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Simulated training program in abdominal paracentesis for undergraduate medical students
Authors:Rodrigo Tejos  Javier Chahuán  Thomas Uslar  Martin Inzunza  Ignacio Villagrán  Valentina Riquelme  Oslando Padilla  Margarita Pizarro  Marcia Corvetto  Julián Varas  Arnoldo Riquelme
Institution:1. Departamento Cirugía Digestiva, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile;2. Centro de Cirugía Experimental y Simulación, Pontificia Universidad Católica de Chile, Chile;3. Departamento Medicina Interna, Escuela de Medicina. Pontificia Universidad Católica de Chile, Chile;4. Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Chile;5. Escuela de Arte, Facultad de Artes, Pontificia Universidad Católica de Chile, Chile;6. Departamento de Salud Pública, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile;7. Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile;8. Centro de Educación Médica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
Abstract:

Background and aims

Abdominal paracentesis is an area that every general physician should know about, and the current learning model is unsafe for patients. Simulation allows students to develop their skills prior to clinical confrontation with minimal risks. The aims of this study were to design and evaluate a paracentesis simulation workshop for undergraduate students.

Methods

A workshop was implemented using a specially designed and validated simulation model for abdominal paracentesis. The simulated technique considered the recognition of materials, operator equipment, asepsis, anesthesia, puncture and obtaining liquid, collecting samples for analysis, withdrawal of the material and occlusion. A 24-point direct observation checklist was administered to assess the student. We assessed two students at the beginning of the workshop and all the students at the end. A perception survey was applied to attendees at the end of the workshop.

Results

247 students were included and a workshop that involved 8 students per session was held. Students significantly improved their skills comparing pre- and post-evaluation results 13.36 ± 4.46 (55.7%) vs. 22.3 ± 1.83 (92.9%) respectively (n = 69) p < 0.001]. The students’ perception questionnaire (n = 38) showed that the training sessions were highly valued, averaging 4.8 ± 0.38 on a Likert scale of 1–5.

Conclusions

Simulated training in abdominal paracentesis is a very good teaching method. This teaching methodology should be highly recommended as an educational strategy in medicine because it could accelerate the acquisition of clinical skills in a safe learning environment.
Keywords:PUC  Pontificia Universidad Católica de Chile  TAG  two-attempt group  OAG  one-attempt group  DOC  direct observation checklist  DOPS  direct observation of procedural skills  Simulated training  Undergraduate medical students  Ascites  Abdominal paracentesis  Procedural skills  Entrenamiento simulado  Estudiantes de medicina de pregrado  Ascitis  Paracentesis abdominal  Habilidades de procedimiento
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