Guided Imagery: An adjunct to teaching central venous access
Abstract
Learning Objectives: Introduce guided imagery as a novel approach to education and simulation in graduate medical education.
Background: Guided imagery is commonly used in sports psychology for post-injury rehabilitation, rep-max movements, and muscle activation as part of a multifaceted approach to learning. Utilization of guided imagery combined with traditional teaching may provide an innovative and comprehensive approach to graduate medical education.
Objectives: To show greater proficiency in medical students’ ability to obtain central venous access in simulation trainers following exposure to guided imagery teaching methods in comparison to traditional methods.
Methods: Auditioning fourth year medical students were offered the opportunity to participate. They were randomly assigned to two groups, traditional teaching or guided imagery teaching. The traditional teaching group watched a video using traditional methods. The guided imagery group watched a video which also incorporated visualization components, and biofeedback. Proctors blinded to student group assignment then observed each student place an intrajugular triple lumen catheter on a simulation trainer and filled out a standardized rubric. Additionally, participants filled out survey questions before and after the video and again after line placement.
Results: A total of 60 medical students participated; 2 were excluded for having performed 5 or more lines previously. There was no difference in the two groups in self perceived competence prior to watching the video or in the number of lines they had previously performed. The traditional group (n=33) averaged 2.2 errors/need for intervention whereas the guided imagery group (n=25) averaged 1.3 errors/need for intervention (p=.045, 95%CI 0.02 to 1.61). There was no statistical significance in total time or in students’ self-rated confidence post this experience.
Conclusion: The use of guided imagery may be a promising adjunct to traditional teaching methods for procedures in graduate medical education.