Ventriculostomy and Lumbar Drain Management Training: A Randomized Trial of Computer-Based Training vs Self-Directed Video-Based Practice

Abstract

Abstract Purpose: Anesthesiology residents manage external ventricular drains (EVD) or lumbar drains (LP) in the operating room. There is no specific curriculum for anesthesiology residents on these devices. Computer-based training (CBT) utilizes reading material, photos, and questions without interactive content. Self-directed video-based practice (SVP) introduces hands-on training guided by a video example. Methods: A randomized single-blinded prospective trial was executed to compare the educational efficacy of SVP to CBT in managing EVD/LP by anesthesiology resident physicians. Simulation-based assessment was utilized for resident evaluation pre-intervention and at 2 weeks and 3 months post-intervention. Results: Linear regression showed a non-significant difference between the SVP group and the CBT group on performance (p=0.54). Compared to baseline scores, post-training test scores increased by an average of 22% (47 ± 26 vs. 69 ± 21; p<0.0001, 95% CI 16 – 28) points for pre- vs. post-training). A Spearman's comparison correlation demonstrated a high degree of correlation between the Total score and the Global performance ratings (r2 = 0.83, p<0.0001; 95% CI 0.75 – 0.89). Conclusion: CBT and SVP improved performance in managing ventriculostomies and lumbar drains in a simulated environment. There was no statistically significant difference between the CBT and SVP groups nor between post-test 1 and post-test 2. The validation measurement for simulation-based assessment was reliable and had strong evidence of validity.