Jitlp information

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Jitlp information

  1. 1. Improving infant LP skills through simulation-based mastery learning and just-in-time refreshers POISE 2010-2011
  2. 2. Objectives • Overview of an infant LP educational project targeted at interns • To describe the “just-in-time” skill refreshers on simulators …and how YOU can help!
  3. 3. • POISE aims to improve patient outcomes through the development and dissemination of robust educational interventions
  4. 4. THE PROBLEM • Today’s patients can be harmed in the training of tomorrow’s practitioners • Pediatricians perform high-stakes low frequency procedures • Procedural skills require practice to gain proficiency THE SOLUTION • Simulation allows for skill development in lifelike circumstances on models without risk to the patient
  5. 5. HYPOTHESIS • Participation in simulation-based mastery learning with just-in-time refreshers will lead to improved infant LP success rates • Our hospital will have simulators available in all clinical areas where LPs occur
  6. 6. What is mastery training? • Clearly defined target level of performance – Time varies to achieve mastery of skill – Customized based on learner needs • Repetitive deliberate practice (coached) – Kinesthetic learning – Practice-Feedback-Correction-Practice --> independence
  7. 7. 1. Online Survey & Audiovisual Training 2. 3. 4. 4. 5. Mastery JIT: Clinical JIT: Clinical Learning Just-in-time Lumbar Just-in-time Lumbar Session Refresher Puncture Refresher Puncture Session Session Orientation July August September October November December
  8. 8. What are just-in-time refreshers? • Brief (<5 minute) coached refresher on sim – Facilitated by supervising physician for LP • Senior resident, fellow, attending • Additional tool for you to teach the interns! • Proximal to clinical performance (time/place) • Goal directed – To bolus skills before clinical performance
  9. 9. Learning Curve mastery JIT JIT skill time
  10. 10. JIT refresher: details Duration: < 5 minutes (already trained to mastery) Trigger = intern has infant who needs LP 1. Assemble practice LP kit and simulator 2. Ask learner to demonstrate “the best they can do” without your help on the simulator 3. Give feedback, answer questions, coach practice 4. Complete simulator assessment form 5. Supervise clinical LP (and complete form)
  11. 11. 3 steps of JIT 1. Get model and practice LP kit 2. Complete simulator (checklist) – Less than 5 minutes 3. Complete clinical (checklist)
  12. 12. How to set up the simulator 1. Fill bottle with water up to fill-line 2. Insert bottle in pressure bag 3. Inflate bag until pop-off valve hits 150mmHg
  13. 13. Assessment form 1. After JIT sim session-> complete SIDE 1 2. After intern attempts clinical LP-> complete SIDE 2 3. Please make sure all data points completed *Place data collection form into POISE box in clinical area*
  14. 14. Global rating • The scale measures level of independence • “Proficient” indicates ability to perform independently • “Expert” level is not expected
  15. 15. Errors and “near-miss” events • Record all errors or omissions of critical steps
  16. 16. Other Information- Sim LP
  17. 17. Other Information- Clinical LP
  18. 18. 1. Online Survey & Audiovisual Training 2. 3. 4. 4. 5. Mastery JIT: Clinical JIT: Clinical Learning Just-in-time Lumbar Just-in-time Lumbar Session Refresher Puncture Refresher Puncture Session Session

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