Improving the Human Elements of Urinary Catheterisation Training – a Randomised Study of a New Wearable Catheterisation Trainer

Abstract

BACKGROUND Training in practical procedures has traditionally taken place in public hospitals where patients from disadvantaged backgrounds may be less empowered and feel compelled to accept procedure performance by beginners. Part task trainers provide some opportunity for learners to master the psychomotor components of skills but their ‘disembodied’ nature may lead to neglect of the critical human dimensions of procedures, especially those that are uncomfortable or intimate. PURPOSE To trial newly-developed urinary catheterisation trainers aiming to offer both improved fidelity through the use of a novel elastomeric polymer that approximates the characteristics of human skin and wearability by a simulated patient to allow attention to the human dimensions of the procedure. METHODS Year 2 medical students were invited to participate in the study. Participants were randomised by coin-toss to practice with either a prototype new trainer first, then a traditional part-task trainer, or vice versa. They completed questionnaires before and after each practice session. RESULTS 105 students participated. Participants rated the new trainer as much more accurately simulating performing the procedure on a real patient (mean score 7.3cm vs 3.3cm on a 10cm visual analogue scale, p<0.0001) and randomisation arm did not impact on participants’ ratings. Among 91 participants who offered an opinion on which better simulated the human dimensions of the procedure, 100% nominated the new trainer. DISCUSSION Other data to be presented and participants’ textual comments indicate that both better simulation of human tissues and wearability by a simulated patient contributed to participants’ preference for the new trainer. The improved simulator offers the potential for healthcare students who perform the procedure for the first time on hospital patients to be better prepared and more conscious of the human aspects. CONCLUSIONS The new trainer offers better simulation of urinary catheterisation especially in relation to the human dimensions of the procedure.