description:

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

Treatment:

Other: Simulation-based mastery learning