Kessler lp alert update 2014


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Kessler lp alert update 2014

  1. 1. ALERT Presentation: Improving trainee success rates with Infant Lumbar Puncture David Kessler, et al. Columbia University, NY INSPIRE @ IMSH 2014: San Francisco, California,USA International Network for Simulation-based Pediatric Innovation, Research and Education
  2. 2. 2012 44 hospitals 1008 trainees
  3. 3. 2013-14 Collaborators • • • • • • • • • Jennifer Trainor Daniel Lemke Louisdon Pierre Daniel Fein Kathleen Ostrom Megan Lavoie Brett McAninch Joel Clingenpeel Pavan Zaveri Denis Oriot James Gerard Devin Grossman Moon Lee E. Berry Seelbach Amanda Pratt Rita Dadiz Jonathan Jacobs Kevin Ching Marc Auerbach Marjorie Lee White Wendy Van Ittersum Joshua Rocker Lisa McQueen Sujit Iyer Brian Costello Renuka Mehta Maybelle Kou DJ Scherzer Cena Tejani Elsa L Vazquez Melendez
  4. 4. 2013-14 Collaborators Columbia Yale University Comer Children's Hospital Nationwide Children's Hospital Stony Brook University Inova Fairfax Hospital for Children UMDNJ/RWJUH Children's Hospital at Montefiore Children's Hospital Los Angeles Cleveland Clinic Weill Cornell Medical Center Centre Hospitalier de Poitiers Georgia Health Sciences University King Abdulaziz University Hospital University of Rochester Medical Center Children's Hospital of Pittsburgh of UPMC Cohen Childrens medical Center Children's National Medical Center University of Wisconsin Children's of Alabama LeBonheur Children's Hospital UTSW Jacobi Medical Center OSF Saint Francis Medical Center/University of Illinois College of Medicine at Peoria Alfred I dupont Children’s Hospital of the Kings Daughters Brooklyn Hospital Center Ann & Robert H. Lurie Children's Hospital of Chicago Dell Children's Medical Center of Central Texas Emory CHOP Tufts Medical Center/Floating Hospital for Children at Tufts Medical Center SSM Cardinal Glennon Children's Medical Center/SLU
  5. 5. Background Design 2008 Single center RCT in all peds residents n=56 •Sim-training vs video here Add text 2009 Multi-center RCT (10) n=200 Outcomes Results Successful LP, 94% vs 47% confidence, knowledge, skills on simulator Successful LP or 34% vs 34% IV Sim LP vs Sim IV 2010 Multi-center cohort (25) n= 501 Sim LP mastery & JIT vs historical Successful LP 42% vs 34% 2011 Multi-center cohort (33) n=700 Sim LP mastery, JIT and assessed Successful LP Competent 55% Incompetent 28% 2012 Multi-center cohort (38) n=1000 Competency pathway vs none Successful LP pathway vs no pathway 2013 Multi-center cohort (35) n=990 Competency pathway vs none Successful LP pathway vs no pathway International Network for Simulation-based Pediatric Innovation, Research and Education
  6. 6. 1. Online Survey & Audiovisual Training 3. JIT: Just-in-time Refresher Session 2. Mastery Learning Session Orientation July August 4. Clinical Lumbar Puncture September 4. JIT: Just-in-time Refresher Session October November 5. Clinical Lumbar Puncture December
  7. 7. Academic Productivity MANUSCRIPTS JOURNAL PI A Randomized Trial of Simulation-Based Deliberate Practice For Infant Lumbar Puncture Skills. Simulation in Healthcare SIH 2011 Kessler Infant Lumbar Puncture: POISE Pediatric Procedure Video. MedEdPORAL 2011 Interns' Success With Clinical Procedures in Infants After Simulation Training Pediatrics 2013 Kessler Validation of Global Rating Scale and Checklist Instruments for the Infant Lumbar Puncture Procedure. SIH 2013 Gerard Are pediatric interns prepared to perform infant lumbar punctures? A multi-institutional descriptive study. PEC 2013 Auerbach Qualitative evaluation of just-in-time simulationbased learning: The learners' perspective. SIH 2013 Kamdar Auerbach
  8. 8. Works in Progress MANUSCRIPTS IN PROGRESS (S=submitted) PI Competency assessment scale predicts success Auerbach Just-in-time refreshers impact on LP clinical success S Kessler Competency assessment HARD STOP – impact on success Kessler Description of 3rd year success rates Marjorie Barriers to implementation of competency pathway - qualitative Dadiz Impact of sim JIT on analgesia use for infant LP Fein Emergency medicine resident sub-analysis Grossma n Barriers to JIT/workplace learning perceived by instructors-qualitative S Kamdar Resident JIT impact on ILP success Zaveri
  9. 9. 3 Questions to improve study 1. Grant ideas? 2. LP ipad app – in development 3. Current plan: take a year off data collection to let the soil lay “fallow” International Network for Simulation-based Pediatric Innovation, Research and Education
  10. 10. Contact Information Name: David Kessler Institution: CHONY, 5167693777 International Network for Simulation-based Pediatric Innovation, Research and Education