Intraosseous access can be taught to medical students using the four-step approach

BMC Medical Education

Research Article

Sandra Viggers¹  Tobias Stenbjerg Lyngeraa²  Monika Afzali³  Ask Daffy Kvisselgaard⁴ 

[1] Copenhagen Academy for Medical Education and Simulation, Capital Region of Denmark, Herlev, Denmark;Department of Anaesthesiology, Nordsjælland Hospital, Herlev, Denmark;Department of Anaesthesiology, University Hospital of Copenhagen, Herlev, Denmark;Cochrane Anaesthesia, Critical and Emergency Care, The Cochrane Collaboration, Herlev, Denmark;Students’ Society of Anaesthesiology & Traumatology, Faculty of Health and Medical Sciences, University of Copenhagen, Herlev, Denmark;

关键词: Intraosseous access;    Vascular access;    Medical students;    Medical education;    Anaesthesiology;    Traumatology;    Emergency medicine;    Resuscitation;    OSCE and checklist validity;   

DOI  :  10.1186/s12909-017-0882-7

 received in 2016-08-19, accepted in 2017-02-07,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe intraosseous (IO) access is an alternative route for vascular access when peripheral intravascular catheterization cannot be obtained. In Denmark the IO access is reported as infrequently trained and used. The aim of this pilot study was to investigate if medical students can obtain competencies in IO access when taught by a modified Walker and Peyton’s four-step approach.MethodsNineteen students attended a human cadaver course in emergency procedures. A lecture was followed by a workshop. Fifteen students were presented with a case where IO access was indicated and their performance was evaluated by an objective structured clinical examination (OSCE) and rated using a weighted checklist. To evaluate the validity of the checklist, three raters rated performance and Cohen’s kappa was performed to assess inter-rater reliability (IRR). To examine the strength of the overall IRR, Randolph’s free-marginal multi rater kappa was used.ResultsA maximum score of 15 points was obtained by nine (60%) of the participants and two participants (13%) scored 13 points with all three raters. Only one participant failed more than one item on the checklist. The expert rater rated lower with a mean score of 14.2 versus the non-expert raters with mean 14.6 and 14.3. The overall IRR calculated with Randolph’s free-marginal multi rater kappa was 0.71.ConclusionThe essentials of the IO access procedure can be taught to medical students using a modified version of the Walker and Peyton’s four-step approach and the checklist used was found reliable.

【 授权许可】

CC BY   
© The Author(s). 2017