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Is Simulation Training Effective for Ventilator Management?

Residents could touch and manipulate ventilators to develop familiarity and reduce anxiety - without putting patients at risk.

Simulation training lets medical residents practice ventilation management skills…without putting patients at risk.

Simulation training has been shown to be an effective method for medical education. But what about mechanical ventilation management specifically? A recent study at Summa Health System in Akron, Ohio, looked at the effectiveness of a mechanical ventilation boot camp for first year medical residents in surgery and emergency medicine.

The Summa Health study found that the boot camp was effective in increasing competency, knowledge, and confidence with ventilator management.

The three-day training incorporated hands-on scenarios using human patient manikins connected to IngMar Medical’s ASL 5000 Breathing Simulator.

“The ASL 5000 is the only simulator on the market that can manifest the wide variety of pathologic states necessary to provide cutting-edge training to my residents and fellows.“

Rami A. Ahmed, DO, FACEP, Simulation Medical Director, Summa Health System.

In addition to hands-on simulation, other didactic elements were used including: independent reading, a focused PowerPoint presentation, personalized feedback, and a supportive learning environment.

Learners were given identical pre- and post- intervention assessments in the course of the three-day training.

Three-Day Mechanical Ventilation Simulation Curriculum

Day 1: Pre-intervention Evaluation

  • Pre-test confidence survey (5 minutes)
  • Pre-test cognitive multiple-choice exam (25 minutes)
  • Cases and evaluation by critical actions checklist (10 minutes each for 30 minutes total)
    • ARDS
    • Complete lung atelectasis secondary to mucus plugging
    • Pneumothorax in a mechanically ventilated patient
  • Distribution of supplemental readings for independent study (estimated 4 hours of reading)

Day 2: Curriculum and Educational Intervention

  • Case structure:
    • Two to three residents participated in the case (10 minutes)
    • Evaluation by critical actions checklist (evaluated during case)
    • Bedside debriefing by intensivists (20 minutes)
    • PowerPoint presentation review (15 minutes)
  • Pathology reviewed:
    • ARDS
    • Complete lung atelectasis secondary to mucus plugging
    • Altered mental status secondary to overdose
    • Pneumothorax in a mechanically ventilated patient
    • Dynamic hyperinflation

Day 3: Post-intervention Evaluation

  • Post-test confidence survey (5 minutes)
  • Post-test cognitive multiple-choice exam (25 minutes)
  • Cases and evaluation by critical actions checklist (ten minutes each for 30 minutes total)
    • ARDS
    • Complete lung atelectasis secondary to mucus plugging
    • Pneumothorax in a mechanically ventilated patient

Results: 

The post-test evaluation found significant increases in cognitive knowledge, clinical performance, and confidence.

“This study demonstrates the feasibility and effectiveness of a boot camp curriculum for residents on the basics of mechanical ventilation.“

The increase was attributed to numerous factors including the utilization of multiple teaching methodologies to accommodate different learning styles, the supportive learning environment, personalized feedback, and the opportunity for residents to touch and manipulate the ventilators to develop familiarity and reduce anxiety.

Read the full study.

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