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
3. 2013-14 Collaborators
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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. 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. 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
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. 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. 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. Contact Information
Name: David Kessler
Institution: CHONY
dk2592@columbia.edu, 5167693777
International Network for Simulation-based Pediatric Innovation, Research and Education
