Ramesh M Nataraja1,2, Stephanie Khoo3, Michael Ditchfield3, Nathalie R Webb1. 1. Department of Paediatric Surgery, Urology and Surgical Simulation, Monash Children's Hospital, Melbourne, Victoria, Australia. 2. Department of Paediatrics, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia. 3. Department of Radiology, Monash Children's Hospital, Melbourne, Victoria, Australia.
Abstract
BACKGROUND: Intussusception is a common, potentially life-threatening paediatric condition. Non-operative treatment with an air enema has been established as the clinical gold standard. There is no validated model for the training of this procedure. Our aim was to produce a novel air enema reduction simulator and validate its use as a training tool. METHODS: A low-cost paediatric intussusception air enema simulator was created. It was designed to include essential key clinical procedural steps. Participants included both procedural experts and novices from the Departments of Paediatric Radiology and Surgery. The simulator was assessed for face and content validity and its physical, conceptual and experiential fidelity by a structured questionnaire using a 5-point Likert's scale. Statistical analysis included a t-test, and a P-value of <0.05 was considered significant. RESULTS: Twenty-four clinicians completed the simulation activity (expert: 13 and novices: 11). All experts had performed a minimum of 40 clinical procedures, and 46% had performed >50 procedures. All scores were favourable in all domains for face and content validity: 3.5 (physical appearance), 3.3 (insertion of the tube and taping), 3.1 (holding of the buttocks) and 3.5 (performing the air enema). The simulator also scored highly with fidelity assessment; visual 3.5, conceptual 3.4. There was no difference in procedural confidence with experts (3.8 versus 3.6, P = 0.28), but there was for novices (1.0 versus 2.9, P = 0.0002). CONCLUSIONS: This low-cost air enema reduction simulator for intussusception has an excellent educational potential for use in a training program in a tertiary centre, as well as, resource-constrained environments.
BACKGROUND: Intussusception is a common, potentially life-threatening paediatric condition. Non-operative treatment with an air enema has been established as the clinical gold standard. There is no validated model for the training of this procedure. Our aim was to produce a novel air enema reduction simulator and validate its use as a training tool. METHODS: A low-cost paediatric intussusception air enema simulator was created. It was designed to include essential key clinical procedural steps. Participants included both procedural experts and novices from the Departments of Paediatric Radiology and Surgery. The simulator was assessed for face and content validity and its physical, conceptual and experiential fidelity by a structured questionnaire using a 5-point Likert's scale. Statistical analysis included a t-test, and a P-value of <0.05 was considered significant. RESULTS: Twenty-four clinicians completed the simulation activity (expert: 13 and novices: 11). All experts had performed a minimum of 40 clinical procedures, and 46% had performed >50 procedures. All scores were favourable in all domains for face and content validity: 3.5 (physical appearance), 3.3 (insertion of the tube and taping), 3.1 (holding of the buttocks) and 3.5 (performing the air enema). The simulator also scored highly with fidelity assessment; visual 3.5, conceptual 3.4. There was no difference in procedural confidence with experts (3.8 versus 3.6, P = 0.28), but there was for novices (1.0 versus 2.9, P = 0.0002). CONCLUSIONS: This low-cost air enema reduction simulator for intussusception has an excellent educational potential for use in a training program in a tertiary centre, as well as, resource-constrained environments.