Key summary points
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.
AbstractSection FindingsMost 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%).
AbstractSection MessageSimulation-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.
Abstract
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.
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Data availability
The data that support the findings of this study are available from the corresponding author, M.L., upon reasonable request.
References
Haute Autorité de Santé - Guidelines for prevention and management of adverse effects after lumbar puncture [Prévention et prise en charge des effets indésirables pouvant survenir après une ponction lombaire] (2019) [internet]. https://www.has-sante.fr/jcms/p_3067854/fr/prevention-et-prise-en-charge-des-effets-indesirables-pouvant-survenir-apres-une-ponction-lombaire. Accessed 1 June 2022
Engelborghs S, Niemantsverdriet E, Struyfs H, Blennow K, Brouns R, Comabella M et al (2017) Consensus guidelines for lumbar puncture in patients with neurological diseases. Alzheimers Dement 8:111–126
Duits FH, Martinez-Lage P, Paquet C, Engelborghs S, Lleó A, Hausner L et al (2016) Performance and complications of lumbar puncture in memory clinics: results of the multicenter lumbar puncture feasibility study. Alzheimers Dement 12(2):154–163
Paquet C, Latour F, Saulnier I, Hanon O (2012) Multicenter study on lumbar puncture indication, clinical practice and feasibility. Rev Neurol (Paris) 168(1):28–32
Haute Autorité de Santé - Guidelines for Healthcare simulation [Simulation en Santé] (2019) [internet]. https://www.has-sante.fr/jcms/c_930641/fr/simulation-en-sante. Accessed 1 June 2022
Lydon S, Reid McDermott B, Ryan E, O’Connor P, Dempsey S, Walsh C et al (2019) Can simulation-based education and precision teaching improve paediatric trainees’ behavioural fluency in performing lumbar puncture? A pilot study. BMC Med Educ 19(1):138
Barsuk JH, Cohen ER, Caprio T, McGaghie WC, Simuni T, Wayne DB (2012) Simulation-based education with mastery learning improves residents’ lumbar puncture skills. Neurology 79(2):132–137
Gaubert S, Blet A, Dib F, Ceccaldi PF, Brock T, Calixte M et al (2021) Positive effects of lumbar puncture simulation training for medical students in clinical practice. BMC Med Educ 21(1):18. https://doi.org/10.1186/s12909-020-02452-3
Vrillon A, Gonzales-Marabal L, Ceccaldi PF, Plaisance P, Desrentes E, Paquet C, Dumurgier J (2022) Using virtual reality in lumbar puncture training improves students learning experience. BMC Med Educ 22(1):244. https://doi.org/10.1186/s12909-022-03317-7
Cognat E, Koehl B, Lilamand M, Goutagny S, Belbachir A, de Charentenay L et al (2021) Preventing post-lumbar puncture headache. Ann Emerg Med 78(3):443–450. https://doi.org/10.1016/j.annemergmed.2021.02.019. (Epub 2021 May 7)
Courtois-Amiot P, Cloppet-Fontaine A, Poissonnet A, Benit E, Dauzet M, Raynaud-Simon A, Paquet C, Lilamand M (2022) Hypnosis for pain and anxiety management in cognitively impaired older adults undergoing scheduled lumbar punctures: a randomized controlled pilot study. Alzheimers Res Ther 14(1):120. https://doi.org/10.1186/s13195-022-01065-w
Pole MediTice UFR Medecine Paris Diderot (2020) VIDEO 01 Ponction Lombaire VR180 V3 Video | Pole MediTice UFR Medecine Paris Diderot [Video]. https://youtu.be/EqtrQUfKO9U. Accessed 18 Apr 2022
Ross S (2021) Twelve tips for effective simulation debriefing: a research-based approach. Med Teach 43(6):642–645. https://doi.org/10.1080/0142159X.2020.1831689. (Epub 2020 Oct 14)
Pearson GME, Welsh T, Pocock LV, Ben-Shlomo Y, Henderson EJ (2022) Transforming undergraduate education in geriatric medicine: an innovative curriculum at bristol medical school. Eur Geriatr Med 13(6):1487–1491. https://doi.org/10.1007/s41999-022-00690-w. (Epub 2022 Sep 7)
Masud T, Ogliari G, Lunt E, Blundell A, Gordon AL, Roller-Wirnsberger R et al (2022) A sco** review of the changing landscape of geriatric medicine in undergraduate medical education: curricula, topics and teaching methods. Eur Geriatr Med 13(3):513–528. https://doi.org/10.1007/s41999-021-00595-0. (Epub 2022 Jan 1)
Premadasa IG, Shehab D, Al-Jarallah KF, Thalib L (2008) Frequency and confidence in performing clinical skills among medical interns in Kuwait. Med Teach 30(3):e60–e65. https://doi.org/10.1080/01421590801915652
McMillan HJ, Writer H, Moreau KA, Eady K, Sell E, Lobos A-T et al (2016) Lumbar puncture simulation in pediatric residency training: improving procedural competence and decreasing anxiety. BMC Med Educ. https://doi.org/10.1186/s12909-016-0722-1
Lenchus J, Issenberg SB, Murphy D, Everett-Thomas R, Erben L, Arheart K et al (2011) A blended approach to invasive bedside procedural instruction. Med Teach 33(2):116–123. https://doi.org/10.3109/0142159X.2010.509412. (Epub 2010 Sep 27)
Acknowledgements
The authors would like to thank the staff from the simulation-training platform iLumens Paris Nord, Université Paris Cité as well as the MédiTICE engeneering team. The authors also thank the residents who got involved in this research project.
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ML, AV, LGM, JB, EP, and CP contributed to the study conception and design. Material preparation, data collection, and analysis were performed by ML, AV, LGM, and JD. The first draft of the manuscript was written by ML and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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This is an educational research, involving medical residents only. The Gérond'if Ethics Committee (Paris, France) has confirmed in April 2022 that no ethical approval is required.
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Lilamand, M., Vrillon, A., Gonzales-Marabal, L. et al. Lumbar puncture training with healthcare simulation improves self-confidence and practical skills of French medical residents in geriatrics. Eur Geriatr Med 14, 615–623 (2023). https://doi.org/10.1007/s41999-023-00769-y
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DOI: https://doi.org/10.1007/s41999-023-00769-y