Background
Methods and Design
Objectives
Study design
Setting and participants
Inclusion and exclusion criteria
Randomization
Training curriculum
Assessment
Correct identification of incision location | 1
Poor
The chosen dissection plane deviates tremendously from the suggested site | 2 | 3
Sufficient
The chosen dissection plane deviates slightly from the suggested site | 4 | 5
Excellent
4th/5th intercostal space; mid/anterior axillary line |
Correct plane of dissection subcutaneously | 1
Poor
Both distance or execution of tunneling lack accuracy | 2 | 3
Sufficient
Either distance or execution of tunneling lack accuracy | 4 | 5
Excellent
Both distance and execution of tunneling are accurate |
Blunt dissection on top side of rib | 1
Poor
Flawed dissection; not carried out on top side of rib | 2 | 3
Sufficient
Solid dissection carried out with minor errors | 4 | 5
Excellent
Confident cut through the subcutaneous layers and intercostal muscles |
Scissors/clamp guarded with other hand during dissection and pulled out without closing the instrument | 1
Poor
Hazardous handling that might affect the patient | 2 | 3
Sufficient
Improvable handling | 4 | 5
Excellent
Confident handling of the used instruments |
Digital exploration of pleural cavity on chest wall to rule out adhesions | 1
Poor
No digital exploration | 2 | 3
Sufficient
Finger inserted in pleural cavity | 4 | 5
Excellent
Digital exploration in 360° with turning of the wrist rules out adhesions |
Drain guarded with hand while being inserted | 1
Poor
Hazardous handling that might affect the patient | 2 | 3
Sufficient
Improvable handling | 4 | 5
Excellent
Confident handling of the used instruments |
Drain inserted into pleural cavity | 1
Poor
Tube advancement is carried out poorly | 2 | 3
Sufficient
Tube advancement is carried out with minor errors | 4 | 5
Excellent
Forceps unclamped in time and tube manually advanced. |
Estimate made of drain length | 1
Poor
Estimate deviates tremendously from rater’s opinion | 2 | 3
Sufficient
Estimate deviates slightly from rater’s opinion | 4 | 5
Excellent
Optimal estimate stated |
Economy of time and motion | 1
Poor
Many unnecessary/disorganized movements | 2 | 3
Sufficient
Organized time/motion, some unnecessary movement | 4 | 5
Excellent
Maximum economy of movement and efficiency |
Amount of help/assistance needed from tutor | 1
Poor
Task could not be carried out without extensive assistance | 2 | 3
Sufficient
Trainee only raises important questions in order to maximize performance | 4 | 5
Excellent
Almost no assistance needed; task is carried out confidently |