O12 Achieving competency in core skills – improving the performance of collection of peripheral blood cultures using simulation-based education and fluency training

IntroductionThe collection of Peripheral Blood Cultures (PBCs) is a core skill required of junior doctors. Contaminated PBC results may lead to inappropriate diagnosis and have implications for both patient safety and cost. Previous data has demonstrated a low level of knowledge, and little experience, in collecting peripheral blood cultures among Irish interns1. Using simulation-based education (SBE) and fluency training is one emerging means of ensuring proficiency in the performance of specific tasks with important implications for patient outcomes2. Fluency is defined as the performance of a task with both accuracy and speed, and characterises expert performance.MethodsA randomised controlled trial was conducted with interns in University Hospital Galway (UHG). The intervention group (n=20) received fluency training targeting collection of PBCs, and two control groups received either: a task analysis of the PBC skill only (n=20), or training-as-usual only (n=19). The performance of these groups was compared at baseline and post-test. Analysis of PBC contamination rates in the hospital will be used to compare performance in the clinical setting across the groups.ResultsIt took a mean of seven trials for the intervention group to reach fluency. Total training time was 13 hours, 47 minutes. Intervention group performance of the task improved significantly more than both control groups from baseline to final trial (Wilks lambda =.242, F(2, 42)=65.75, p