When should we perform a repeat training on adrenaline auto-injector use for physician trainees?

Allergol Immunopathol (Madr). Sep-Oct 2014;42(5):472-5. doi: 10.1016/j.aller.2013.07.008. Epub 2013 Oct 28.


Background: Studies demonstrate that both doctors and patients may use adrenaline auto-injector improperly and the usage skills are improved by training. In this study, we aimed to determine the appropriate frequency of training to maintain skills for adrenaline auto-injector use.

Methods: We invited all interns of 2011-2012 training period. At baseline, all participants were given theoretical and practical training on adrenaline auto-injector use. The participants were randomly assigned into two groups. We asked those in group 1 to demonstrate the use of adrenaline auto-injector trainer in the third month and those in group 2 in the sixth month.

Results: One hundred and sixty interns were enrolled. Compared with the beginning score, demonstration of skills at all the steps and total scores did not change for the group tested in the third month (p=0.265 and p=0.888, respectively). However; for the group examined in the sixth month; the demonstration of skills for proper use of the auto-injector at all steps and the mean time to administer adrenaline decreased (p=0.018 and p<0.001, respectively). Besides, the group which was tested in the third month was better than the group which was tested in the sixth month in terms of demonstrating all steps (p=0.014), the total score (p=0.019), mean time of change to administer adrenaline (p<0.001) and presumptive self-injection into thumb (p=0.029).

Conclusions: Auto-injector usage skills of physician trainees decrease after the sixth month and are better in those who had skill reinforcement at 3 months, suggesting continued education and skill reinforcement may be useful.

Keywords: Adrenaline; Anaphylaxis; Auto-injector; Skill; Training; Usage.

MeSH terms

  • Adult
  • Bronchodilator Agents / administration & dosage*
  • Education, Medical, Graduate / methods*
  • Epinephrine / administration & dosage*
  • Female
  • Humans
  • Injections, Intramuscular / methods
  • Internship and Residency
  • Male
  • Young Adult


  • Bronchodilator Agents
  • Epinephrine