? 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.