Mannequin-Based Teaching to Reinforce the Concept of Intravenous Administration in 2nd Year MBBS Students

Drug administration errors account for 15.34% of all medication errors. The financial consequences of such errors are tremendous and, could in fact, directly influence the cost of healthcare. Wrong dilutions and wrong IV infusion speed, improper dose/quantity due to wrong dose calculation and so on are the various types of drug administration errors that occur during parenteral administration.

To study the effectiveness of mannequin-based teaching (MBT) over conventional teaching byevaluating following parameters-difference in the pre-and post-demonstration score of students in demonstrating the procedure of IV injection, increase in the number of students correctly solving the problem on calculation of drip rate and setting up an IV infusion drip in a mannequin, feedback of the students about the new teaching-learning method, that is MBT.

On obtaining Institutional Ethics Committee approval, 15 2nd year MBBS students were randomly selected and their written informed consent was taken. Students were asked to perform IV injection on mannequin. They were observed and scored with a pre-validated checklist, followed by demonstration of ideal IV injection procedure and repetition of the same procedure by the students. Acomparison of the pre-and post-demonstration scores was done. Moreover, a clinical problem on dopamine infusion was given for calculation of dose of the drug required and rate of infusion. Students were then taught to calculate the drip rate and adjust the same on the mannequin. A comparison of their preand post-demonstration scores was done. Students’ feedback, regarding the teaching methodology, was taken on a Likert scale. Statistical analysis was done using paired t-test (p<0.001) and Wilcoxon signed-rank test (p<0.001) for total score of critical steps, pre-and post-demonstration.

53% students did not apply tourniquet pre-demonstration, whereas postdemonstration all the students applied the tourniquet properly. 67% did not aspirate to confirm the IV access pre-demonstration, whereas 40% in post-demonstration did not confirm the IV access. 53% did not check for pain/swelling while giving the IV injection pre-demonstration, whereas 33% in post-demonstration group did not check for pain/swelling. 60% did not dispose the waste properly pre-demonstration, whereas this number was a mere 7% post-demonstration; [mean difference ± SD = 2.533 ± 1.995]. In pre-demonstration, none of the students were able to calculate the drip rate, whereas in post-demonstration, all the students were able to calculate the drip rate and adjust the same on the IV drip setup on the mannequin.e”80% of the students strongly agreed that MBT was easier to understand compared with conventional methods, made pharmacology practical more interesting, inspired confidence in doing the procedure in the future and will help in imagining a real-life patient scenario.

Significant difference is noticed in pre-and post-demonstration score in IV injection technique. 100% improvement was seen in calculation of dose and setting up an IV infusion rate. This helps in integrating the relevance of pharmacology to the clinical scenario thus making it more interesting and resulting in increased gain in knowledge and skills of the students. Overall, students were satisfied with MBT, as with this, there is a change from passive learning to active learning as suggested by Medical Council of India.