Simulator-Based Training Sustainably Improves Confidence, Theoretical Knowledge, and Success Rates in Lumbar Puncture Among Medical Students: A Prospective Case-Control Study

Abstract

Background: Lumbar puncture (LP) is an essential tool in everyday clinical neuropsychiatric practice. It has been demon strated that, among junior doctors, the procedure is associated with elevated levels of stress and anxiety, which can ultim ately result in patient suffering. Notwithstanding the evident challenges, innovative teaching methodologies have not yet become a standard in daily clinical practice, despite the existence of different LP simulators. Methods: The prospective case–control study comprised 20 undergraduate medical students who participated in a tutorial that encompassed both theoretical knowledge and practical training regarding LP, utilizing a simulation model (“tutorial group”). Twenty-one students who were instructed in LP technique according to teaching methods from everyday clinical practice were used as controls (“control group”). A questionnaire was administered to all students, enquiring about con fidence levels, theoretical knowledge, and their proficiency when handling the puncture needles. Moreover, the success rate in performing their initial 4 LPs was measured. Results: The students in the tutorial group demonstrated significantly higher success rates in performing their first 4 LPs (median 3 vs. 1, p<0.001). Furthermore, confidence levels and safety when handling the puncture needles were significantly higher in the tutorial group, as well as knowledge regarding theoretical backgrounds. Higher confidence and safety in needle handling were strongly associated with a higher success rate. Conclusion: Short simulator-based tutorials have been shown to be an effective method of increasing the skills of young physicians and students in LP, and thus enhancing patient safety. Analogous approaches should be implemented on a large scale in medical education.