Using simulation models to teach junior doctors how to insert chest tubes: a brief and effective teaching module

Intern Med J. 2008 Dec;38(12):887-91. doi: 10.1111/j.1445-5994.2007.01586.x. Epub 2008 Feb 14.


Background: Pleural procedures may cause serious complications when incorrectly carried out. There is a need to find effective methods for teaching how to insert a chest drain safely.

Aim: To assess the effectiveness of a programme for teaching chest tube insertion using a simulation model (SuperAnnie).

Methods: Groups of four to six junior doctors were enrolled in a 2-h teaching session, covering both theoretical knowledge and practical chest tube insertion techniques using a simulation model. Before the teaching module, participants completed a questionnaire about their confidence and skill levels and were videotaped inserting a standard chest tube in the model. The assessments were repeated 1 month after the teaching module. The video clips were scored by two independent assessors using an 18-point scoring system that was blinded to whether the taping was pre- or post-teaching.

Results: Forty-nine doctors completed the study. Baseline video assessment scores were low (median score 4 (maximum possible score 18), interquartile range (IQR) 2-7.5) and were not associated with past experience, the doctor's self-confidence level or their self-assessed skill rating. After teaching, video assessment scores improved significantly (mean score 13, IQR 10.5-15). Doctors with the lowest baseline scores showed the most improvement. There were also improvements in doctors' self-confidence and self-assessed skill levels, although there remained no association between these measures and video assessment scores.

Conclusions: A brief teaching module using a simulation model is effective in improving confidence and skill in chest tube insertion.

MeSH terms

  • Chest Tubes*
  • Clinical Competence* / standards
  • Female
  • Humans
  • Internship and Residency / methods*
  • Internship and Residency / standards
  • Male
  • Models, Educational*
  • Teaching / methods*
  • Teaching / standards