Using simulation models to teach junior doctors how to insert chest tubes: a brief and effective teaching module

Abstract

Background: Pleural procedures may cause serious complications when incorrectly carried out. There is a need to find effective methods for teaching how to insert a chest drain safely. Aim: To assess the effectiveness of a programme for teaching chest tube insertion using a simulation model (SuperAnnie). Methods: Groups of four to six junior doctors were enrolled in a 2‐h teaching session, covering both theoretical knowledge and practical chest tube insertion techniques using a simulation model. Before the teaching module, participants completed a questionnaire about their confidence and skill levels and were videotaped inserting a standard chest tube in the model. The assessments were repeated 1 month after the teaching module. The video clips were scored by two independent assessors using an 18‐point scoring system that was blinded to whether the taping was pre‐ or post‐teaching. Results: Forty‐nine doctors completed the study. Baseline video assessment scores were low (median score 4 (maximum possible score 18), interquartile range (IQR) 2–7.5) and were not associated with past experience, the doctor’s self‐confidence level or their self‐assessed skill rating. After teaching, video assessment scores improved significantly (mean score 13, IQR 10.5–15). Doctors with the lowest baseline scores showed the most improvement. There were also improvements in doctors’ self‐confidence and self‐assessed skill levels, although there remained no association between these measures and video assessment scores. Conclusions: A brief teaching module using a simulation model is effective in improving confidence and skill in chest tube insertion.