Board 442 - Research Abstract Infant Lumbar Punctures Success Rates Reported by Upper Level Residents (Submission #459) Marjorie Lee White, MD, MPPM, MEd 8 , Pavan Zaveri, MD 4 , Berry Seelbach, MD 9 , Renuka Mehta, MBBS, MRCP, DCH,FAAP 6 , Brett McAninch, MD, FAAP 3 , Daniel Fein, MD 1 , Todd Chang, MD 2 , Rebekah Burns, MD 7 , Marc Auerbach, MD, MSCI 11 , Jaewon Jang, MS 10 , and David Kessler, MD, MSc 5 1 PEDIATRIC EMERGENCY MEDICINE, CHILDREN’S HOSPITAL AT MONTEFIORE, BRONX, NY, USA; 2 EMERGENCY MEDICINE, CHILDREN’S HOSPITAL LOS ANGELES, LOS ANGELES, CA, USA; 3 CHILDREN’S HOSPITAL OF PITTSBURGH OF UPMC, USA; 4 EMERGENCY MEDICINE, CHILDREN’S NATIONAL MEDICAL CENTER, WASHINGTON, DC, USA; 5 PEDIATRICS AND EMERGENCY MEDICINE, COLUMBIA UNIVERSITY MEDICAL CENTER, NEW YORK PRESBYTE- RIAN MORGAN STANLEY CHILDREN’S HOSPITAL OF NEW YORK, NEW YORK, NY, USA; 6 PEDIATRICS, GEORGIA REGENTS UNIVERSITY, AUGUSTA, GA, USA; 7 PEDIATRICS, DIVISION OF EMERGENCY MEDICINE, NORTHWESTERN UNIVERSITY, ANN AND ROBERT H LURIE CHILDREN’S HOSPITAL OF CHICAGO, CHICAGO, IL, USA; 8 PEDIATRICS/EMERGENCY MEDI- CINE, UNIVERSITY OF ALABAMA AT BIRMINGHAM, BIRMINGHAM, AL, USA; 9 UNIVERSITY OF KENTUCKY, USA; 10 YALE UNIVERSITY, NEW HAVEN, CT, USA; and 11 PEDIATRICS, YALE UNIVERSITY SCHOOL OF MEDICINE, NEW HAVEN, CT, USA. Introduction/Background: Infant lumbar puncture (ILP) is a common proce- dure that is considered an essential skill for pediatric trainees by the American Board of Pediatrics. Despite this requirement, there is a 66% reported failure rate when trainees perform ILP (Kessler, 2013). Research done by INSPIRE has demonstrated that mastery learning sessions and just-in-time refreshers can improve procedural competency for ILP. However, the decay in ILP skills over time and success rates of se- nior residents nearing the end of their training is unknown. This study consisted of a survey of upper level residents to explore their experience in performing and supervis- ing ILPs. The primary aim is to measure the first attempt procedural success rates for senior residents performing ILPs in order to evaluate the skill maintenance over time. Methods: A 30 question survey was developed by expert consensus and piloted by pediatric emergency medicine fellows who provided feedback on content and me- chanics of the survey via a modified e-Delphi process. The survey queried residents about their experience with ILP during their final year of training including informa- tion about their own performance of ILP and their experience supervising the proce- dure. Additionally, they were asked to provide specific details about their most recent ILP. The data collected for their most recent ILP mirrors what was collected by IN- SPIRE in prior studies to document intern ILP performance. The data collection tool was distributed via an email with a SurveyMonkey TM link from site investigators using a standardized communication pattern. IRB approval was obtained at all 10 partici- pating institutions. Data from the resident’s most recent ILP was used to calculate an overall success rate. Procedural success is defined as first needle pass when its RBC cell count was reported as less than or equal to 1000 or if the fluid is described as clear on the first attempt. Results: One hundred ninety eight (86%) out of a possible 241 3 rd and 4 th year residents completed the survey. Eight seven percent were pediatric residents, 10% were combined medicine pediatrics and 3% were emergency medicine. Ninety-two percent were PGY3 and 8% were PGY4. Seventy three percent of respondents reported that they participated in ILP training during their intern year. Respondents reported that they supervised a median of 7 LPs during their final year and performed a median of 2. When asked specific questions about their most recent ILP, 68% reported they were not supervised. Overall ILP success rate was 52.94% (95% CI 43.25%, 62.63). When upper level residents were attempting an ILP after another provider had already attempted, the success rate was 24.14% (95% CI 13.13%, 35.15%) which is statistically significantly lower (P<0.001). Conclusion: Upper level pediatric residents had a first attempt success rate of 53% for ILP. Although this is higher than interns, faculty procedure success rates have been reported to be significantly higher. A significant amount of work remains to close this important gap in procedural training. It is our hope that the INSPIRE developed Pro- cedural Skills Training Package including preparation (LEARN), demonstrations (SEE), simulation-based training (PRACTICE), summative assessment on a simulator (PROVE), clinical performance (DO) and continued training and performance (MAINTAIN) can be used to fill this gap. Reference: 1. Kessler et. al. Interns’ Success with Clinical Procedures in Infants after Simulated Training. Pediatrics 2013;131;e811. Disclosures: RBaby Foundation rababy foundation my smart health care. Board 443 - Research Abstract An Interprofessional