A Comprehensive Infant Lumber Puncture Novice Procedural Skills Training Package: An INSPIRE Simulation-Based Procedural Skills Training Package

Publication ID Published Volume
9724 March 13, 2014 10


The purpose of these materials is to provide a comprehensive simulation-based training and assessment package related to the infant lumbar puncture (LP) procedure for novice providers. This package involves multiple phases of training and assessment that will facilitate skills development for a novice provider in order to maximize their performance in the clinical setting.

As new learners enter a clinical setting, they may be asked to perform an LP without having had any experience on a live infant. This multimodal package will use simulation as a formative assessment medium for review of LP training on a simulator prior to performing an LP on a live infant patient. The simulated environment provides a means for trainees to achieve a specific competency level via practice without affecting live patients (Kneebone et al 2009). As per the International Network for Simulation-based Pediatric Innovation, Research, and Education (INSPIRE) study, this educational module is based on six phases, including preparation (LEARN), demonstrations (SEE), Simulation-based training (PRACTICE), summative assessment on a simulator (PROVE), clinical performance (DO), and continued training and performance (MAINTAIN) (Kessler et al 2011).

This component of the package covers the LEARN, SEE and PRACTICE phases for the LP procedure and includes a faculty resource guide, a train-the-trainer video, a faculty guide and the checklist materials.

We are currently developing modules on the PROVE (summative assessment module), DO/MAINTAIN (just-in-time work-place based competency assessment modules) phases of this package.


Auerbach M, Chang T, Fein D, et al. A comprehensive infant lumber puncture novice procedural skills training package: an inspire simulation-based procedural skills training package. MedEdPORTAL Publications. 2014;10:9724. http://doi.org/10.15766/mep_2374-8265.9724

Contains Information Suitable for Patient Education

Educational Objectives

  1. The educator should be able to conduct a scripted mastery learning session.
  2. The educator should be able to demonstrate expert modeling of the procedure with deconstruction into the sub-component tasks of the procedure on a simulator.
  3. The educator should be able to explain the sub-component tasks of the procedure while demonstrating.
  4. The educator should be able to utilize the mastery learning checklist to guide formative feedback.
  5. The educator should be able to assess the learners performance on the simulator using the mastery checklist.
  6. The educator should be able to provide formative feedback on sub-component steps of the procedure.
  7. The educator should be able to coach the learner through repetitive deliberate practice on a simulator to achieve a minimum passing score.
  8. The learner should be able to understand the sub-component steps on the mastery checklist.
  9. The learner should be able to verbalize the sub-component tasks of the deconstructed procedure.
  10. The learner should be able to self-reflect on performance using the checklist.
  11. The learner should be able to demonstrate the sub-component tasks on the simulator to a minimum passing standard after repetitive deliberate practice.
  12. The overarching goal of this educational model is to improve clinical success rates and outcomes of an infant LP through a simulation-based intervention.


  • Simulation, Infant, Infant umbar Puncture, Procedural Skills, Educational Measurement, Mastery Learning, Learning, Deliberate Practice, Pediatrics, Summative Assessment


  1. Kessler DO, Arteaga G, Ching K, Haubner L, Kamdar G, Krantz A, Lindower J, Miller M, Petrescu M, Pusic M, Rocker J, Shah N, Strother C, Tilt L, Weinberg ER, Chang TP, Fein DM, Auerbach MA. A Single Simulation Training Session Is Insufficient to Improve Interns' Procedural Outcomes. Pediatrics. 2013 March 131 (3) e811. http://dx.doi.org/10.1542/peds.2012-0607
  2. Kessler D, Auerbach MA, Tunik M, Pusic M, Foltin JC. A Randomized Trial of Simulation-Based Deliberate Practice For Infant Lumbar Puncture Skills. Simulation in Healthcare 2011. August 6(4) 197-203. http://dx.doi.org/10.1097/sih.0b013e318216bfc1
  3. Kamdar G, Kessler DO, Tilt L, Srivastava G, Khanna K, Chang T, Balmer D, Auerbach, MA. Qualitative Evaluation of Just-In-Time Simulation-Based Learning: The Learners’ Perspective. Simulation in Healthcare 2013 8(1), 43-48. http://dx.doi.org/10.1097/SIH.0b013e31827861e8
  4. Auerbach MA,Chang T, Krantz A, Pratt A, Gerard J, Quinones C, Pusic M, Kessler D. Are pediatric interns prepared to perform infant lumbar punctures? A multi-institutional descriptive study. Pediatric Emergency Care. 2013 April 29(4):453-457. http://dx.doi.org/10.1097/PEC.0b013e31828a2011

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