P14 Part-task training with low-fidelity simulation is an effective method of pericardiocentesis training

Background Pericardiocentesis is a core skill for cardiologists. For those in UK training, a formative Direct Observation of Practical Skills (DOPS) assessment is mandated; however, the availability of practical pericardiocentesis training in clinical practice remains a challenge. The use of part-task trainers in practical skill training is well documented and allows trainees to learn in a safe environment away from the clinical setting. 1 Their use specifically in teaching pericardiocentesis is less well reported. We present our experience of a novel practical ultrasound-guided pericardiocentesis training course. Summary of Work A half-day course was developed encompassing part-task training, and interactive lectures based on the European Society of Cardiology guidelines including indications, complications and the interpretation of echocardiographic appearances of pericardial effusions and tamponade. Part-task training was performed using an ‘Ultrasound-Guided Thoracentesis/Pericardiocentesis Simulator’ (Kyoto Kagaku co. ltd., model MW17) and Vivid-i (GE) echocardiography machine. The skill was demonstrated first by a Consultant cardiologist and was subsequently performed by each delegate. Each delegate repeated the procedure in the context of a clinical vignette, where the part-task trainer was accompanied by a patient monitor (Laerdel) to simulate changes in patient haemodynamic status during and after the procedure. This provided a framework for semi-structured debrief on skill performance and discussion of potential causes, complications and management of pericardiocentesis. All candidates completed matched pre- and post-course assessments involving Extended Matching and Multiple Choice Questions, and an evaluation form. All candidates on GMC-approved training schemes were able to complete DOPS assessments using the NHS e-portfolio system. Results Two half-day courses were each attended by six cardiology trainees and clinical fellows at ST3 +level. 100% (n=12) and 92% (n=11) rated the practical skills session as ‘very good’ or ‘good’ in usefulness and presentation respectively. 100% (n=12) of attendees reported the course met their educational needs ‘very well’ or ‘well’. Thematic analysis of feedback supported the use of practical part-task training for pericardiocentesis which met delegates’ expectations and training objectives. Quantitative analysis demonstrated significant improvement in assessment scores following the course (p Discussion Part-task training with low-fidelity simulation is a viable and effective method of pericardiocentesis training. It offers a valuable opportunity to develop this core practical skill in accordance with local and national training requirements, without compromising patient safety. Important limitations of the pericardiocentesis model used include the initial cost, damage to skin pads during training, and the lack of ventricular contraction which reduces echocardiographic fidelity. Reference 1. E Diederich, et al. The effect of model fidelity on learning outcomes of a simulation-based education programme for central venous catheter insertion. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare December 2015;10(6):360–367.