Rounding Simulation with Students of Medicine, Nursing and Pharmacy (Submission #746) David Wilks, MD 1 , Russell Doerr, EMT-P 3 , Daniel Summers, RN, BSN, CEN, EMT-P 3 , Jason Craig, EMT-P 3 , Lena Maynor, PharmD, BCPS 4 , Jon Wietholter, PharmD, BCPS 4 , Jay Martello, PharmD, BCPS 4 , Charles Ponte, PharmD,DPNAP, FAADE, FCCP, FASHP, FAPhA 4 , Gail VanVoorhis, MSN, RNC 2 , and Lee Ann Miller, EdD 3 1 WEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE, MORGANTOWN, WV, USA; 2 NURSING, WEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE, MORGANTOWN, WV, USA; 3 WEST VIRGINIA SIMULATION TRAINING AND EDUCATION FOR PATIENT SAFETY (WVSTEPS), WEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE, MORGANTOWN, WV, USA; and 4 WEST VIRGINIA UNIVERSITY SCHOOL OF PHARMACY, MORGANTOWN, WV, USA. Introduction/Background: Interprofessional education (IPE) occurs when two or more professions learn with, from and about each other to improve collaboration and the quality of care. 1 IPE is important in the development of practitioners in var- ious practice settings and can effectively reinforce knowledge of roles and responsibil- ities of various healthcare disciplines and improve interprofessional communication. 2- 4 Opportunities to enhance communication skills early in the curriculum via IPE may allow students to be better prepared to interact with other disciplines in acute care environments. 3 Methods: We developed an interprofessional rounding experience, incorporating medical, nursing and pharmacy students. The primary learning objectives were to en- hance interprofessional communication skills and increase understanding of the roles of other healthcare practitioners in the acute care setting. Faculty members from Schools of Pharmacy, Nursing and Medicine collaborated on design. Two cases, in- volving one standardized patient (SP) and one manikin simulator, were developed. Students were divided into working groups consisting of one third year medical stu- dent, two to three senior nursing students and two to three third year pharmacy students. Students were provided with preliminary patient data prior to the IPE expe- rience for pre-rounding purposes. During the IPE experience, student groups rounded on each patient and developed collaborative care plans. This experience em- phasized interprofessional communication and fostered a better understanding of the role of each healthcare provider during inpatient rounds. Verbal and written feedback regarding communication skills and interprofessional collaboration were provided by the SP and a faculty facilitator from one of the participating disciplines. Additionally, students completed a required self-evaluation of their interprofessional communica- tion skills while watching videotape of the encounter. A clinical assessment was performed using a pre and post experience test. Results: Students were surveyed. Students agreed or strongly agreed with the follow- ing statements: 1) I enjoyed having an opportunity to interact with students from other disciplines. - 96%; 2)This experience heightened my awareness to the roles that other disciplines play in the delivery of patient-care. - 91%; 3) After completion of this IPE, my comfort level communicating with other healthcare disciplines has increased. - 84%; 4) I felt overwhelmed by the experience due to my unfamiliarity with what the other disciplines provided during patient care scenarios. - 40%; 5) Overall, this IPE experience was valuable for my professional growth. - 88%. Conclusion: The Results of our assessment suggest that students believe that the IPE rounding experience is valuable and increases knowledge of the various roles of healthcare professionals included in the simulation. Students indicated an increased comfort level in communicating with other healthcare disciplines as a result of the ex- perience. The need for experiences such as this one is indicated by the 40% who felt overwhelmed by the experience due to their unfamiliarity with what the other disciplines provided during patient care scenarios. References 1. The Definition and Principles of Interprofessional Education. Center for Ad- vancement of Interprofessional Education (CAIPE). http://www.caipe.org.uk/ about-us/the-definition-and-principles-of-interprofessional-education/ Accessed June 12, 2013. 2. Shrader S, McRae L, King WM, Kern D. A simulated interprofessional rounding experience in a clinical assessment course. Am J Pharm Educ. 2011;75(4):61 3. Kane-Gill SL, Smithburger PL. Transitioning knowledge gained from simulation to pharmacy practice. Am J Pharm Educ. 2011;75(10):210. 4. Vyas D, McCulloh R, Dyer C, Gregory G, Higbee D. An interprofessional course using human patient simulation to teach patient safety and teamwork skills. Disclosures: None. Vol. 8, Number 6, December 2013 q 2013 Society for Simulation in Healthcare 605 Copyright © 2013 by the Society for Simulation in Healthcare. Unauthorized reproduction of this article is prohibited.