# Impact of a Structured Training Program on Medical Student Confidence and Behavior During Their First Radial Arterial Puncture: Comparative Study

## TL;DR

A structured training program for medical students improved their confidence and reduced use of anesthesia during first radial artery punctures, despite similar anxiety levels.

## Contribution

Demonstrates that structured simulation-based training alters student behavior during clinical procedures, even without changing self-reported confidence.

## Key findings

- Students in the structured training group were significantly less likely to use local anesthesia during their first radial artery puncture.
- Behavioral indicators suggested improved self-efficacy despite similar self-reported apprehension between groups.
- First-attempt success rates were comparable between the trained and control groups.

## Abstract

Radial artery puncture is a common clinical procedure essential for assessing gas exchange but is frequently perceived as stressful by inexperienced operators, who fear causing pain to their patients. Despite its practical relevance, formal training in this procedure is inconsistently integrated into medical curricula. This study evaluated whether a structured training program—combining theoretical instruction, simulation-based practice, and debriefing—could influence students’ procedural confidence and decision-making and patient experience during their first clinical arterial puncture.

This study aimed to determine whether structured simulation-based training influences medical students’ anxiety, confidence, and technical performance and patient experience during their first arterial puncture.

Third-year medical students who had never performed an arterial puncture were assigned to 1 of 2 groups: a structured training group (group 1) or a control group receiving informal or no specific training (group 2). After performing their first arterial puncture under supervision, students completed a questionnaire assessing apprehension, satisfaction, and confidence. The decision to use local anesthesia, puncture success, and patient-rated pain and apprehension were also recorded. A total of 67 students participated (group 1: n=24, 35.8%; group 2: n=43, 64.2%), with 61 patients included. Statistical comparisons were performed using the Fisher exact and nonparametric Mann-Whitney U tests (α=.05).

Self-reported apprehension and confidence were similar between groups. However, group 1 students were significantly less likely to use local anesthesia compared to group 2 students (7/20, 35% vs 28/36, 77.8%, respectively; P=.003), suggesting greater procedural confidence. First-attempt success rates were comparable (group 1: 3/13, 23.1%; group 2: 14/29, 48.3%; P=.18). Median patient-reported pain scores were numerically but not statistically significantly lower when anesthesia was used (2.1, IQR 1.2‐4.0 vs 4.8, IQR 2.1‐6.4; P=.08).

Structured training influenced students’ behavior during their first arterial puncture, reducing reliance on anesthesia despite similar levels of self-reported apprehension. Although confidence ratings did not differ, behavioral indicators suggested improved self-efficacy and readiness for clinical performance. These findings support the behavioral impact of structured procedural education and call for future research using validated assessment tools and long-term follow-up.