Paired Versus Individual Epinephrine Injection Procedural Skills Training, Compared Effectiveness in an Anaphylaxis Simulation (1090-002324) (Research Abstract Professor Rounds: Group 4)
Start time: Thursday, January 28, 2021, 1:00 PM End time: Thursday, January 28, 2021, 2:00 PM Session Type: Research Abstracts (Completed Studies)
To investigate the effect of practicing on a peer versus individual practice on time to action and correctness of delivery of an epinephrine autoinjector training pen on a standardized patient demonstrating signs of anaphylaxis.
Hospital volunteers and local college simulation center visitors participated in small group lectures on the management of anaphylaxis from July 2018-August 2019. Groups were randomly assigned to hands-on autoinjector training through individual or paired practice with a group peer. Each learner then participated in an anaphylaxis simulation scenario with a standardized patient. Outcomes included time and correctness of epinephrine injection in an anaphylaxis scenario with a standardized patient, and self-reported comfort administering epinephrine.
Significantly more paired learners delivered the injection correctly, 88% (43/49) vs. 61% (28/46), difference of 27%, (95% confidence interval 10%-43%), p=0.003. The difference in time to action for individual learners, median 10 (4,25) seconds, and paired learners, 10 (4,33) seconds, was not statistically significant, p=0.21. When learner age was included in regression modeling, delivery correctness remained significant, and time to action was statistically significant; paired learners administered the injection 26% (95% CI 4-48%) faster than individual learners, p=0.002. Post-study procedural comfort survey data did not differ significantly between learner groups, median 9/10 and 10/10 respectively, p=0.14.
Paired-practice may be superior to practicing alone for a high-risk procedural skill such as epinephrine injection administration in the setting of anaphylaxis, and that learner age is associated with differential performance in a scenario that should be age neutral.