{
  "abstract": "Background\n\nTraditional landmark-guided lumbar puncture (LP) has high failure rates among novice emergency medicine (EM) clinicians. While ultrasound guidance improves success, structured training models remain limited and expensive. We evaluated a cost-effective, simulation-based flipped classroom curriculum for teaching ultrasound-guided LP to EM residents and trainees.Methods\n\nWe developed a high-fidelity, custom 3D-printed spinal simulator costing approximately $40 USD per unit. The curriculum utilized a flipped classroom model combining online theoretical modules with hands-on, deliberate practice.Results\n\nTwenty-two participants (9 EM residents, 13 PGY trainees) completed the training programme; paired landmark-versus-ultrasound OSCE data were available for the seven residents who completed both phases. Among EM residents with paired data (n = 7), the ultrasound-guided phase OSCE completion rate was 100%, compared to 43% during the earlier landmark phase (a large but statistically non-significant difference, p = 0.125, McNemar's exact test). The ultrasound-guided phase was associated with higher rubric-rated performance scores and overall ratings (nominally significant, uncorrected for multiple comparisons); needle passes (median 7 vs. 12) and procedure times were also lower but did not reach statistical significance in this small paired sample. Both groups reported significantly lower procedural stress with ultrasound guidance, with a smaller, non-significant increase in confidence.Conclusions\n\nA flipped classroom curriculum utilizing a low-cost, 3D-printed simulator is a feasible and well-received educational innovation for teaching ultrasound-guided LP, with encouraging but preliminary performance findings for EM residents that require confirmation in controlled studies.",
  "abstract_shown": true,
  "affiliations": [
    "School of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC.",
    "Emergency Department, Chung Shan Medical University Hospital, Taichung, Taiwan, ROC.",
    "Research Assistant Center, Show Chwan Memorial Hospital, Changhua, Taiwan, ROC.",
    "Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan, ROC.",
    "Institute for Research into Cancer of the Digestive System (IRCAD) - Taiwan and Asian Institute of TeleSurgery, Show Chwan Health Care System, Changhua, Taiwan, ROC. c11g@hotmail.com.",
    "Department of Emergency Medicine, Chang Bing Show Chwan Memorial Hospital, No. 6 Lugong Road. Lukang Zhen, Changhua, Taiwan, ROC. c11g@hotmail.com."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Chao-Yen Huang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Sai-Wai Ho"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Po-Ming Chen"
    },
    {
      "affs": [
        4,
        5
      ],
      "name": "Chia-Ching Chen",
      "orcid": "0000-0002-0898-8696"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fpsh1krz23ns3.bib",
  "cited_by": 0,
  "doi": "10.1186/s12909-026-10070-8",
  "fulltext_url": "https://europepmc.org/articles/PMC13717963",
  "id": "fpsh1krz23ns3",
  "issns": [
    "1472-6920"
  ],
  "landing_url": "https://europepmc.org/article/MED/42958232",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2737|Simulation-Based Education in Healthcare"
    ]
  ],
  "openalex": "W7171931236",
  "pdf_url": "https://europepmc.org/articles/PMC13717963?pdf=render",
  "pmcid": "PMC13717963",
  "pmid": "42958232",
  "published": "2026-08-01",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/fpsh1krz23ns3.ris",
  "sources": [
    {
      "first_seen": "2026-11-01T00:20:47Z",
      "native_id": "MED:42958232",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42958232"
    },
    {
      "first_seen": "2026-11-02T12:22:08Z",
      "native_id": "PMC13717963",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s12909-026-10070-8"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2737|Simulation-Based Education in Healthcare",
      "subfield": "physiology"
    }
  ],
  "title": "Simulation-based ultrasound-guided lumbar puncture training using a flipped classroom: a single-arm pilot programme evaluation.",
  "title_text": "Simulation-based ultrasound-guided lumbar puncture training using a flipped classroom: a single-arm pilot programme evaluation.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-02T12:22:08Z",
  "url": "https://research.draconitic.com/paper/fpsh1krz23ns3",
  "venue": "BMC medical education",
  "versions": []
}