Evaluation of lumbar puncture simulator Mk2 (M43B) for teaching epidural placement to novice obstetric anaesthetic trainees
Abstract Number: 171
Abstract Type: Original Research
Teaching advanced technical skills such as neuraxial anaesthesia, to novice anaesthetists can be challenging, particularly given the severity of potential complications. Lumbar puncture simulator Mk2 (M43B) is a part-task trainer produced by Limbs and Things Ltd. for epidural insertion . We investigated whether this is a useful tool for training novice anaesthetists in epidural insertion.
Methods:Phase 1 of the study recruited anaesthetists with experience of 75 or more epidurals . Phase 2 involved novice anaesthetists, prior to their first obstetric anaesthesia training block. Participants performed lumbar epidural insertion on the M43B simulator. Various aspects of insertion were scored by anaesthetists for lifelikeness using a Likert scale (Strongly disagree-0, disagree-1, neither agree/disagree-2, agree-3, strongly agree-4 points). Novice anaesthetists were also asked about usefulness of the simulator for understanding complications of epidural insertion and improving confidence. Experienced anaesthetists completed feedback immediately after using the simulator while novices completed feedback following 3-6 successful labour epidural insertions.
Results:Eighteen experienced anaesthetists (10 consultants, 8 registrars) participated. All provided feedback. Seventeen novice anaesthetists attended simulator teaching. Eleven feedback forms have been received. Mean (SD) months anaesthetic experience of novices was 18 (7). Mean (SD) number of successful labour epidural insertions prior to completing feedback was 5 (2). Results are tabulated below (table 1)
Conclusions:The simulator was found to be lifelike for most aspects of epidural insertion by experienced anaesthetists, although not for catheter threading. However, the overall impression was that the simulator would be a useful tool for training novices. Amongst novice anaesthetists, there was general agreement that attending the simulator was useful for most aspects of epidural insertion although feedback for overall realism was equivocal. However, comments were generally very positive. Particularly appreciated was the chance to become familiar with equipment and boost confidence. There appears to be a useful role for such novel teaching aids as adjuncts to traditional methods.
1. Lumbar puncture & epidural simulator Mk2, http://www.limbsandthings.com
2. Naik VN et al. Cusum analysis is a useful tool to assess resident proficiency at insertion of labour epidurals.Can J Anaes 2003; 50: 694-8