To investigate the effect of a lumbar puncture (LP) simulation-based learning (SBL) session on time it takes neurology residents to achieve competency (perform five LPs supervised).

Several studies have shown SBL can improve residents’ lumbar puncture skills. Our institution implemented a “neurology bootcamp” for PGY-2 neurology residents which included an SBL LP session. In this study we investigated the effect of course completion with achieving competency, thus allowing residents to perform LPs independently.

SBL LP session included supervised consent, positioning, and palpation of landmarks on standardized patient, and procedural training on a simulator. The dates for each resident logged LP (five total) were collected.  We selected residents who began their residency in 2021 to minimize the effect of the COVID-19 pandemic. We compared the time to competency for residents who did not participate in the session and those who did using independent sample t-test.

The sample consisted of 11 residents who had not participated in the simulation session, and 9 residents who had. The mean days to competency for the non-simulation group was 493 days (SD = 231), while for the simulation group was 236 days (SD = 279). This was a statistically significant difference (p = 0.006).

These data show that residents at our institution who participated in the SBL session achieved competency significantly sooner than those who did not participate. The major strength of this study is the outcome being a practical measure rather than subjective learner ratings and simulation metrics, as well as the combined use of a standardized patient and a simulator. Limitations include small sample size and single institution study. There are several unmeasurable factors that may have influenced the time to sign off such as availability of patients to perform the procedure on and the availability of signed off physicians to supervise the procedure.