1. The Effect of Train-the-Trainer
Modules on evaluating Simulated
Lumbar Punctures
Todd Chang, MD
dr.toddchang@gmail.com

2. Background
• The former POISE Network used Train-the-
Trainer (TTT) Modules for supervisors for the
Infant Lumbar Puncture (LP) study
• TTT show how infant LPs should be rated on a
4-point Global Assessment Scale (GAS)
• It is unknown if the TTT truly affected the
supervisors’ ability to rate simulated LPs

4. PICO Question
• Population
– In senior residents, fellows, and attendings who have
supervisory exposure to infant LPs,
• Intervention
– Does the completion of a TTT Module
• Comparison
– Compared with no such use
• Outcome
– Improve the Scoring Accuracy when rating 4
standardized simulated LPs on video?

5. Approach
• Record 4 simulated LPs used in the Validation
study reflecting 4 levels of expertise: Novice,
Beginner, Competent, Proficient
• Randomize scenarios on SurveyMonkey
• Approach POISE Network trainers as the
Intervention Group and ask to rate LP videos
• Approach EXPRESS Network trainers as the
Control Group without exposure to the TTT

6. 3 Questions
• Should there be 3 groups: TTT, LP Study
exposure without TTT, and Control?
• What is the optimal scoring method?
• How do we prevent inoculation when
testing a TTT v2.0 Module?
Todd Chang, MD
dr.toddchang@gmail.com