Background ‘See one, do one, teach one’ has long been the philosophy when it comes to developing procedural skills in medicine. Anecdotally trainees do not feel confident when undertaking procedures such as umbilical cannulation, in the neonatal intensive care environment.
Methods We created a cake including an edible ‘umbilical cord’ made from rice paper. Within the rice paper were 2 arteries and 1 vein represented by red and blue licorique tubes. The rice paper was filled with butter cream to provide stability and a life like consistency. The mock umbilical cord was inserted into a cake. The cake was placed onto a cardboard baby with a reservoir of raspberry juice underneath to allow for aspiration from the umbilical lines once inserted.
The session was undertaken in one of the routine neonatal morning teaching slots. 12 individuals attended ranging from band 5 staff nurse to consultant. Baseline information was gathered about grade of participant, months spent in tertiary neonatal departments.
Cannulation of the umbilical artery and vein were demonstrated by a senior neonatal trainee using a modified 4 stage technique of teaching. Standard equipment used on the unit was used in the demonstration.
Following the demonstration, each participant was then asked to perform the procedure in a non threatening environment.
All participants completed a confidence questionnaire rating their level of confidence in 4 domains: use of aseptic technique, knowledge of equipment needed, umbilical vein insertion (or assistance for nursing staff) and umbilical artery insertion (assistance for nursing staff) at the start and end of the session. A 10 cm Visual Analogue Scael was used. These were then compared to see if there had been any improvement.
Results 12 participants were initially enrolled. Complete data were collected for 10. Confidence improved in all skills assessed. The greatest improvement was seen in UAC insertion in the juniour trainees.
Discussion To our knowledge this is the first study to examine whether cake can be used as an effective teaching tool. We believe that for practical procedures the use of cake can improve knowledge and confidence. The improvement was greatest in junior trainees and nursing staff suggesting this may be a useful teaching tool in the future.
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