670 - Development and Implementation of a Novel Abscess Trainer in Graduate Medical Education

Poster Number: 670
Publication Number: 670.151

Anthony Lucido, Walter Reed National Military Medical Center Department of Pediatrics, bethesda, MD, United States; Richard Zanetti, Air Forcs, Bethesda, MD, United States; Sidney Zven, Walter Reed National Military Medical Center Department of Pediatrics, Annandale, VA, United States; Sarah J. Krajnik, Walter Reed National Military Medical Center, Laurel, MD, United States; Alexandra Mauro, Walter Reed National Military Medical Center, Washington, DC, United States; Jennifer C. Geracht, Walter Reed National Military Medical Center, Washington, DC, United States; Erica L. Parenteau, Walter Reed National Military Medical Center, Germantown, MD, United States

Background: The abscess incision and drainage (I&D) procedure is a requirement for primary care
and surgical training per the Accreditation Council for Graduate Medical Education. I&Ds are
typically performed in acute care settings, with trainees often missing opportunities to perform or
learn the procedure. A simulation model is necessary to address this deficiency and provide an
opportunity for continued learning. Despite this necessity, no viable simulation option currently exists.

Objective: To introduce a realistic, cost-efficient, reproducible simulator and assess its impact on the
development of clinician skill and confidence in performing the I&D procedure.

Design/Methods: Abscesses were created using a balloon, filled with a purulent resembling material,
surrounded by a silicone rubber outer layer. Average cost per simulated abscess was $5 and it took 1 hour to create 20 models. A convenience sample of incoming GME trainees was utilized. Trainees completed pre and post-training surveys assessing comfort and familiarity with the I&D procedure on a Likert scale of 1 through 5. Descriptive statistics were performed for all survey data including mean and standard deviations (SD) for Likert scores, and counts/frequencies for all categorical data. A paired t-test was used to compare pre and post survey data for confidence and preparedness level reported.

Results: 87 trainees utilized the abscess model and completed pre and post surveys. Prior to the training, the mean (SD) confidence level for trainees was 2.5 (1.1) and the mean (SD) preparedness level was 2.4 (1.2). Following the training, the mean (SD) confidence level increased to 3.9 (0.8) with an increase in the mean (SD) preparedness level to 3.9 (0.8). Confidence scores increased by 1.4 (95% CI of 1.2-1.6). Likewise, the preparedness scores showed a statistically significant improvement by 1.5 (95% CI of 1.3-1.6). Trainees reported the abscess model was realistic and beneficial, with a mean (SD) realism score of 3.8 (0.8) and a mean (SD) beneficial score of 4.3 (0.8).

Conclusion(s): Our novel abscess trainer improved confidence and preparedness for GME trainees learning
the I&D procedure. Our trainer was found to be a realistic simulation as evaluated by trainees
with prior experience performing I&D procedures on live patients. This study showed that the novel,
cost efficient, reproducible abscess I&D simulation trainer was effective in improving trainee confidence
and preparedness prior to starting residency training. Widespread use of this model will provide trainees the experience and practice necessary for competence in this procedural skill.