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Procedural simulation in venipuncture for medical undergraduates and its transfer to the bedside: a cluster randomized study

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Abstract

Simulation is accepted as an effective method of learning procedural skills. However, the translational outcomes of skills acquired through simulation still warrants investigation. We designed this study to assess if skills laboratory training in addition to bedside learning (intervention group [IG]) would provide better learning results than bedside learning alone (control group [CG]) in the context of venipuncture training. This prospective, cluster-randomized, single-blind study took place at the Faculty of Medicine, University of Kelaniya, Sri Lanka. Seventeen clusters of second-year medical students were randomly assigned to either IG or CG. The IG trained on venipuncture in the skills laboratory, receiving instruction after modified Payton’s Four Step Method. Following the training, students of both IG and CG underwent bedside learning for one month. Afterward, students of both groups performed venipuncture on actual patients in a clinical setting. An independent, blinded assessor scored students’ performance using the Integrated Procedural Protocol Instrument (IPPI) and a checklist. Patients assessed students’ performance with the Communication Assessment Tool (CAT). Eight and nine clusters were randomized to the intervention and control groups, respectively. IG completed significantly more single steps of the procedure correctly (IG: 19.36 ± 3.87 for checklist items; CG: 15.57 ± 4.95; p < 0.001). IG also scored significantly better on IPPI ratings (median: IG: 27 (12) vs. CG: 21 (8); p < 0.001). Rated by patients, students’ communication skills did not significantly differ between the two groups. Simulation-based venipuncture training enabled students to perform the procedure on actual patients with a higher technical accuracy than students who learned venipuncture at the bedside. Students were able to transfer the skills acquired through venipuncture training at the skill laboratory to the bedside.

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Data Availability

The datasets generated and analyzed during the current study are not publicly available due the fact that they constitute an excerpt of research in progress but are available from the corresponding author on reasonable request.

Abbreviations

IPPI:

Integrated procedural Protocol Instrument

SP:

Standardized patient

CAT:

Communication Assessment Tool

SBPT:

Simulation-based Procedural Training

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Acknowledgements

We thank the following people who contributed to the study: Lecturer M.H.M. Wickramasekara, Faculty of Medicine, University of Kelaniya, Sri Lanka; Lecturer B.D.W. Jayammanne, Faculty of Medicine, University of Kelaniya, Sri Lanka; and N.A.K.S.R. Kumara, Faculty of Medicine, University of Kelaniya, Sri Lanka.

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Authors and Affiliations

  1. Department of Medical Education, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka

    Kaumudee Kodikara

  2. Department of Pharmacology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka

    Thilanka Seneviratne

  3. Department of Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka

    Ranjan Premaratna

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All the authors made substantial contributions to the work. All the authors gave final approval to the submitted paper. All authors agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. For individual contributions: K.K. contributed to research conceptualization, data acquisition, data analysis, and drafting of the article. T.S. contributed to data interpretation and critically revising the manuscript. R.P. contributed to data interpretation and critically revising the manuscript. All authors approved the final version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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The study was approved by the ethics review committee of the Faculty of Medicine, University of Kelaniya (P/233/11/2019). As this was a purely educational intervention, trial registration was deemed exempt. Informed written consent was obtained from all study participants and the patients. Further, permission for conducting the study in the clinical setting was obtained from the Director of the Colombo North Teaching Hospital and relevant Consultants in the Wards. Study participation was voluntary, and all participants were assured of anonymity and confidentiality. The research was carried out in accordance with the guidelines of Declaration of Helsinki.

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Kodikara, K., Seneviratne, T. & Premaratna, R. Procedural simulation in venipuncture for medical undergraduates and its transfer to the bedside: a cluster randomized study. Adv in Health Sci Educ (2023). https://doi.org/10.1007/s10459-023-10293-0

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