The importance of simulation in lumbar puncture training

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By Héloïse Guillot  /   18th August 2021

🔹 The challenges of lumbar puncture training

Sim&Care, lumbar puncture simulator
Lumbar puncture is a very common and invasive medical procedure. It involves the sampling of cerebospinal fluid (CSF) from the subarachnoid space by inserting a needle between the spinous processes of two lumbar vertebrate. It is used for diagnostic purposes and in some therapeutic cases, mainly in emergency rooms, internal medicine, neurology or pediatrics.

It is a procedure that can be potentially painful, that induces anxiety, and can lead to serious complications. However, like many delicate medical gestures, it is often taught directly at the patient’s bed, according to the “see one, do one, teach one” method. Medical students acquire theoretical education, observe procedures performed by their peers, and perform their practical training directly on the patient. This method is flawed and affects both the patient and the student. On the one hand, it often causes variable procedural skill acquisition, and stress among students, who face very variable training depending on their course, since opportunities to practice do not always arise during hospitals internship. In addition, training on the patient can raise ethical issues. He is forced to endure mistakes, which can cause unnecessary pain and complications. The lumbar puncture is thus perceived by the students as a difficult and stressful gesture and 1 out of 2 students fail at their first attempt. It is also common for patient to refuse to be treated by students for this procedure.
Lack of practice for medical student leads to lack of self-confidence, which increases anxiety and can lead to mistakes. It it is therefore particularly important that medical students benefit from prior training, which is known to improve the success rate of the first punctures.

🔹 Simulation as an ideal training tool

Simulation is now emerging as an essential training method for healthcare professionnels, as it allow training in various situations under realistic conditions, without running the risk of real error. For lumbar puncture training, it allows the user to endlessly reproduce the gesture without endangering the patient, in a controlled and secure environment. In line with the “never the first time on the patient” principle, students benefit from innovative learning experiences through simulation and can not only sustainably acquire technique skills, but also build up their self-confidence to deliver real patient care, thus contributing to improve care quality and safety.

🔹 How InSimo’s work fits into this issue

To be complete and effective, this training must cover different key points. the student must practice the technical gesture, and be able to anticipate the expected sensations. However, he must also be able to communicate with his patient throughout the procedure, in order to obtain his consent, explain the steps of the procedure, and reassure him.
In order to provide a complete simulation solution, InSimo has developed Sim&Care, the first hybrid simulator for lumbar puncture training. By combining force feedback, biomechanical simulation of 3D anatomies, augmented reality and real-time sound immersion, Sim&Care offers an innovative educational approach and takes into account the procedure as a whole.
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Sim&Care, lumbar puncture simulator

🔹 Read more!

To find out how Sim&Care meets the need for a complete educational solution for lumbar puncture training, don’t hesitate to read our article series on the subject:
🔹Palpation and sensations during a lumbar puncture: how Sim&Care take these aspects into account
🔹Complication factors in a lumbar puncture: how students can prepare with Sim&Care
lumbar puncture simulator
Find out more about Sim&Care, our Lumbar Puncture Simulator
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References

Barsuk J.H., Cohen E.R., Caprio T., MacGaghie W.C., Simuni T., Wayne D.B. Simulation-based education with mastery learning improves resident lumbar puncture skills. Neurology (2012) 79(2): 132-137.
Färber M., Hummel F., Gerloff C., Handels H. Virtual Reality Simulator for the Training of Lumbar Punctures. Methods of Information in Medicine (2009) 48(5): 493-501.
McMillan H.J., Writer H., Moreau K.A., Eady K., Sell E., Lobos A-T., Grabowski J., Doja A. Lumbar puncture simulation in pediatric residency training: improving procedural competence and decreasing anxiety. BMC Medical Education (2016) 16: 198.
Moulaye A. Evaluation des étudiants, internes et résidents sur lap ratique de la ponction lombaire au cours des stages hospitaliers. The Pan African Medical Journal (2019) 33: 56.
Uppal V., Kearns R.J., McGrady E.M. Evaluation of M43B Lumbar puncture simulator-II as a training tool for identification of the epidural space and lumbar puncture. Anaesthesia (2011) 66: 493-496.
White M.L., Jones R., Zinkan L., Tofil N. Transfer of Simulated Lumbar Puncture Training to Clinical Setting. Pediatric Emergency Care (2012) 28(10): 1009-1012.